Healthcare Management Forum最新文献

The One Health perspective highlights the potential synergies between the human, animal, and environmental health sciences, especially in an era of budget shortfalls, climate change, and emerging infectious diseases of zoonotic origin. Canadian physicians and veterinarians arguably lay the foundation of One Health in the late 19^th century, when they pioneered the study of "comparative medicine" in Montreal, but they fell into disciplinary silos before World War I to the lasting detriment of the Canadian population. This article explores both the advantages and impediments to cross-disciplinary healthcare collaboration in Canada, highlighting the country's vast size, sparse population, and political decentralization in particular, and offers a number of policy recommendations that would allow the country to reclaim its rightful role as a leader in the One Health movement.

This article investigates whether, in the context of rising nationalism, drawing attention to national innovation strategies influences public health behaviours, particularly vaccine uptake. It draws on an original two-wave panel study of United Kingdom (UK) respondents during the COVID pandemic. The survey included an experimental design, which primed respondents with a nationalist framing of COVID-19 vaccines, drawing attention to the UK's role in developing the AstraZeneca vaccine and in rapid approval and roll out of other vaccines. Our results show no significant impact of nationalist framing on vaccine willingness, even among those with nationalist or science-skeptical views. These findings suggest public health authorities should be cautious with nationalist framing, as it may be ineffective or counterproductive.

Private Equity (PE) investment in healthcare has grown substantially in recent years, raising alarm about its impact on patient care, healthcare professionals, and the overall integrity of the healthcare system. The influx of PE investments into healthcare has sparked debates regarding profit-driven motives, cost-cutting measures, and potential risks to patient safety and access to essential services. This article examines the extent and possible impacts of private equity in Canadian healthcare using data from a proprietary database. Drawing upon evidence from academic studies in the United States, this article provides evidence on the adverse impacts on the quality of care, the deterioration in working conditions, and degradation of the healthcare system. It provides suggestions to limit the predatory impacts of PE investment.

COVID-19 increased the use of technology in everyday life and highlighted critical applications for assistive technologies. This comparative research study explores how assistive technologies, including socially assistive robots, can be adopted by long-term care homes to mitigate the lasting effects of the pandemic. In particular, we investigated the types of assistive technologies used by long-term care facilities to help with the care of older residents and for what tasks. Furthermore, we identified barriers to adoption and proposed policy measures that encourage technology adoption.

Primary care is the key health system strategy for improving health, enhancing patient and clinician experience, saving money, and promoting equity. Once a pioneer in primary care, Canada now fails to provide access to millions of people. This crisis is widely recognized, but policy responses are varied and mostly incremental and piecemeal. The goal of providing primary care to everyone seems unrealistic and elusive in Canada, yet it has long been attained in many other countries. Without an explicit policy goal of primary care for all, most likely on a geographic basis, Canada will continue to underinvest and underperform in primary care, with ramifications that include rapidly escalating costs, emergency department and hospital overcrowding and a growing and inequitable burden of preventable suffering. A commitment to work towards this goal is needed now to ensure that Canadians have access to high-quality well-organized care for everyone.

Pharmaceutical companies claim that they need high drug prices to generate sufficient profits to invest in innovation. While this claim can be valid in principle, it is contradicted by the extent to which "Big Pharma" companies in the United States (US) distribute profits to shareholders in the form of cash dividends and stock buybacks. For 2013-2022, the 14 US-based pharmaceutical companies in the S&P 500 Index paid out 54% of net income as dividends and another 51% as buybacks. Incentivizing senior corporate executives to allocate resources in this financialized manner is, as we document, their stock-based compensation. In effect, these companies use high stock prices to boost stock yields at the expense of investing in innovation and compensating workers and taxpayers who make value-creating contributions to the corporation. Given the prominence of US-based pharmaceutical corporations in Canada, we explain how their financialization results in high Canadian drug prices and underinvestment in pharmaceutical research and development in Canada.

In today's evolving healthcare landscape, leaders must innovate and collaborate to ensure safe, accessible, and high-quality care. Addressing complex issues like climate change, workforce resiliency crises, and the erosion of public trust, alongside equity and inclusive services, is critical. This article offers insights into the role of quality standards and assessment programs as catalysts for innovation and future collective impact. Using examples from Health Standards Organization and Accreditation Canada, it illustrates how these levers of change enable leaders to improve patient and workforce safety, advance integrated care, and strengthen the health of communities. Embracing people-centred and evidence-informed solutions to enable new mindsets and ways of working lays the foundation for sustainable, resilient learning health systems.

Successful innovation clusters are notoriously difficult to establish, and many attempts fail. How can we go about designing such systems reliably? We describe how ecosystems can be strengthened through grassroots bottom-up efforts that empower user and community innovation, as opposed to economic policies that dictate innovation. Specifically focusing on the healthcare industry, we advocate that community hospitals which constitute 90% of all hospitals in Canada are the ideal setting for such community innovation efforts. We investigated the distribution of innovation output from hospitals over the past 13 years and found a decrease in predominance of major teaching hospitals, supporting the potential role for community hospitals in this space. We categorize different types of innovations and recommend institutional policies that can sustain bottom-up, micro-level efforts. Such policies could improve and enhance the development of micro-innovations and the creation of health innovation clusters.

This study explores the deployment of Artificial Intelligence (AI) in Canadian hospitals from 2000 to 2021, focusing on metropolitan areas. We investigate how local public and private research ecosystems and links to national and international AI hubs influence the adoption of AI in healthcare. Our analysis shows that AI research outputs from public institutions have a significant impact on AI competences in hospitals. In addition, collaborations between hospitals are critical to the successful integration of AI. Metropolitan areas such as Toronto, Montreal, and Vancouver are leading the way in AI deployment. These findings highlight the importance of local AI research capabilities and international hospital collaborations and provide guidance to policy-makers and health leaders to drive the diffusion of AI technology in healthcare.

Scaling the innovative models of care, policies, practices, and technologies that deliver true value requires deliberate, focused effort. We need to simultaneously apply practical strategies that enable change agents to drive meaningful, sustainable impact to address particular challenges that a health system is facing, alongside implementing proven, evidence-informed approaches that broadly strengthen health system foundations. Both approaches matter; it's not about choosing between them. Rather, we need to respond to the health system's specific and immediate needs, while also growing culture, capacity, systems, and tools that enable transformation in quality and safety.