March 19, 2012
“Putting Health in context: What is health? For some, health means the absence of disease and pain; for others, it is a general feeling of wellness. The World Health Organization (WHO) defines health more broadly: ‘the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.’
This broad definition aligns with the Conference Board’s overarching goal in benchmarking Canada’s performance—to measure quality of life in Canada and in its peer countries. Most Canadians would agree that without health, quality of life is severely compromised.
How do we measure health performance?: To measure health performance, we evaluate Canada and 16 peer countries on the following 11 report card indicators: life expectancy; self-reported health status; premature mortality; mortality due to cancer; mortality due to circulatory disease; mortality due to respiratory disease; mortality due to diabetes; mortality due to diseases of the musculoskeletal system; mortality due to mental disorders; infant mortality; and mortality due to medical misadventures.
It is important to note that the Conference Board is not attempting to rate Canada’s health care system. Although the health care system has an impact on the health status of a population, our goal is to evaluate the health status of Canadians and of their peers in other countries.
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Posted in Multimedia, READ Portal | Tagged with Canada, Chronic disease, Indicators, Prevention and control | No Comments
February 27, 2012
“With the goal to improve healthcare services and delivery, Stanton Territorial Hospital in the Northwest Territories (NWT) invited the Canadian Health Services Research Foundation (CHSRF) to explore opportunities to collaborate in the redesign and improvement of the health system. This article describes the NWT’s efforts to transform its healthcare delivery to more appropriately care for people living with chronic diseases. It also sets the context for the initial meeting between the NWT and CHSRF and the collaborative journey that continues, with the bringing together of 40 health system managers, policy makers and clinicians, along with CHSRF staff and guest faculty, with a shared vision to redesign care to better meet the needs of people living with chronic diseases in the territory.”
Posted in Journal Articles, READ Portal | Tagged with Canada, Chronic disease, Health care reform | No Comments
January 13, 2012
“This bulletin reports the results of the 2011 Commonwealth Fund International Health Policy Survey and compares the experiences of sicker Canadians with chronic conditions to those of the general public. Cost was shown to be one of the most significant barriers:
- 23% of sicker Canadians said they had skipped a dose of medication or did not fill a prescription due to cost, compared to just 10% of the general population.
- 12% of sicker Canadians reported not visiting a doctor due to cost concerns, compared to just 4% of the general population.
Sicker Canadians also fare worse when it comes to the coordination of their care and being engaged in their health care. These issues, as well as recommendations to eliminate the barriers this population faces, are outlined in the bulletin.”
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Posted in READ Portal, Reports & Papers | Tagged with Canada, Chronic disease | No Comments
November 10, 2011
“In high-income countries, patients with complex care needs account for a disproportionate share of national health spending… These patients typically see multiple clinicians at different locations, making care coordination imperative. To learn more about the experiences of these “sicker adults,” a new Commonwealth Fund survey focused on patients with high care needs in 11 countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the U.S.
Despite variation in patients’ experiences across the globe, all countries are facing similar challenges in providing effective care to sicker adults, contending with coordination gaps, lapses in communication between providers, and missed opportunities for engaging patients in management of their own care. Moreover, all countries can learn from one another, the authors conclude.
(The bottom line is) across 11 countries, adults with complex care needs who had a medical home reported fewer coordination failures with their care, including medical errors and test duplication, as well as better relationships with their doctors and greater satisfaction with care.”
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Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Chronic disease, Integrated care, Quality assessment | No Comments
October 26, 2011
“This paper focuses on care coordination in the patient-centered medical home; however, to cultivate a coordinated patient-centered health care delivery system, the PCMH model must be connected to the medical neighborhood. Coordinating care across providers means connecting with specialty and subspecialty providers, many of whom are essential to the successful treatment of chronic illnesses.
The report features three core elements:
- Expert-authored articles on the definition, role and function of care coordination, as well as tools for implementation, and measurement and monitoring of its effectiveness
- Case examples
- Summary of survey responses from select practices.”
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Posted in READ Portal, Reports & Papers | Tagged with Chronic disease, Patient-centered care | No Comments
October 6, 2011
“The aim of this paper is to describe the different forms of integrated care and to summarise evidence on their impact. The paper is based on a major review published by The King’s Fund (Curry and Ham 2010) and has been prepared in the light of the increased interest in integrated care arising out of the work of the NHS Future Forum and the government’s response. Key messages are:
- integrated care takes many different forms and may involve whole populations, care for particular groups or people with the same diseases, and co-ordination of care for individual service users and carers
- there is good evidence of the benefits of integrated care for whole populations, as seen in organisations such as Kaiser Permanente, the Veterans Health Administration and integrated medical groups in the United States
- there is good evidence of the benefits of integrated care for older people as seen in areas like Torbay
- there is mixed evidence of the benefits of integrated care for people with long-term conditions like diabetes and for people with complex needs
- there is evidence of the benefits of care co-ordination for individual service users and carers, especially when multiple approaches are used together
- integrated care in the NHS needs to be pursued at all levels to overcome the risks of fragmentation, and of service users ‘falling between the cracks’ of care
- policy-makers need to act on the evidence not by promoting a preferred approach but by supporting clinical and managerial leaders to adapt the ingredients of integrated care discussed in this briefing to improve outcomes for the populations they serve.”
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Posted in READ Portal, Reports & Papers | Tagged with Chronic disease, Integrated care | No Comments
October 4, 2011
“The present study, funded by CPHI (Canadian Health Population Initiative), reviews the body of evidence associated with the return on investment (ROI)i of mental health promotion and mental illness prevention.ii The specific research question being addressed is as follows:
‘What are the extent, range and nature of research activity in the area of economic analysis of mental health promotion and mental illness prevention?’”
“Both peer-reviewed (2001 to 2011) and grey literature sources were explored.The review shows that several systematic reviews and/or meta-analyses make the case for investing in mental health promotion and mental illness prevention, although the number of randomized controlled trials in each area is low. This report shows evidence of this finding for the health, education and workplace sectors and, to a lesser extent, the criminal justice and social services sectors, recognizing that there are considerable overlaps among these categories and studies.”
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Posted in READ Portal, Reports & Papers | Tagged with Canada, Chronic disease, Disease management, Mental health | No Comments
September 27, 2011
“Background: Available studies have shown few quality-related advantages of electronic health records (EHRs) over traditional paper records. We compared achievement of and improvement in quality standards for diabetes at practices using EHRs with those at practices using paper records. All practices, including many safety-net primary care practices, belonged to a regional quality collaborative and publicly reported performance.
Methods: We used generalized estimating equations to calculate the percentage-point differ- ence between EHR-based and paper-based practices with respect to achievement of composite standards for diabetes care (including four component standards) and outcomes (five standards), after adjusting for covariates and accounting for clustering. In addition to insurance type (Medicare, commercial, Medicaid, or uninsured), patient-level covariates included race or ethnic group (white, black, Hispanic, or other), age, sex, estimated household income, and level of education. Analyses were con- ducted separately for the overall sample and for safety-net practices.
Results: From July 2009 through June 2010, data were reported for 27,207 adults with diabetes seen at 46 practices; safety-net practices accounted for 38% of patients. After adjustment for covariates, achievement of composite standards for diabetes care was 35.1 percentage points higher at EHR sites than at paper-based sites (P<0.001), and achievement of composite standards for outcomes was 15.2 percentage points higher (P=0.005). EHR sites were associated with higher achievement on eight of nine component standards. Such sites were also associated with greater improvement in care (a difference of 10.2 percentage points in annual improvement, P<0.001) and outcomes (a difference of 4.1 percentage points in annual improvement, P=0.02). Across all insurance types, EHR sites were associated with significantly higher achievement of care and outcome standards and greater improvement in diabetes care. Results confined to safety-net practices were similar.
Conclusions: These findings support the premise that federal policies encouraging the meaning- ful use of EHRs may improve the quality of care across insurance types.”
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Posted in Journal Articles, READ Portal | Tagged with Chronic disease, e-health | No Comments
August 18, 2011
“The delivery of best practice care can markedly improve clinical outcomes in patients with chronic disease. While the provision of a skilled, multidisciplinary team is pivotal to the delivery of best practice care, the occupational or skill mix required to deliver this care is unclear; it is also uncertain whether such a team would have the capacity to adequately address the complex needs of the clinic population. This is the role of needs-based health workforce planning. The objective of this article is to describe the development of an evidence-informed, needs-based health workforce model to support the delivery of best- practice interdisciplinary chronic disease management in the primary and community care setting using diabetes as a case exemplar.”
Posted in Journal Articles, READ Portal | Tagged with Chronic disease, Quality of care | 1 Comment
May 24, 2011
“Many of the estimated thirty-two million Americans expected to gain coverage under the Affordable Care Act are likely to have high levels of unmet need because of various chronic illnesses and to live in areas that are already underserved. In New Mexico an innovative new model of health care education and delivery known as Project ECHO (Extension for Community Healthcare Outcomes) provides high-quality primary and specialty care to a comparable population. Using state-of-the-art telehealth technology and case-based learning, Project ECHO enables specialists at the University of New Mexico Health Sciences Center to partner with primary care clinicians in underserved areas to deliver complex specialty care to patients with hepatitis C, asthma, diabetes, HIV/AIDS, pediatric obesity, chronic pain, substance use disorders, rheumatoid arthritis, cardiovascular conditions, and mental illness. As of March 2011, 298 Project ECHO teams across New Mexico have collaborated on more than 10,000 specialty care consultations for hepatitis C and other chronic diseases.”
Posted in Journal Articles, READ Portal | Tagged with Access to care, Chronic disease, Disease management, Primary health care | No Comments
