August 10, 2011
“Concern about chronic condition care is growing as the prevalence of chronic conditions such as diabetes and high blood pressure increases in Canada.1 For many chronic conditions, prevalence increases with age, causing a disproportionate health burden on seniors—Canadians age 65 and older.2 Patients with chronic conditions—in particular multiple chronic conditions, also called comorbidity—typically have poorer quality of life and require considerable health care resources. Effective prevention and management of chronic conditions is required, especially in the face of Canada’s large boomer generation entering the senior age category.
This study examined the reported experiences of seniors in Canada being treated for chronic conditions in primary health care (PHC) settings. The results of the study can be used to enhance our understanding of patients’ use of health care services and health status, the quality of patient–provider communication, patient self- management and medication management. This report is focused on seniors because they are more likely than younger people to have chronic conditions, especially comorbidities that can be complex and difficult to manage.”
Posted in READ Portal, Reports & Papers | Tagged with Canada, Health care costs, Health services for the aged | No Comments
August 3, 2011
“Clinician dependent costs are the costs of care that are under the discretion of the healthcare provider. These costs include the costs of drugs, tests and investigations, and discretionary outpatient visits and impatient stays. The purpose of this review was to summarize recent evidence, relevant to both developed and developing countries on whether evidence based clinical guidelines can change hospitals variable costs which are clinician dependent, and the degree of financial savings achieved at hospital level. Potential studies for inclusion were identified using structured searches of Econlit, J-Stor, and Pubmed databases. Two reviewers independently evaluated retrieved studies for inclusion. The methodological quality of the selected articles was assessed using the Oxford Centre for Evidence- Based Medicine (CEBM) levels of evidence. The results suggest that 10 of the 11 interventions were successful reducing financial costs. Most of the interventions, either in modeling studies or real interventions generate significant financial saving, although the former reported higher savings because the studies assumed 100 percent compliance. “
Posted in Journal Articles, READ Portal | Tagged with Cost effectiveness, Economics, Health care costs | No Comments
July 29, 2011
“Does your organization disclose medical errors when they occur? Does the practice of disclosure increase or decrease your liability costs?
The reported evidence from several medical centers indicates that there are both patient safety and financial benefits with disclosing medical errors. However, a widely reported and controversial expert study offers significant cautions about the disclosure route. This paper provides an overview of medical error disclosure, and analyzes the financial impact of disclosure on health care organizations.”
Posted in READ Portal, Reports & Papers | Tagged with Health care costs, Policy, Prevention and control | No Comments
May 5, 2011
“The objective of the report was to review the evidence on the impact of health information technology (IT) on all phases of the medication management process (MMIT) (prescribing and ordering, order communication, dispensing, administration and monitoring as well as education and reconciliation), to identify the gaps in the literature and to make recommendations for future research.
(The results show) physicians were more often the subject of evaluation than other participants. Other health care professionals, patients, and families are important but not studied as thoroughly as physicians. These nonphysicians groups often value different aspects of MMIT, have diverse needs, and use systems differently. Hospitals and ambulatory clinics were well-represented in the literature with less emphasis placed on long-term care facilities, communities, homes, and nonhospital pharmacies. Most studies evaluated changes in process and outcomes of use, usability, and knowledge, skills, and attitudes. Most showed moderate to substantial improvement with implementation of MMIT. Economics studies and those with clinical outcomes were less frequently studied. Those articles that did address economics and clinical outcomes often showed equivocal findings on the effectiveness and cost-effectiveness of MMIT systems. Qualitative studies provided evidence of strong perceptions, both positive and negative, of the effects of MMIT and unintended consequences. We found little data on the effects of forms of medications, conformity, standards, and open source status. Much descriptive literature discusses implementation issues but little strong evidence exists. Interest is strong in MMIT and more groups and institutions will implement systems in the next decades, especially with the Federal Government’s push toward more health IT to support better and more cost-effective health care.”
Posted in READ Portal, Reports & Papers | Tagged with Cost effectiveness, Health care costs, Health technology, Technology | No Comments
March 31, 2011
“Key messages
Canada’s publicly funded healthcare system is facing increasing cost control pressures. Hospitals alone represent a substantial burden on provincial health budgets, accounting for 28% of total costs. Presently, in the Canadian system, the primary source of funding for hospitals is through a global budget. Under this model, a fixed (global) amount of funding is distributed to each hospital to pay for all hospital-based services for a fixed period of time (commonly one year). Global budgets:
- Are based on historical spending, inflation, negotiations and politics in many provinces, rather than on the type and volume of services provided.
- Constrain hospital spending growth and create budgetary predictability; however, its consequences may be decreased services and increases in waiting times.
- Do not provide incentives to improve access, quality or efficiency of hospital care.
Funding hospitals on the basis of the type and volume of services they provide has become the international norm. Known as activity-based funding (ABF), these systems have been systematically supplementing global budgets in public and private insurance-based health systems around the world. ABF:
- Provides powerful financial incentives to stimulate productivity and efficiency: efficient hospitals retain the difference between the payment amount and the hospital’s actual cost of production.
- Is associated with higher volumes of hospital care, shorter lengths of stay, and yet has not been linked to poorer quality of care.
- Is linked to higher overall spending, due to higher volumes of patients being treated, and evidence of lower cost per admission is mixed.
Combining properties of ABF and global budgets may optimize the strengths of both global budgets and ABF. Many countries that have ABF to fund their hospital systems utilize a blend of global budgets to control spending, while instituting an ABF mechanism to create incentives for hospitals to provide timely and equitable access, appropriate volume of care, and efficient care.
In the Canadian context, recommendations are:
- Adopt population-based funding at the regional level to reduce historical funding inequities by recognizing differences in need across populations, regions and over time.
- Blend ABF and global budgets to create incentives for hospitals to improve hospital efficiency and access.
Posted in READ Portal, Reports & Papers | Tagged with Canada, Economics, Funding, Health care costs, Health care reform, Policy | No Comments
February 21, 2011
This 2010 report from the Health Council of Canada examines the issues affecting the health of Canadians. While acknowledging that individual choices, such as smoking, drinking, or dietary habits, have an impact on health, it also argues that determinants of health, cultural, environmental, and socio-economic factors, have an equal impact on health.
This report strive to educate government, institutions, and individuals on the issues of determinants of health in order to help Canadians overcome its challenges. All people need to be aware of how different factors impact health, so that Canadians can work together to make these problems a thing of the past.
Posted in READ Portal, Reports & Papers | Tagged with Canada, Health care costs, Health care reform | No Comments
February 16, 2011
This white paper is one part of two resources from the Institute for Healthcare Improvement that are targeted towards helping healthcare managers identify and eliminate financial excess and waste while ensuring that quality is not negatively impacted. The paper specifically focuses on how to identify initiatives that improve the bottom line in terms of cash outflows. It recommends following a step-by-step process to eliminate inefficiencies and result in an anuual savings of 1% to 3% each year.
The second resource is a the “Quality Improvement Savings Tracker Worksheet,” an Excel file that helps healthcare managers track cost savings from the initiatives. Combined, these two tools have the potential to result in significant reductions on financial outflows.
Posted in READ Portal, Reports & Papers | Tagged with Economics, Efficiency, Health care costs | No Comments
February 7, 2011
The Patient Cost Estimator, http://www.cihi.ca/CIHI-ext-portal/internet/en/document/spending+and+health+workforce/spending/spending+by+category/pce# is an innovative tool that allows for the viewing of estimated average hospital costs by Case Mix Group (CMG) at both the provincial and national levels.
The tool allows hospital staff, policy-makers and researchers to access the information and make more accurate financial forecasts. It also presents an opportunity for the public to gain a better understanding of where major costs are incurred by our health system.
Posted in Multimedia, READ Portal | Tagged with Canada, Economics, Health care costs | No Comments
December 2, 2010
As Ontario experiments with new patient-based payment methods under the Excellent Care for All Act, The Change Foundation offers analysis, examples, and advice on using funding models to improve the quality and experience of patient care.
Posted in Mass Media Articles, READ Portal | Tagged with Economics, Funding, Health care costs, Health care reform | No Comments
December 1, 2010
Health systems around the world are under increasing strain because of the rising prevalence of chronic conditions, including diabetes, heart disease, and asthma. For more than 15 years, disease-management programs (DMPs) have been promoted as a solution to this problem. By carefully coordinating the delivery of high-quality care to patients with chronic conditions, the programs are supposed to enhance the patients’ health, reduce hospitalization rates, and lower treatment costs.
Posted in Journal Articles, READ Portal | Tagged with Disease management, Economics, Health care costs | No Comments
