Healthcare PolicyPub Date : 2025-11-01DOI: 10.12927/hcpol.2025.27692
Shoo K Lee, Scott Mcleod, Brian H Rowe, Sukhy K Mahl
{"title":"Canada's Primary Healthcare Crisis - How Can We Fix It?","authors":"Shoo K Lee, Scott Mcleod, Brian H Rowe, Sukhy K Mahl","doi":"10.12927/hcpol.2025.27692","DOIUrl":"10.12927/hcpol.2025.27692","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"21 1","pages":"32-43"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12782352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783210","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}
Healthcare PolicyPub Date : 2025-11-01DOI: 10.12927/hcpol.2025.27621
Lucie Richard
{"title":"Opportunities to Enhance Coding of Homelessness in Canadian Hospital Administrative Data.","authors":"Lucie Richard","doi":"10.12927/hcpol.2025.27621","DOIUrl":"10.12927/hcpol.2025.27621","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"21 1","pages":"19-27"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12782354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783225","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}
Healthcare PolicyPub Date : 2025-11-01DOI: 10.12927/hcpol.2025.27741
Amrit Thandi, Dennis B Campbell, David J T Campbell, Anita Quach, Charlene Mo, Dana Lee Olstad, Eldon Spackman, Reed F Beall
{"title":"Healthy Grocery Shopping Incentives in Canada: A Survey of How, How Much, and How Often.","authors":"Amrit Thandi, Dennis B Campbell, David J T Campbell, Anita Quach, Charlene Mo, Dana Lee Olstad, Eldon Spackman, Reed F Beall","doi":"10.12927/hcpol.2025.27741","DOIUrl":"10.12927/hcpol.2025.27741","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"21 1","pages":"52-71"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12782356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783147","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}
Healthcare PolicyPub Date : 2025-08-01DOI: 10.12927/hcpol.2025.27622
Christoph Schimmele, Feng Hou
{"title":"Employment in the Canadian Medical Profession by Immigrant Status, Racialized Group and Gender.","authors":"Christoph Schimmele, Feng Hou","doi":"10.12927/hcpol.2025.27622","DOIUrl":"10.12927/hcpol.2025.27622","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 4","pages":"33-40"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087470","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}
Healthcare PolicyPub Date : 2025-08-01DOI: 10.12927/hcpol.2025.27664
François Gallant, Lise Babin, James Ted Mcdonald
{"title":"Healthcare Access Gaps Persist for French-Preferring Citizens in Canada's Only Officially Bilingual Province: Analysis of New Brunswick Patient Care Experience Survey Data.","authors":"François Gallant, Lise Babin, James Ted Mcdonald","doi":"10.12927/hcpol.2025.27664","DOIUrl":"10.12927/hcpol.2025.27664","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 4","pages":"48-56"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087644","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}
Healthcare PolicyPub Date : 2025-08-01DOI: 10.12927/hcpol.2025.27665
Douglas Clark
{"title":"Access, Value and Reform: An Analysis of Canada's Pharmaceutical Policy Framework.","authors":"Douglas Clark","doi":"10.12927/hcpol.2025.27665","DOIUrl":"10.12927/hcpol.2025.27665","url":null,"abstract":"<p><p>This is a rejoinder to an article challenging the pharmaceutical industry's claims that Canada lags in access to innovative drugs due to substandard policies. This rejoinder is in agreement with the article's main argument that Canada succeeds in attracting the new drugs that matter most, and that higher prices or stronger intellectual property protection would have a negligible impact on the timing and degree to which new drugs are launched here generally. At the same time, the rejoinder does acknowledge the legitimacy of the industry's concerns around system inefficiencies stemming from federal-provincial fragmentation but posits that national pharmacare could resolve industry and payer concerns alike. The article calls for thoughtful reform, deeper research into unmet needs and a shift in focus toward patient-relevant outcomes.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 4","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087754","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}
Healthcare PolicyPub Date : 2025-08-01DOI: 10.12927/hcpol.2025.27667
Michael Pervan, Jason M Sutherland
{"title":"The Opportunity for Canada and Australia to Learn From One Another's Health Systems.","authors":"Michael Pervan, Jason M Sutherland","doi":"10.12927/hcpol.2025.27667","DOIUrl":"10.12927/hcpol.2025.27667","url":null,"abstract":"<p><p>Provincial healthcare systems are experiencing significant challenges in providing timely access to publicly funded healthcare. The population is aging, increasingly comorbid (Naik et al. 2024), immigration is high (Government of Canada 2024) and public investment in additional healthcare services has not kept pace (CIHI 2024). Meanwhile, challenges to publicly funded healthcare delivery continue to mount; private and for-profit providers are making significant inroads in some provinces and eroding equity of access (Quesnel-Vallée et al. 2020). Canadians are increasingly skeptical that public administration of healthcare is affordable, accessible, effective or efficient.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 4","pages":"6-20"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087647","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}
Healthcare PolicyPub Date : 2025-08-01DOI: 10.12927/hcpol.2025.27620
Angel Ruhil, Mina Alizadehsadrdaneshpour, Turjoy Ghose, Eric Nauenberg
{"title":"Virtual Care: Evidence From the Pandemic Regarding Changes in Access to Psychiatric Care in Canada.","authors":"Angel Ruhil, Mina Alizadehsadrdaneshpour, Turjoy Ghose, Eric Nauenberg","doi":"10.12927/hcpol.2025.27620","DOIUrl":"10.12927/hcpol.2025.27620","url":null,"abstract":"<p><p>The COVID-19 pandemic disrupted access to clinical services, prompting an easing of restrictions on accessing care virtually. While virtual care can substantially differ from in-person care in most specialties, this is minimally true of psychiatry, making it ideal for examining the impact of virtual delivery on access. This paper shows that those already facing access barriers faced new ones during the pandemic. The findings - based on Canadian Institute for Health Information data - highlight disparities in mental healthcare access for low-income individuals, children and adolescents, seniors and rural communities. Moreover, increased access for more patients came at the expense of fewer services per patient.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 4","pages":"41-47"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087639","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}
Healthcare PolicyPub Date : 2025-08-01DOI: 10.12927/hcpol.2025.27666
Joel Lexchin
{"title":"Are Therapeutically Important Drugs No Longer Available in Canada?","authors":"Joel Lexchin","doi":"10.12927/hcpol.2025.27666","DOIUrl":"10.12927/hcpol.2025.27666","url":null,"abstract":"<p><p>The pharmaceutical industry and its allies often claim that various aspects of Canadian pharmaceutical policy result in new drugs not being introduced into the Canadian market. These arguments ignore international evidence that shows that only a minority of new drugs offer major therapeutic gains. A corollary to the industry's message is the threat that new drugs will not be made available if governments or regulatory agencies introduce measures that threaten the profits of pharmaceutical companies. The government should not be intimidated by these threats and should continue to take actions that increase accessibility to necessary medications for all residents of Canada.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 4","pages":"21-28"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087729","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}
Healthcare PolicyPub Date : 2025-08-01DOI: 10.12927/hcpol.2025.27663
Stephanie Garies, Dewdunee Himasara Pathiraja, Kerry A Mcbrien, James A Dickinson, Noah Crampton, Cathy A Eastwood, Danielle A Southern, Kees Van Boven, Huib Ten Napel, Maeve O'beirne, Alexander Singer, Olawunmi Olagundoye, Keith Denny, David J T Campbell, Terrence Mcdonald, Neil Drummond, Hude Quan, Aimie Lee, Michelle Smekal, William A Ghali, Rubee Dev, Tyler Williamson
{"title":"Canadian Family Physician Preferences on Updating the Classification System for Health Conditions and Related Issues.","authors":"Stephanie Garies, Dewdunee Himasara Pathiraja, Kerry A Mcbrien, James A Dickinson, Noah Crampton, Cathy A Eastwood, Danielle A Southern, Kees Van Boven, Huib Ten Napel, Maeve O'beirne, Alexander Singer, Olawunmi Olagundoye, Keith Denny, David J T Campbell, Terrence Mcdonald, Neil Drummond, Hude Quan, Aimie Lee, Michelle Smekal, William A Ghali, Rubee Dev, Tyler Williamson","doi":"10.12927/hcpol.2025.27663","DOIUrl":"10.12927/hcpol.2025.27663","url":null,"abstract":"<p><p>Physician billing claims are used to inform health system planning and for other secondary purposes. In most provinces/territories, diagnoses are coded using a system adopted in 1979, the International Classification of Diseases version 9 (ICD-9). This study aimed to understand the perspectives of family physicians on updating ICD-9. Canadian family physicians completed an online patient vignette coding exercise and electronic survey to capture preferences on two newer coding systems (ICD-11; International Classification for Primary Care version 3 [ICPC-3]), compared with the current ICD-9 system. The focus of this paper is the survey data, which were analyzed descriptively. One hundred and sixty-one family physicians from six provinces participated. Over half of them (58%) stated that ICD-9 should be replaced, and 86% of them felt confident learning a new coding system. After the coding exercise, most participants reported that they were very or somewhat satisfied with both newer systems (77% for ICD-11; 73% for ICPC-3). Family physicians in our study support replacing the outdated ICD-9 system to better reflect their workload and patient complexity. This paper provides recommendations for provinces/territories considering modernizing physician billing requirements.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 4","pages":"57-69"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087439","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}