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Value in Primary Care: Evidence from the Canadian Primary Care Sentinel Surveillance Network. 初级保健的价值:来自加拿大初级保健哨点监测网络的证据。
Healthcare Policy Pub Date : 2023-05-01 DOI: 10.12927/hcpol.2023.27093
Sabrina T Wong, Rachael Morkem, Ayat Salman, David Barber, Jerome A Leis
{"title":"Value in Primary Care: Evidence from the Canadian Primary Care Sentinel Surveillance Network.","authors":"Sabrina T Wong,&nbsp;Rachael Morkem,&nbsp;Ayat Salman,&nbsp;David Barber,&nbsp;Jerome A Leis","doi":"10.12927/hcpol.2023.27093","DOIUrl":"https://doi.org/10.12927/hcpol.2023.27093","url":null,"abstract":"<p><p>Primary care antimicrobial stewardship programs are virtually non-existent. Using electronic medical record (EMR) data for an interrupted time series study, the authors examined the relationship between antibiotic prescriptions for acute respiratory tract infections (RTIs) and the COVID-19 pandemic. The main outcome of the study was to gauge the proportion of RTI encounters with an antibiotic prescription. The pre-pandemic RTI antibiotic prescribing rate was 27.8%. During the COVID-19 pandemic, prescribing dropped significantly by 9.4% (<i>p</i> < 0.001). Almost 750,000 fewer patients could potentially avoid receiving an antibiotic prescription for RTI. The authors also discuss the value of EMR data; their use can help develop insights for health system improvement.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"18 4","pages":"57-71"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dd/89/policy-18-057.PMC10370397.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9890399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Value-Based Healthcare: Is It Just Another Buzzword? 基于价值的医疗保健:这只是另一个流行语吗?
Healthcare Policy Pub Date : 2023-05-01 DOI: 10.12927/hcpol.2023.27096
Fiona Clement
{"title":"Value-Based Healthcare: Is It Just Another Buzzword?","authors":"Fiona Clement","doi":"10.12927/hcpol.2023.27096","DOIUrl":"https://doi.org/10.12927/hcpol.2023.27096","url":null,"abstract":"<p><p>The concept of value-based healthcare has been gaining traction, with several issues of <i>Healthcare Policy</i> discussing the agenda and highlighting pockets of excellence. However, we currently have no shared common goal that would define value-based healthcare. Furthermore, we have major limitations in measuring both the cost and benefit components of the concept of value, irrespective of the definition. It is time to make progress, which will include a recognition of the need to engage the public in a discussion around the values of the Canadian healthcare system and the federal government taking a hands-on role for the accountability of value as an outcome.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"18 4","pages":"18-25"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/15/policy-18-018.PMC10370400.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9890400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of Electronic Medical Record Data to Create a Dashboard on Access to Primary Care. 使用电子病历数据创建获得初级保健的指示板。
Healthcare Policy Pub Date : 2023-05-01 DOI: 10.12927/hcpol.2023.27092
Mylaine Breton, Isabelle Gaboury, François Bordeleau, Catherine Lamoureux-Lamarche, Élisabeth Martin, Véronique Deslauriers, Jean-Benoît Deville-Stoetzel
{"title":"Use of Electronic Medical Record Data to Create a Dashboard on Access to Primary Care.","authors":"Mylaine Breton,&nbsp;Isabelle Gaboury,&nbsp;François Bordeleau,&nbsp;Catherine Lamoureux-Lamarche,&nbsp;Élisabeth Martin,&nbsp;Véronique Deslauriers,&nbsp;Jean-Benoît Deville-Stoetzel","doi":"10.12927/hcpol.2023.27092","DOIUrl":"https://doi.org/10.12927/hcpol.2023.27092","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to present a proof of concept of a dashboard on a set of indicators of access to primary healthcare (PHC) based on electronic medical records (EMRs).</p><p><strong>Methods: </strong>This research builds on a multi-method design study including (1) a systematic review, (2) a pilot phase and (3) the development of a dashboard.</p><p><strong>Results: </strong>Eight indicators were carefully selected and successfully extracted from EMRs obtained from 151 PHC providers. Indicators of access over time, as well as among providers and among clinics, have been enabled in the dashboard.</p><p><strong>Conclusion: </strong>EMR data enabled the development of a real-time dashboard on access, giving PHC providers a reliable portrait of their own practice, its evolution over time and how it compares with those of their peers.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"18 4","pages":"72-88"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/64/92/policy-18-072.PMC10370395.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9890402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Problem of Money and Health: The Need for Value in Healthcare. 金钱与健康的问题：医疗保健需要价值。
Healthcare Policy Pub Date : 2023-05-01 DOI: 10.12927/hcpol.2023.27097
Jason M Sutherland
{"title":"A Problem of Money and Health: The Need for Value in Healthcare.","authors":"Jason M Sutherland","doi":"10.12927/hcpol.2023.27097","DOIUrl":"10.12927/hcpol.2023.27097","url":null,"abstract":"<p><p>Almost ten years ago, on june 5, 2013, jeffrey simpson of the globe and mail wrote that more money was not the answer to reducing wait times for elective surgery (Simpson 2013). The editorial's text described the billions that had been spent by provinces through the federal Wait Times Reduction Fund to supply more surgeries and that meaningful progress on surgical wait times was still lacking.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"18 4","pages":"8-17"},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10370392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9895629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Provinces and Territories Are Overdue for an Update in Healthcare Funding Policies. 各省和地区早该更新医疗保健资助政策。
Healthcare Policy Pub Date : 2023-02-01 DOI: 10.12927/hcpol.2023.27039
Jason M Sutherland
{"title":"Provinces and Territories Are Overdue for an Update in Healthcare Funding Policies.","authors":"Jason M Sutherland","doi":"10.12927/hcpol.2023.27039","DOIUrl":"https://doi.org/10.12927/hcpol.2023.27039","url":null,"abstract":"<p><p>Even before the recent funding announcement, the provinces had money earmarked for spending on health services, therapies and devices. Canadians expect that this money will be put to work to improve access to scheduled services and emergency care, to increase capacity of primary care to manage complex conditions and to begin the assembly of patients' health information. This does not represent an exhaustive list as most provinces also have other pressing needs, including access to and quality of long-term care and mental healthcare services.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"18 3","pages":"6-16"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/7c/policy-18-006.PMC10019515.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9225539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nursing Home Residents' Use of Radiography in New Brunswick: A Case for Mobile Radiography? 新不伦瑞克省养老院居民使用放射摄影的情况：移动式放射摄影的案例？
Healthcare Policy Pub Date : 2023-02-01 DOI: 10.12927/hcpol.2023.27036
Eric Plant, Rose Mccloskey, Isdore Chola Shamputa, Kavish Chandra, Paul Atkinson, Jacqueline Fraser, Tushar Pishe, Patrick Price
{"title":"Nursing Home Residents' Use of Radiography in New Brunswick: A Case for Mobile Radiography?","authors":"Eric Plant, Rose Mccloskey, Isdore Chola Shamputa, Kavish Chandra, Paul Atkinson, Jacqueline Fraser, Tushar Pishe, Patrick Price","doi":"10.12927/hcpol.2023.27036","DOIUrl":"10.12927/hcpol.2023.27036","url":null,"abstract":"<p><strong>Introduction: </strong>Identifying ways to eliminate unnecessary transfer of nursing home (NH) residents to hospitals provides an opportunity to improve outcomes and use scarce healthcare resources more efficiently. This study's goal was to better understand where NH residents access X-ray (XR) and computed tomography (CT) scans and to determine if there was a case for mobile radiography policies in New Brunswick.</p><p><strong>Methods: </strong>A retrospective analysis of all the visits to the emergency department (ED) and outpatient imaging departments in two hospitals in Saint John, New Brunswick, in 2020, that involved XR or CT investigations was conducted.</p><p><strong>Results: </strong>There were 521 visits by 311 unique NH residents and 920 investigations (688 XR and 232 CT scans). Most investigations were ordered in the ED (696 of 920; 75.6%; confidence interval: 72.8-78.3%). Of the NH residents who visited the ED and received either an XR or a CT scan, 33.2% received only XR imaging and were discharged back to the NH after a mean ED stay of 5.15 hours.</p><p><strong>Discussion: </strong>The pattern of NH residents' use of the ED for their imaging needs supports the creation of mobile XR policies to deliver more safe and efficient care in a Canadian medium population urban centre.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"18 3","pages":"31-46"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10019512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multinational Pharmaceutical Companies Shortchange Canada in Research and Development Investments: Is It Time to Pursue Other Options? 跨国制药公司在研发投资上欺骗加拿大:是时候寻求其他选择了吗?
Healthcare Policy Pub Date : 2023-02-01 DOI: 10.12927/hcpol.2023.27038
Shoo K Lee, Sukhy K Mahl, Jessica J Green, Joel Lexchin
{"title":"Multinational Pharmaceutical Companies Shortchange Canada in Research and Development Investments: Is It Time to Pursue Other Options?","authors":"Shoo K Lee,&nbsp;Sukhy K Mahl,&nbsp;Jessica J Green,&nbsp;Joel Lexchin","doi":"10.12927/hcpol.2023.27038","DOIUrl":"https://doi.org/10.12927/hcpol.2023.27038","url":null,"abstract":"<p><p>In 1987, the government passed legislation to protect brand-name pharmaceutical firms against competition from generic drug brands in exchange for economic investment in Canadian pharmaceutical research and development (R&D). Since 2002, brand-name pharmaceutical companies' R&D investments have fallen short of their commitment, while Canadians now pay the fourth highest drug prices of all the Organisation for Economic Co-operation and Development member countries. In this article, we examine the degree to which brand-name pharmaceutical companies have fallen short of their promises, discuss whether a patent policy is the best strategy to secure Canadian pharmaceutical R&D funding and propose practical alternatives to this arrangement.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"18 3","pages":"17-24"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/36/f0/policy-18-017.PMC10019517.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Pharmacist Disciplinary Action: What Do Pharmacists Get in Trouble for? 药剂师纪律处分：药剂师会因为什么惹上麻烦？
Healthcare Policy Pub Date : 2023-02-01 DOI: 10.12927/hcpol.2023.27034
Ai-Leng Foong-Reichert, Kelly A Grindrod, David J Edwards, Zubin Austin, Sherilyn K D Houle
{"title":"Pharmacist Disciplinary Action: What Do Pharmacists Get in Trouble for?","authors":"Ai-Leng Foong-Reichert, Kelly A Grindrod, David J Edwards, Zubin Austin, Sherilyn K D Houle","doi":"10.12927/hcpol.2023.27034","DOIUrl":"10.12927/hcpol.2023.27034","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to determine the reasons for disciplinary action and resultant consequences for Canadian pharmacists and any associations with demographic factors.</p><p><strong>Methods: </strong>Regulatory body disciplinary action cases from 10 Canadian provinces were coded. Demographic information was coded.</p><p><strong>Results: </strong>There were 665 pharmacist cases from nine provinces between January 2010 and December 2020. The rate of disciplinary action was low (1.37 cases/1,000 practitioners/year). Professional misconduct was the most common category of violation. Male pharmacists were overrepresented in disciplinary action cases. Most cases involved community pharmacists.</p><p><strong>Conclusion: </strong>This study is the first, to our knowledge, in Canada to analyze the demographic factors of pharmacists subjected to disciplinary action. It updates a previous review of pharmacist disciplinary action (Foong et al. 2018).</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"18 3","pages":"60-71"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10019516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Commentary: Reconsidering Pharmaceutical Research and Development Investments. 评论:重新考虑药物研发投资。
Healthcare Policy Pub Date : 2023-02-01 DOI: 10.12927/hcpol.2023.27037
Marc-André Gagnon
{"title":"Commentary: Reconsidering Pharmaceutical Research and Development Investments.","authors":"Marc-André Gagnon","doi":"10.12927/hcpol.2023.27037","DOIUrl":"https://doi.org/10.12927/hcpol.2023.27037","url":null,"abstract":"<p><p>Following Lee and colleagues' (2023) article explaining how Canadians are being shortchanged by drug companies when it comes to investments in research and development (R&D), this rejoinder adds context and appends two other very problematic elements in the debate between wishful narratives over the industry's contribution in R&D and actual numbers. First, even the current stricter definition of R&D investment might simply be too large considering that elements such as seeding trials - a well-known marketing device - can be accounted for as R&D expenditures. Second, this rejoinder identifies how Statistics Canada acted in concert with Innovative Medicines Canada to reinforce the industry's preferred narratives around R&D expenditures. This situation puts into question the trustworthiness of Canada's statistical agency.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"18 3","pages":"25-30"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/46/c4/policy-18-025.PMC10019513.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9225540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Dentist Disciplinary Action: What Do Dentists Get in Trouble for? 牙医纪律处分：牙医会因为什么惹上麻烦？
Healthcare Policy Pub Date : 2023-02-01 DOI: 10.12927/hcpol.2023.27033
Ai-Leng Foong-Reichert, Sherilyn K D Houle, Zubin Austin, David J Edwards, Kelly A Grindrod
{"title":"Dentist Disciplinary Action: What Do Dentists Get in Trouble for?","authors":"Ai-Leng Foong-Reichert, Sherilyn K D Houle, Zubin Austin, David J Edwards, Kelly A Grindrod","doi":"10.12927/hcpol.2023.27033","DOIUrl":"10.12927/hcpol.2023.27033","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to determine the reasons for disciplinary action, the consequences and any associations with demographic factors for Canadian dentists.</p><p><strong>Methods: </strong>Publicly available regulatory body disciplinary action cases from 10 Canadian provinces were coded. Demographic factors were also coded.</p><p><strong>Results: </strong>There were 344 dentist cases from five provinces between January 2010 and December 2020. The rate of disciplinary action was low (1.38 cases/1,000 practitioners/year). Clinical incompetence was the most common category of disciplinary action, followed by professional misconduct and dishonest business practices. Male dentists were overrepresented in the disciplinary action cases compared to the rest of the workforce.</p><p><strong>Conclusion: </strong>This study is the first, to our knowledge, to describe the outcomes of regulatory body disciplinary action for Canadian dentists.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"18 3","pages":"72-83"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10019511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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