June 27, 2012
The Wait Time Alliance (WTA) has issued national report cards annually since 2007. Initially, our report cards were solely directed at provincial performance in the five areas identified in the 2004 Health Accord: cancer (radiation therapy); heart (bypass surgery); joint replacement (hip and knee); sight restoration (cataract) and diagnostic imaging (CT and MRI). Since then, the WTA has directed its attention
toward: (1) broadening the scope to include Canadians’ access to all areas of care; (2) improving the quality of public reporting on timely access; (3) highlighting issues that contribute to lengthy wait times; and, (4) identifying best practices to improve wait times.
The 2012 report card is the WTA’s most comprehensive effort to date to shed light on all of these areas.It contains six sections:
Posted in READ Portal, Reports & Papers | Tagged with Access to care, Benchmarking, Canada, Indicators, Wait lists | No Comments
June 22, 2012
In this commentary, we hope to stimulate innovation in the field of health care performance measurement. We will discuss several considerations regarding the use of three quality indicators that are commonly used to improve accountability in the Canadian context. Specifically, we will focus on the hospital standardized mortality ratio (HSMR), all-cause urgent readmissions, and emergency department length of stay (ED-LOS; see Textbox 1). We discuss “the good,” “the bad,” and “the ugly” to illustrate both positive and negative consequences related to measurement. We conclude with specific recommendations regarding investments to improve quality measurement.
Posted in Journal Articles, READ Portal | Tagged with Benchmarking, Canada, Indicators, Mortality rates, Program evaluation, Statistics & numerical data | No Comments
June 5, 2012
Health Council of Canada. (2012). Progress Report 2012: Health care renewal in Canada. Retrieved from http://healthcouncilcanada.ca/tree/ProgressReport2012_FINAL_EN.pdf Monitoring progress on the accords—the 2003 First Ministers’ Accord on Health Care Renewal1 and the 2004 10-Year Plan to Strengthen Health Care2—is a key element of the Health Council of Canada’s mandate. But the challenge is to determine how […]
Posted in 2014 Health Accord, READ Portal, Reports & Papers | Tagged with Canada, Health care reform, Indicators, Policy, Primary health care | No Comments
May 30, 2012
“There is growing interest in the systematic assessment and international benchmarking of quality of care provided in different healthcare systems, and major work is under way to support this process through the development and validation of quality indicators that can be used internationally…
Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Indicators, Quality assessment | No Comments
May 24, 2012
“The patient-centered medical home has emerged as a promising solution to address the significant fragmentation, poor quality, and high costs that afflict the U.S. health care system. The medical home model includes core components of primary and patient-centered care, recent innovations in practice redesign and health information technology, and changes to the way practices and providers are paid. There are initiatives across the country testing the promise of the medical home model. However, to properly evaluate and compare results that will aid in the implementation of these and other initiatives, researchers need a standard set of core measures. This brief describes the process and recommendations of more than 75 researchers who came together to identify a core set of standardized measures to evaluate the patient-centered medical home. It focuses on two domains of medical home outcomes: cost/utilization and clinical quality.”
Posted in READ Portal, Reports & Papers | Tagged with Indicators, Patient-centered care, Quality assessment, Statistics & numerical data | No Comments
May 15, 2012
The aim of this guide is to encourage users of international comparisons of health and health care data to consider some of the factors that can influence variation between countries, and to assist them in interpreting the results. Drawing on a range of examples—using health and health care data for Organisation for Economic Co-operation and Development (OECD) countries—this guide highlights the types of question to consider about data quality, the basis for country selection and the techniques used to present the results. It is a general guide, and considering each of the factors presented here may not always be possible.
Posted in READ Portal, Reports & Papers, Uncategorized | Tagged with Benchmarking, Indicators, Statistics & numerical data | No Comments
May 8, 2012
In this paper, we discuss the current capacity for governments and their health information and quality agencies to report on the performance of their health systems. We also provide international and Canadian examples of governments that are using improved performance reporting mechanisms to support their health care priorities and goals. To do this, they rely on strategic health plans to guide service implementation, complemented by reporting frameworks that use health indicators to monitor performance over a set period of time, and report their achievements regularly to the public. The strategic plans are revised regularly in light of changing political, economic, and social circumstances within each jurisdiction. In some cases, governments have begun using performance-based funding programs as a way to drive performance improvement and achievement of their health care objectives.
As a country, how can we improve the way we set goals and measure changes to health care and the health of Canadians? How do we make sure that activities are focused on achieving positive results? How do we improve accountability for achieving these results, especially in light of the significant public resources employed in the delivery of health care in Canada? These questions predate the existing health accords and remain to be answered.
This paper is intended to raise the profile of performance reporting in Canada’s health care system and to increase our collective understanding of the opportunities to improve it in the interest of better accountability.
Posted in 2014 Health Accord, READ Portal, Reports & Papers | Tagged with Canada, Indicators, Quality assessment | No Comments
May 7, 2012
“This analysis uses data from the Organization for Economic Cooperation and Development and other sources to compare health care spending, supply, utilization, prices, and quality in 13 industrialized countries: Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. The U.S. spends far more on health care than any other country. However this high spending cannot be attributed to higher income, an older population, or greater supply or utilization of hospitals and doctors. Instead, the findings suggest the higher spending is more likely due to higher prices and perhaps more readily accessible technology and greater obesity. Health care quality in the U.S. varies and is not notably superior to the far less expensive systems in the other study countries. Of the countries studied, Japan has the lowest health spending, which it achieves primarily through aggressive price regulation.”
Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Health care costs, Indicators, Quality assessment | 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.
- 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
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