Reports & Papers
This category hosts grey literature (i.e. resources such as corporate, think tank, and government reports).
April 11, 2012
“On January 31, 2011, the Minister of Health requested that the Standing Senate Committee on Social Affairs, Science and Technology initiate the second parliamentary review of the 10-Year Plan to Strengthen Health Care (10-Year Plan), an agreement reached by First Ministers on September 16, 2004 that focuses on federal/provincial/territorial (F/P/T) collaboration in the area of health care reform. The committee’s study is undertaken pursuant to section 25.9 of the Federal-Provincial Fiscal Arrangements Act, which requires that a parliamentary committee review progress towards the implementation of the 10-Year Plan on or before March 31, 2008 and three years thereafter. The committee’s review also includes an examination of the separate Communiqué on Improving Aboriginal Health, which was released by First Ministers and Leaders of National Aboriginal Organizations1 on 14 September, 2004.
This report presents the committee’s findings regarding progress towards the implementation of the 10-Year Plan and the Communiqué on Improving Aboriginal Health and identifies further actions that could be taken in support of the objectives outlined in these documents. It reflects the testimony presented by witnesses over the course of 13 hearings and one roundtable discussion, as well as many written submissions received from interested organizations and individuals.
The key themes raised by these witnesses provide the basis and spirit of the recommendations outlined in this report. Witnesses emphasized to this committee the central importance of adopting a holistic understanding of health that sees physical and mental wellbeing as inextricably linked and equally important to the efficiency and quality of health care systems. This holistic concept of health has become a framing principle for this report.”
Posted in 2014 Health Accord, READ Portal, Reports & Papers | Tagged with | No Comments
April 10, 2012
“Background: Clostridium difficile infection (CDI) is a common and sometimes fatal health-care–associated infection; the incidence, deaths, and excess health-care costs resulting from CDIs in hospitalized patients are all at historic highs. Meanwhile, the contribution of nonhospital health-care exposures to the overall burden of CDI, and the ability of programs to prevent CDIs by implementing CDC recommendations across a range of hospitals, have not been demonstrated previously.
Methods: Population-based data from the Emerging Infections Program were analyzed by location and antecedent health-care exposures. Present-on-admission and hospital-onset, laboratory-identified CDIs reported to the National Healthcare Safety Network (NHSN) were analyzed. Rates of hospital-onset CDIs were compared between two 8-month periods near the beginning and end of three CDI prevention programs that focused primarily on measures to prevent intrahospital transmission of C. difficile in three states (Illinois, Massachusetts, and New York).
Results: Among CDIs identified in Emerging Infections Program data in 2010, 94% were associated with receiving health care; of these, 75% had onset among persons not currently hospitalized, including recently discharged patients, outpatients, and nursing home residents. Among CDIs reported to NHSN in 2010, 52% were already present on hospital admission, although they were largely health-care related. The pooled CDI rate declined 20% among 71 hospitals participating in the CDI prevention programs.
Conclusions: Nearly all CDIs are related to various health-care settings where predisposing antibiotics are prescribed and C. difficile transmission occurs. Hospital-onset CDIs were prevented through an emphasis on infection control.
Implications for Public Health: More needs to be done to prevent CDIs; major reductions will require antibiotic stewardship along with infection control applied to nursing homes and ambulatory-care settings as well as hospitals. State health departments and partner organizations have shown leadership in preventing CDIs in hospitals and can prevent more CDIs by extending their programs to cover other health-care settings.”
Posted in READ Portal, Reports & Papers | Tagged with Prevention and control | No Comments
April 9, 2012
“The Issue: When patients have an active role in their own health care, the quality of their care, and of their care experience improves, studies show. Efforts to increase patients’ engagement in their care—for example, through shared decision-making and self-management of a chronic condition—have proliferated internationally as nations strive for high-value, high-performance health systems. This study, authored by Commonwealth Fund researchers, examines results from a 2011 Fund survey in 11 countries focusing on patients with complex health care needs.
Key Findings:
- To assess the level of patients’ engagement with their regular doctors, the researchers analyzed responses to survey items on whether the doctor spends enough time with patients, explains things in a way that is easy to understand, and encourages questions. Patients in Norway and Sweden were the least likely to be engaged by their regular providers, with only about one of three responding positively to all three questions. At the top end of the range, at least two of three patients in Australia, New Zealand, Switzerland, the U.K., and the U.S. reported positive care interactions.
- In seven of the 11 countries—Australia, Canada, the Netherlands, Norway, Sweden, the U.K., and the U.S.—patients with below-average incomes were significantly less likely to have been engaged by their regular doctor in their care. The U.S. stood out for the widest income-based disparities.
- Survey participants were asked how often the specialist physicians treating them provide opportunities to ask questions about recommended treatments, tell them about their treatment choices, and involve them as much as they would like in decisions about their care. Four-fifths of patients in Switzerland and the U.K. replied “always” or “often” to all three questions, as did two-thirds or more of Dutch, New Zealand, and U.S. respondents. Respondents in France, Germany, Norway, and Sweden were the least likely to report shared decision-making with specialists.
- In all countries, patients reporting positive communication and engagement with their regular doctor were far more likely to rate the quality of care they received in the past year as “excellent” or “very good.” The difference was greatest in the U.S.: 78 percent of patients who said they were engaged in their care rated the quality of their care highly, compared with 43 percent of those who said they were not engaged.
- Engaged patients were also less likely to report a medical, medication, or lab test error in the past two years, and had more positive views of the health system as a whole.”
Posted in READ Portal, Reports & Papers | Tagged with Patient satisfaction, Patient-centered care | No Comments
April 6, 2012
“The Project for an Ontario Women’s Health Evidence-Based Report (POWER) has taken a comprehensive look at health inequities in Ontario associated with income, education, race/ethnicity, where one lives, and how these differ by gender. In doing so, we documented sizable and modifiable health inequities across multiple measures. We have also demonstrated that the social determinants of health affect the health of women and men differently. It is well-known that social factors—rather than medical care or health behaviours—are the primary drivers of health and health inequities. The social determinants of health influence both physical and mental health. Furthermore, the social determinants of health, which work through many complex and intertwining pathways, are not evenly distributed across the population. The POWER Study Framework emphasizes the importance of these social factors, while recognizing that the way we shape our health care services and community resources can mediate the effects of the social determinants of health.
Prior reports have examined the burden of illness in the population, access to health care services, cancer, cardiovascular disease, depression, musculoskeletal conditions, diabetes, reproductive health, and HIV infection by assessing variation in performance on a broad set of evidence-based indicators of population health and health system performance. We identified many opportunities for intervention and improvement, and we worked closely with decision makers across the province to ensure that our objective findings would be used to inform practice an policy. In this chapter, we synthesize prior analyses that examined the health of low-income, minority, and immigrant women, and enrich this by reporting additional indicators of the social determinants of health and immigrant women’s health. In doing so, we paint a powerful picture of the health needs of populations at risk, how these differ among women and men in different groups, and highlight the role of the social determinants of health.”
Posted in READ Portal, Reports & Papers | Tagged with Canada, Indicators | No Comments
April 2, 2012
“ISSUE: Are there differences between Ontario’s primary care models in who they serve and how often their patients/clients go to the emergency department (ED)?
STUDY: This study examined patients/clients enrolled in: Community Health Centres (CHCs, a salaried model), Family Health Groups (FHGs, a blended fee-for-service model), Family Health Networks (FHNs, a blended capitation model), Family Health Organizations (FHOs, a blended capitation model), Family Health Teams (FHTs, an interprofessional team model composed of FHNs and FHOs), ‘Other’ smaller models combined, as well as those who did not belong to a model. Electronic record encounter data (for CHCs) and routinely collected health care administrative data were used to examine sociodemographic composition, patterns of morbidity and comorbidity (case mix) and ED use. ED visits rates were adjusted to account for differences in location and patient/client characteristics.
KEY FINDINGS
- Compared with the Ontario population, CHCs served populations that were from lower income neighbourhoods, had higher proportions of newcomers and those on social assistance, had more severe mental illness and chronic health conditions, and had higher morbidity and comorbidity. In both urban and rural areas, CHCs had ED visit rates that were considerably lower than expected.
- FHGs and ‘Other’ models had sociodemographic and morbidity profiles very similar to those of Ontario as a whole, but FHGs had a higher proportion of newcomers, likely reflecting their more urban location. Both urban and rural FHGs and ‘Other’ models had lower than expected ED visits.
- FHNs and FHTs had a large rural profile, while FHOs were similar to Ontario overall. Compared with the Ontario population, patients in all three models were from higher income neighbourhoods, were much less likely to be newcomers, and less likely to use the health system or have high comorbidity. ED visits were higher than expected in all three models.
- Those who did not belong to one of the models of care studied were more likely to be male, younger, make less use of the health system and have lower morbidity and comorbidity than those enrolled in a model of care. They had more ED visits than expected.”
Posted in READ Portal, Reports & Papers | Tagged with Canada, Emergency service, Indicators, Statistics & numerical data | No Comments
March 30, 2012
“Overview: Antibiotic resistance development is a natural process of adaption leading to a limited lifespan of antibiotics. Unnecessary and inappropriate use of antibiotics favours the emergence and spread of resistant bacteria. A crisis has been building up over decades, so that today common and life-threatening infections are becoming difficult or even impossible to treat. It is time to take much stronger action worldwide to avert an ever increasing health and economic burden. A new WHO publication “The evolving threat of antimicrobial resistance – Options for action” describes examples of policy activities that have addressed AMR in different parts of the world. The aim is to raise awareness and to stimulate further coordinated efforts.”
Posted in READ Portal, Reports & Papers | Tagged with Infection control, Prevention and control | No Comments
March 28, 2012
“This report presents key findings from the 2010 cycle of (The Health Behaviour in School-aged Children study [HSBC]). Current priorities for the public health system in Canada are particularly emphasized. As the HBSC study has traditionally focused upon the importance of social settings and conditions as potential determinants of health, this focus continues in the current report. In addition, this report examines the mental health of young Canadians as a primary theme.
In addition to our analysis of survey results from over 26,000 students, this report was informed by findings from a national youth engagement workshop. The purpose of this workshop was to obtain insights from a cross-section of young Canadians with respect to the key mental health findings. Efforts made to integrate the perspectives of young people directly into this report were driven by a philosophy that the opinions and insights of youth matter and the Federal Government’s role in supporting youth engagement through its committment to the United Nations Convention on the Rights of the Child. This represents a new initiative for HBSC in Canada, with interpretation of the national report findings being enriched by this process.”
Posted in READ Portal, Reports & Papers | Tagged with Canada, Statistics & numerical data | No Comments
March 23, 2012
“‘Many patients are already online, and the next generations of patients and caregivers will conduct more and more of their daily activities through social media.’
– Neil Seeman, CEO, Health Strategy Innovation Cell
Our two-part guide to current practice and future promise in using social media to benefit patients is for the social media novice and initiated alike. It’s part of a suite of interactive resources produced by The Change Foundation in partnership with the Health Strategy Innovation Cell at Massey College, University of Toronto, to help healthcare organizations better understand the potential and limitations of social media, and to prompt them to use these tools to capture and improve the patient experience.
Part 1, Introduction and Key Issues in the Current Landscape, reports on: how healthcare organizations are using social media; the link to quality improvement; leading practices, opportunities and limitations; and issues such as privacy, data control, ethics, and return on investment.”
Posted in READ Portal, Reports & Papers | Tagged with Canada, Social media | No Comments
March 13, 2012
“In the health sector, Lean is a patient-focused approach to systematically eliminating waste in health care organizational processes in order to improve quality, productivity and efficiency. In essence, Lean involves mapping out the patient journey from the time they enter the system until they exit the system in order to identify activities that provide value to the patient and eliminate those that add no value (waste). Once wasteful activities are removed, remaining steps are made more efficient and integrated so that services flow smoothly. This means that services are “pulled” only when needed by patients. The final step of Lean is the pursuit of continuous improvement by repeating the cycle to get it more and more streamlined.
In November 2010, Leadership Council1 decided to support the use of Lean within the health authorities as a process redesign tool. One of the strategic actions or Key Result Areas (KRAs) for achieving the Ministry of Health’s Innovation and Change Agenda is concerned with reducing waste and increasing value in the health care sector using Lean methods. A key deliverable for this KRA is an annual report for Leadership Council that outlines how Lean has been used in the province. This report presents seven case studies that have been identified by the health authorities as compelling and successful Lean initiatives.”
Posted in READ Portal, Reports & Papers | Tagged with Canada, Efficiency, Process improvement | No Comments
March 12, 2012
“Health Policy and Systems Research (HPSR) is often criticized for lacking rigour, providing a weak basis for generalization of its findings and, therefore, offering limited value for policy-makers. This Reader aims to address these concerns through supporting action to strengthen the quality of HPSR.
The Reader is primarily for researchers and research users, teachers and students, particularly those working in low- and middle-income countries (LMICs). It provides guidance on the defining features of HPSR and the critical steps in conducting research in this field. It showcases the diverse range of research strategies and methods encompassed by HPSR, and it
provides examples of good quality and innovative HPSR papers.
The production of the Reader was commissioned by the Alliance for Health Policy and Systems Research (the Alliance) and it will complement its other investments in methodology development and postgraduate training.”
Posted in READ Portal, Reports & Papers | Tagged with Health planning, Policy, Public health | No Comments
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