Healthcare Policy最新文献

Early psychosis intervention (EPI) is a complex model of care designed to be delivered by a large multidisciplinary team. However, in practice, it is often delivered by very small teams, particularly in rural areas. This study analyzed fidelity data from over half of Ontario EPI programs (n = 24) to compare model fidelity in programs with smaller (≤2.1 staff) and larger (≥4.3 staff) teams. Few differences were identified, suggesting that small teams may be a viable option to deliver the EPI model, although both large and small teams were challenged to deliver almost a third of the elements of care.

The search for profit in the Ontario long-term care (LTC) home sector means that inspections and fines are unlikely to drive quality improvement. For-profit ownership, operations and contracts thwart accountability for quality and financial stewardship while blocking full public reporting, thus preventing public oversight. Laying out the problems presented by the for-profit LTC homes' financial and operations infrastructure with examples, this commentary presents policy paths forward to address the problem of profit and improve accountability.

Providing services in a patient's preferred language is linked to safe and quality care. This paper presents the process and outcomes of implementing practices of active offer (AO) of French-language services in a hospital setting in a region of Ontario with a low density of francophones. Participating unit managers and site coordinators selected AO practices and carried out an implementation plan. The implementation's success was linked to the support received from higher management and site coordinators. Challenges included the managers' rival priorities and perceived language priorities. This process could be applied to meet the needs of other language communities.

Canada's healthcare system is struggling to provide primary care and acute care for ever-increasing numbers of patients, who are turning to emergency medical services (EMS) agencies to obtain timely care when in need. Paramedics are experiencing the downstream effects of these challenges, leading to a diversion of ambulances away from the communities they serve, increased call volumes and staff burnout. Well-intended policies, such as a borderless EMS system, should not be used as a stopgap measure to service non-emergency calls, and there should be a defined and enforceable process for returning ambulances to their home communities. Community paramedic and alternative treatment destinations represent an evolving area of paramedic practice that could offer solutions to some of the challenges faced by the healthcare system and relieve some of the occupational issues faced by paramedics. However, to fully realize the benefits offered by some of these changes in paramedic practice, they must adopt evidence-based best practices and be accompanied by relevant changes in paramedic education and supportive government policy.

The number of expensive drugs for rare diseases (EDRDs) approved by Health Canada and their contribution to healthcare costs have been rapidly increasing. The federal government has announced a three-year funding commitment of $1.4 billion for EDRDs, but principles need to be developed for how that funding will be allocated, especially in cases where insufficient data are available to guide decision making. Here, we review the role of evidence quality in making choices and draw on the experience from other countries to put forward five principles about how the money should be spent.

Providing services in a patient's preferred language is linked to safe and quality care. This paper presents the process and outcomes of implementing practices of active offer (AO) of French-language services in a hospital setting in a region of Ontario with a low density of francophones. Participating unit managers and site coordinators selected AO practices and carried out an implementation plan. The implementation's success was linked to the support received from higher management and site coordinators. Challenges included the managers' rival priorities and perceived language priorities. This process could be applied to meet the needs of other language communities.

Background: Medical school deans wield considerable influence over research, clinical and educational missions at their institutions. This study investigates conflict of interest (COI) of Canadian medical school deans.

Method: The websites of all 17 Canadian medical schools were searched for any mention of relationships between deans and pharmaceutical or medical device companies.

Results: No COIs were discovered for 11 of the deans. Six had COIs, including participating in research funded by pharmaceutical companies and received consulting and speaker fees.

Discussion: A minority of deans had COIs with healthcare industry companies. Whether deans' COIs affect policies at the medical schools they lead should be the subject of further investigation.

Healthcare is canada's favourite punching bag. Admittedly, Canadian healthcare has many problems and, sometimes, it feels as though the system cannot get anything right. But is all the criticism fair?

Aligning with Crump and colleagues' (2024) conclusions on cataract surgery, this article champions a level playing field for expanding surgical capacities for straightforward surgeries. It is agnostic toward for-profit or not-for-profit models. It argues for experimenting with new ambulatory facilities to meet urgent needs, emphasizing Ontario's successful two-decade experience with models such as the Kensington Eye Institute. The discussion advances a three-tiered pricing framework, advocating for transparent, structured pricing to reduce wait times and improve public health outcomes. This approach seeks to balance annual commitments, quarterly adjustments and spot market needs, promoting innovation, cost-efficiency and quality care.

Ethnolinguistically diverse 2S/LGBTQI+ (two-spirit, lesbian, gay, bisexual, transgender, queer and intersex) populations have unique healthcare needs and experience health inequities compared to their cisgender or heterosexual peers. This community-based participatory study sought to describe the profile and healthcare needs and experiences of official language minority French-speaking 2S/LGBTQI+ adults in Manitoba. Participants (N = 80) reported that gender and sexual identity were often concealed from service providers; many respondents faced discrimination based on their ethnolinguistic and sexual identities. Service gaps are identified pertaining to mental and sexual health; locating 2S/LGBTQI+-friendly, patient-centred care in French is difficult. Policy and practice should address systemic inequity and discrimination experienced by this equity-seeking population.