Healthcare Policy最新文献

Hospitals are in tough straights currently with queues in their emergency departments and very long wait times for elective surgery. Many hospitals are also bleeding red ink. Prominent teaching hospitals are facing multi-million-dollar operating deficits in Ontario. Hamilton Health Sciences and The Ottawa Hospital each reported operating deficits of more than $20 million in 2025 (Hamilton Health Sciences Corporation 2025; The Ottawa Hospital 2025).

Proposals to "fix" Canada's primary care crisis by expanding the workforce or scaling up interprofessional teams risk repeating past failures. The deeper challenge lies in structural fragmentation, the absence of coherent system design and weak accountability. Sustainable transformation requires more than piecemeal reforms or pilot projects. It demands implementing a systems approach that is premised on a consensus-based, pan-Canadian strategy anchored in shared aims, principles and investments in the structural attributes of high-performing primary care systems. These evidence-informed attributes are identified in the Aggarwal-Hutchison framework. Without meaningful structural reform, new spending will yield only incremental gains, keeping Canada bound to Ixion's wheel - a self-inflicted cycle of crisis, renewal and disappointment.

Introduction: Pharmacists' service fees are paid to pharmacies, not directly to pharmacists, which may hinder the adoption of expanded pharmacists' services. Our aim was to identify barriers and enablers to pharmacists' delivery of services in relation to the payment model.

Methodology: We conducted semi-structured interviews with community pharmacists or owners in British Columbia using a constructivist approach and performed a thematic analysis.

Results: Three themes emerged: tension regarding pharmacists' perception of their role in healthcare, influence of systemic factors on pharmacists' role and autonomy over practice.

Conclusion: While payment is a significant factor in deterring pharmacists from clinical service delivery, systemic factors also influence how pharmacists feel about their role.

Housing is a critical social determinant of health, yet until recently, hospitals did not routinely collect data on homelessness. National homelessness coding mandates have brought attention to an often poorly represented issue, but largely reaffirm existing evidence - homelessness is a growing public health issue. Governments and health systems should not just document the ongoing crisis but also leverage administrative data to prevent homelessness. Policies aimed at early detection, cross-sectoral data integration and affordable housing are needed to address the upstream drivers of homelessness.

Canada's primary healthcare system is in crisis today, with over 4.6 million Canadians not having access to a consistent primary care provider. In this paper, we employed a forecasting model to examine family physician (FP) supply and demand, and the associated costs, and discuss potential solutions. Based on the forecasting model, in the most likely case scenario, the FP shortage will reach a peak of 15,354 FPs in 2037, and this deficit will persist even 28 years later in 2052. Potential solutions include multiple levels of care providers, team-based care, providing additional training opportunities and pathways, re-defining the FP role and compensation model, improving system efficiencies and increasing accountability.

Background: Financial incentives may improve diet quality and reduce food insecurity, but how incentives align with population preferences for delivery (mode, structure) and shopping habits (frequency, spending) remains unclear.

Methods: A July 2022 cross-sectional survey of 1,601 Canadian adults (excluding Quebec) examined incentive preferences, shopping frequency and healthy food spending shortfalls using Poisson and generalized linear models.

Results: Weekly instant loyalty card discounts were most preferred. The median spending gap was $12.50 (mean $21.48), with food-insecure participants reporting the largest gaps.

Conclusion: Aligning incentive design with population preferences and shopping habits may enhance uptake. Higher-value incentives may be needed to more fully engage food-insecure populations.

Homelessness is a critical social determinant of health, driving disparities in healthcare utilization, morbidity and mortality. In 2018, the Canadian Institute for Health Information (CIHI) mandated the coding of homelessness in hospital administrative data, which more than doubled case identification. However, 25 % of cases remain undetected, and two-thirds of flagged patients were not currently homeless, though they have a documented history of homelessness. We summarize recent evidence and present opportunities for CIHI and health systems to further improve the accuracy of homelessness coding in Canadian hospital administrative data, which would enhance its utility for health research, policy making and health system planning.

This study examines how immigrant status and place of education affect skill utilization among Canadians with a medical degree, using the 2021 Census of Population. Immigrants with a foreign education were less likely to be employed as doctors than Canadian-educated immigrants or Canadian-born people. Among foreign-educated immigrants, racialized people had a larger disadvantage in employment as doctors than their White counterparts. Canadian-educated immigrants mostly had similar employment outcomes as Canadian-born people, but those from the Black, South Asian and Arab/West Asian groups had worse outcomes. A similar disadvantage was found among Canadian-born people from the Black, South Asian and Arab/West Asian groups.

Language differences between patients and care providers are a major barrier to delivering quality healthcare. We describe citizen-reported access to healthcare in their preferred official language in New Brunswick by examining survey data from the New Brunswick Health Council (2021 and 2023). Nearly all New Brunswickers report access to a primary care provider in their preferred official language, but other sectors of primary care (e.g., pharmacy, specialists, telehealth) represent significant challenges for French-preferring citizens. Given New Brunswick's unique context as Canada's only officially bilingual province, we highlight research opportunities that could inform strategies to improve language-concordant healthcare nationally.