June 20, 2012
Introduction:
This discussion paper is the outcome of a think tank session the Canadian Working Group on HIV and Rehabilitation hosted in March 2011. It outlines issues of access to rehabilitation services for people living with complex chronic and episodic conditions1, promotes discussion on appropriate and timely services, and identifies opportunities for policy-makers and clinicians to consider issues related to chronic conditions and episodic disabilities and to take action to address these issues.
Posted in READ Portal, Working Papers | Tagged with Chronic disease, Health services for the aged, Quality improvement | No Comments
June 7, 2012
More than 4 million people in England with a long-term physical health condition also have mental health problems, and many of them experience significantly poorer health outcomes and reduced quality of life as a result. In terms of NHS spending, at least £1 in every £8 spent on long-term conditions is linked to poor mental health and well-being – between £8 billion and £13 billion in England each year.
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May 23, 2012
“We recommend that health care systems across Canada move actively to provide self-management
supports in a more systematic way. We see four key areas for action:
1) Create an integrated, system-wide approach to self-management support. Current efforts to promote,
deliver, and evaluate self-management support are often fragmented. This report highlights several integrated approaches that we can learn from. Continued progress on the delivery and uptake of self-management support should be monitored against specific health system performance objectives, measures, and targets. Further research in key areas, such as cost-effectiveness and how best to sustain program effects in the longer-term, is also needed.
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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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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.”
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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.”
Click here to read the full article
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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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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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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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