Challenges and Opportunities: Results of the 2013-2014 Health Care in Canada Survey (original) (raw)
Related papers
2015
Drawing on data from 11 iterations of the Health Care in Canada (HCIC) surveys between 1998 and 2014, this paper summarizes trends in citizens’, physicians’, nurses’, pharmacists’ and administrators’ perceptions of the quality, access and affordability of health care in Canada, as well as innovative priorities to improve future care and predictions for its success. We found that timely access to, and affordability of, care have become the leading causes of concern in recent years among the public and health professionals alike, displacing inadequate funding and lack of professional staff, the leading causes of concern at the turn of the last century. Moreover, these issues are predicted, by all stakeholders, to likely worsen in the ensuing five years. Nonetheless, the perception among the majority of public and all professional stakeholders of the overall quality of our health system has remained relatively unchanged. In terms of priorities to improve care, increasing professional s...
Access to Health Care in Canada: Yesterday, Today and Tomorrow
2017
Canadian universal health care, or Medicare, continues to evolve in its fifth decade. Recently, complex components like patient centred and end of life care have been adjudicated and adopted by a majority of stakeholders. Overall quality of care delivered and received continues to be rated highly by the public and health professionals. However, one concern persists as the most important unresolved care issue by all stakeholders. It is the perception of less than optimal access to care, specifically timely access. Analysis of data from repeated Health Care in Canada (HCIC) surveys over the past two decades reveals that, in 1998, only four percent of the public expressed a general concern around wait times. However, by 2007, the general public’s concern had risen to 20 percent; and, rose to 36 percent in 2016. And, timely access was perceived as worsening in all regions of the country over the past five years, the negative momentum being highest in British Columbia and lowest in the P...
Health Systems’ Performance Roundtables - Canada. Canada Health System Data
Romanian Journal of Psychiatry, 2013
Strengths Canadians consider access to health care benefits part of citizens’ rights. Universal health insurance covers everyone including immigrants and refugees. The 1984 Canada Health Act defines the principles of health care delivery: Public administration of health insurance by an accountable nonprofit agency: This has kept costs far below those of the United States Comprehensiveness: All insured services must be covered. Universality: All citizens living within a province are covered. Portability: Insurance is portable across Canada. Accessibility: Access time to necessary services should be reasonable. It covers all of the population with access to medical services and hospitalization. Health care is financed through income taxes. Major investment in public health care since the mid-1990s, including capital infrastructure. Health care costs have been maintained at sustainable levels (except for pharmaceuticals). The Federal government has focused on improving the timeliness, quality and safety of health care. Lower costs and time spent in administrative tasks, not having to select patients or justify treatment planning. Psychiatric care is largely based in hospital and other institutions and group practices and emphasizes an interdisciplinary, team-based approach. Mental health services begin with primary care which is increasingly responsible for first response and follow-through care. Growing emphasis on outpatient and community care. The Canadian health care system provides similar services as the US model with significantly lower costs. Strong planning relationships among medical and other professional faculties, provincial government health agencies, and medical, psychiatric and other professionals orders and colleges. Telemedicine for long-distance learning and medical consultations is increasing. Growing acceptance of best practices and evidence-based medicine. Weaknesses The Federal government covers only 26% of health care costs which means that although it defines and monitors principles, the major financing and all of the delivery of health care services is the responsibility of the 10 provinces and 3 northern territories, which it cannot easily ensure. The Federal government has not established clear national standards for health care delivery. Pharmaceutical costs have increased disproportionately compared to other health care costs. Services such as dentistry, optometry and medications are not covered for outpatients who must pay personally or through employee benefit plans. There is a lack of a national “pharmacare” strategy to reduce costs. Workloads increase with the burden to respond to all needs. Private-practice psychiatry and as a result psychodynamic psychotherapy are waning. Waiting lists for care versus quality of care. Inpatient services are subject to increasing pressure due to the aging population and greater emphasis on outpatient and community care. Use of IT services, digital charts and telemedicine is not being optimized. Opportunities The shift to primary care means a re-visioning of health care services with a growing emphasis on shared care between primary care providers and specialists. Telemedicine and IT services Threats Rising pharmaceutical costs Increasing private practice clinics with surcharges for uninsured services to ensure privileged access to care The lack of political will to define and enforce national standards. Bibliography: 1. Jeste, Dilip (2013). Canadian Psychiatry and Health Care System. Psychiatric News, January 4, 2013, 48(1): 6. 2. Marchildon, Gregory P. (2013). Canada: Health Systems Review 2013. Health Systems in Transition, 15(1):1-179.
Health Systems in Transition, Vol. 15, no. 1, pp. 1-179, 2013
Canada is a high-income country with a population of 33 million people. Its economic performance has been solid despite the recession that began in 2008. Life expectancy in Canada continues to rise and is high compared with most OECD countries; however, infant and maternal mortality rates tend to be worse than in countries such as Australia, France and Sweden. About 70% of total health expenditure comes from the general tax revenues of the federal, provincial and territorial governments. Most public revenues for health are used to provide universal medicare (medically necessary hospital and physician services that are free at the point of service for residents) and to subsidise the costs of outpatient prescription drugs and long-term care. Health care costs continue to grow at a faster rate than the economy and government revenue, largely driven by spending on prescription drugs. In the last five years, however, growth rates in pharmaceutical spending have been matched by hospital spending and overtaken by physician spending, mainly due to increased provider remuneration. The governance, organization and delivery of health services is highly decentralized, with the provinces and territories responsible for administering medicare and planning health services. In the last ten years there have been no major pan-Canadian health reform initiatives but individual provinces and territories have focused on reorganizing or fine tuning their regional health systems and improving the quality, timeliness and patient experience of primary, acute and chronic care. The medicare system has been effective in providing Canadians with financial protection against hospital and physician costs. However, the narrow scope of services covered under medicare has produced important gaps in coverage and equitable access may be a challenge in these areas.
The ecology of medical care for adults in Alberta, 2002/03 to 2016/17: a retrospective cohort study
CMAJ Open, 2020
Background: If we are to improve the patient experience, knowing where and with whom people receive professional health advice and treatment (the ecology of medical care) is the first step. We designed this study to define the ecology of medical care in Alberta and to examine whether province-wide implementation of 5 policy changes between 2003 and 2012 changed patterns of care among adults in the province. Methods: This was a retrospective cohort study of adults (age ≥ 18 yr) in Alberta using routinely collected data from 6 linked administrative health databases, the 2016 Canadian Community Health Survey and the Alberta Health Link teletriage system. We collected data on all encounters with pharmacists, primary care physicians, specialists, emergency departments and hospitals in 2002/03, 2009/10 and 2016/17. Results: Between 2002/03 and 2016/17, the community-dwelling adult population of Alberta increased from 2.66 million to 3.84 million; the median age increased from 41 to 43 years, and the proportion with at least 1 ambulatory-care-sensitive condition increased from 20.6% to 27.8%. The proportion who saw a primary care physician decreased significantly (from 70.8% to 68.2%, p < 0.001), as did the proportion who visited an emergency department (from 20.6% to 19.2%, p < 0.001); the declines were seen in all subgroups examined. The proportion who saw a specialist as an outpatient increased from 31.9% to 33.2% (p < 0.001), and the proportion who received at least 1 medication dispensation increased from 54.9% to 60.2% (p < 0.001). The proportion admitted to an acute care hospital (5.6%−6.5%) or academic hospital (1.2%) was relatively stable over time. Interpretation: Despite implementation of 5 system-wide changes designed to affect the delivery of primary and specialty medical care as well as the use of pharmacist and nursing services in Alberta, patterns of health care delivery changed little between 2002/03 and 2016/17. Rather than searching for a policy "magic bullet," health care planners may be better served by focusing on upscaling and implementing interventions proven to be efficacious.
Building on Values: The Future of Health Care in Canada
Royal Commission Report, 2002
This is the final report of the Royal Commission on the Future of Health Care in Canada - commonly known as the Romanow Commission.Taken together, the 47 recommendations contained in this report serve as a roadmap for a collective journey by Canadians to reform and renew their health care system. They outline actions that must be taken in 10 critical areas, starting by renewing the foundations of Canadian medicare.
Primary Health Care in Canada: Systems in Motion
Milbank Quarterly, 2011
During the 1980s and 1990s, innovations in the organization, funding, and delivery of primary health care in Canada were at the periphery of the system rather than at its core. In the early 2000s, a new policy environment emerged.
A Reflection of the Canadian Healthcare System Navigating Strengths and Shortcomings
1.3 Objectives and Scope of the Report This research report aims to consolidate existing literature to assess the state of the Canadian healthcare system in relation to other countries and in light of the COVID-19 pandemic. Primarily, we will dissect Canada’s position on an international front through a comparison of health metrics, and financing models. Subsequently, different healthcare models will be compared and benchmarked against global standards. Moreover, we will scrutinize the effectiveness of various funding mechanisms and inherent disparities in healthcare quality among Canadian provinces versus a centralized national approach. We will also explore the expansion of healthcare services and strategies for managing chronic diseases. Additionally, the report will address the impact of the COVID-19 pandemic on the Canadian healthcare system, assessing its strengths and vulnerabilities. By analyzing the system through a critical lens, we aim to shed light on its achievement and areas for improvement with the ultimate goal of fostering informed dialogue and positive change in healthcare delivery across Canada. Ultimately, the report aims to propose solutions and future directions to enhance the overall efficacy and inclusivity of the Canadian healthcare system. 1.4 Methodology Sources that focused on developing or underdeveloped countries or sources originating from conspiracy websites are excluded [see Table 1]. Table 1. Eligibility Criteria Inclusion Source articles, reports, or books Primary focus on Canadian studies Data from reputable sources (e.g., government agencies, WHO) Published in 2011 to present Primary qualitative, quantitative, or mixed-methods studies Case studies from countries with well -documented success or innovation in healthcare delivery. Exclusion Developing or underdeveloped countries Conspiracy websites
The Lancet, 2018
Access to health care based on need rather than ability to pay was the founding principle of the Canadian health-care system. Medicare was born in one province in 1947. It spread across the country through federal cost sharing, and eventually was harmonised through standards in a federal law, the Canada Health Act of 1984. The health-care system is less a true national system than a decentralised collection of provincial and territorial insurance plans covering a narrow basket of services, which are free at the point of care. Administration and service delivery are highly decentralised, although coverage is portable across the country. In the setting of geographical and population diversity, long waits for elective care demand the capacity and commitment to scale up effective and sustainable models of care delivery across the country. Profound health inequities experienced by Indigenous populations and some vulnerable groups also require coordinated action on the social determinants of health if these inequities are to be effectively addressed. Achievement of the high aspirations of Medicare's founders requires a renewal of the tripartite social contract between governments, health-care providers, and the public. Expansion of the publicly funded basket of services and coordinated effort to reduce variation in outcomes will hinge on more engaged roles for the federal government and the physician community than have existed in previous decades. Public engagement in system stewardship will also be crucial to achieve a high-quality system grounded in both evidence and the Canadian values of equity and solidarity.
Nursing Leadership, 2010
highest, at 100%). Canadian adults were the least likely to report same-day access and most likely to report long waits (six days or more) to see a doctor when sick, and along with Americans and Australians, were the most likely to report difficulty getting after-hours care. Canadian adults were the most likely to have gone to a hospital emergency department (ED) in the past two years, to have made multiple visits, and to say they went to the ED for care their doctor could have provided if available. These high rates are contributing to long ED wait times, with 46% of Canadians (the highest of all the countries) reporting waiting two hours or more in the ED to be seen (Schoen et al. 2007).