Healthcare Papers最新文献_第9页

The Quest for Value in Canadian Healthcare: The Applied Value in Healthcare Framework. 加拿大医疗保健的价值追求:医疗保健框架中的应用价值。

Healthcare Papers Pub Date : 2019-12-01 DOI: 10.12927/hcpap.2019.26029

Deirdre McCaughey, Gwen McGhan, Sumedh Bele, Nishan Sharma, Natalie C Ludlow

{"title":"The Quest for Value in Canadian Healthcare: The Applied Value in Healthcare Framework.","authors":"Deirdre McCaughey, Gwen McGhan, Sumedh Bele, Nishan Sharma, Natalie C Ludlow","doi":"10.12927/hcpap.2019.26029","DOIUrl":"https://doi.org/10.12927/hcpap.2019.26029","url":null,"abstract":"The exponential rise in healthcare costs in developed nations has sharpened the need for greater \"value\" in healthcare. Porter's (2010) seminal work is one of the most cited definitions and equation for value-based care. The pursuit of greater value in our healthcare system is of paramount importance, yet translating value-based healthcare (VBHC) into a framework that can be effectively utilized in the Canadian system remains a challenge. To address this challenge, we propose that VBHC can be adapted to fit the Canadian healthcare system through (1) visionary leadership for and conceptualization of VBHC at the federal government level and (2) thoughtful application of VBHC at the provincial government level. Our applied value in healthcare framework serves as a platform from which VBHC initiatives, programs and outcome measures can be systematically organized and executed within provincial healthcare systems. This methodical approach could support both provincial ministries and their health systems in pursuit of VBHC and provide the basis for explicit measurement of VBHC success, thereby helping to address the pressing issue of sustainability of the Canadian healthcare system while optimizing patient-centred outcomes of care.","PeriodicalId":35522,"journal":{"name":"Healthcare Papers","volume":"18 4","pages":"48-57"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37511199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Building on Primary Care Reforms and Indigenous Self-Determination in the Northwest Territories: Physician Accountability and Performance in Context. 在西北地区建立初级保健改革和土著自决:背景下的医生问责制和绩效。

Healthcare Papers Pub Date : 2018-04-01 DOI: 10.12927/hcpap.2018.25573

Susan Chatwood

引用次数: 4

From Autonomous Gatekeepers to System Stewards: Can the Alberta Agreement Change the Role of Physicians in Canadian Medicare? 从自主看门人到系统管理员:阿尔伯塔协议能改变医生在加拿大医疗保险中的角色吗?

Healthcare Papers Pub Date : 2018-04-01 DOI: 10.12927/hcpap.2018.25575

Tom McIntosh

引用次数: 2

Value for Money through Effective Stewardship. 通过有效的管理实现物有所值。

Healthcare Papers Pub Date : 2018-04-01 DOI: 10.12927/hcpap.2018.25571

Gregory P Marchildon, Michael Sherar

引用次数: 0

Canada's Ailing Healthcare System: It's the Doctors' Fault? 加拿大病态的医疗体系:是医生的错?

Healthcare Papers Pub Date : 2018-04-01 DOI: 10.12927/hcpap.2018.25574

Jack M Mintz

引用次数: 1

Physician Service Costs: Is There Blame to Share Around? 医生服务费用:是否有责任分担?

Healthcare Papers Pub Date : 2018-04-01 DOI: 10.12927/hcpap.2018.25579

Audrey Laporte

引用次数: 1

Healthcare Delivery and Physician Accountability in Quebec: A System Ready for Change. 魁北克的医疗服务和医生问责制:一个准备改变的系统。

Healthcare Papers Pub Date : 2018-04-01 DOI: 10.12927/hcpap.2018.25578

Lawrence Rosenberg

引用次数: 1

Doctors and Canadian Medicare: Improving System Performance Requires System Change. 医生和加拿大医疗保险:提高系统性能需要系统变革。

Healthcare Papers Pub Date : 2018-04-01 DOI: 10.12927/hcpap.2018.25577

Richard H Glazier, Tara Kiran

{"title":"Doctors and Canadian Medicare: Improving System Performance Requires System Change.","authors":"Richard H Glazier, Tara Kiran","doi":"10.12927/hcpap.2018.25577","DOIUrl":"https://doi.org/10.12927/hcpap.2018.25577","url":null,"abstract":"Many of the issues raised and insights provided by Marchildon and Sherar (2018) in their essay on doctors and Canadian medicare are on target. The inadequacy of available data on physician payment, however, calls into question the robustness of some interprovincial comparisons, and when it comes to compensation, comparisons to US physicians would be most relevant. In contrast to their assertion of a steadily increasing growth rate in physician expenditure, a more recent and longer view shows historically low growth in the past few years. Furthermore, the blame assigned to physicians and their medical associations needs to be shared with governments and most of all could be attributed to the lack of system structures and supports for improvement. New governance arrangements at the group or regional levels are needed but are insufficient in themselves. The additional features embodied in the Patient's Medical Home are essential for advancing primary care. Going even further, full population registration, greater availability of alternate payment arrangements, active participation of physicians in healthcare administration and support for meaningful measurement and feedback loops are among the changes required to transform Canadian medicare.","PeriodicalId":35522,"journal":{"name":"Healthcare Papers","volume":"17 4","pages":"41-47"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36562680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Measuring Physicians' Incomes with a Focus on Canadian-Controlled Private Corporations. 以加拿大控制的私营公司为重点衡量医生的收入。

Healthcare Papers Pub Date : 2018-04-01 DOI: 10.12927/hcpap.2018.25572

Lars Nielsen, Arthur Sweetman

{"title":"Measuring Physicians' Incomes with a Focus on Canadian-Controlled Private Corporations.","authors":"Lars Nielsen, Arthur Sweetman","doi":"10.12927/hcpap.2018.25572","DOIUrl":"https://doi.org/10.12927/hcpap.2018.25572","url":null,"abstract":"Understanding physician remuneration and its growth is extremely complex, much more so than for a typical worker. Highlighting one narrow aspect of this issue, this paper focuses on governments' increased incentives for physicians to incorporate and the ensuing physician response in the period 1996-2011. Nationally, incorporation rates increased for both general practitioners and specialists between 1996 and 2011. We observe that the largest changes in provincial regulation were in Ontario, and incorporation increased from 18% in 2001 to 54% five years later. Incorporation is less common in Quebec, where the incentives were the weakest. Married male physicians, middle-aged physicians (regardless of sex), physicians with higher incomes and physicians born outside of Canada are all more likely to incorporate their practices. On average, incorporated physicians realized a 4% reduction in personal income taxes and accumulated retained earnings of at least $10,000 per annum in their Canadian-controlled private corporations in our data period. The benefits of incorporation stem largely from retained earnings and income splitting. Many physicians benefit from one or both; however, the benefits of incorporation are not equally distributed. Sex, marital status and income affect the magnitude of the financial benefit of incorporation.","PeriodicalId":35522,"journal":{"name":"Healthcare Papers","volume":"17 4","pages":"77-86"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36562685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Doctors and Canadian Medicare: Improving Accountability and Performance. 医生和加拿大医疗保险:改进问责制和绩效。

Healthcare Papers Pub Date : 2018-04-01 DOI: 10.12927/hcpap.2018.25580

Gregory P Marchildon, Michael Sherar

引用次数: 2