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Commentary: Which Principles Should Apply for a National Strategy on Rare Diseases? 评论：国家罕见病战略应适用哪些原则？
Healthcare Policy Pub Date : 2024-08-01 DOI: 10.12927/hcpol.2024.27353
Marc-AndrÉ Gagnon
{"title":"Commentary: Which Principles Should Apply for a National Strategy on Rare Diseases?","authors":"Marc-AndrÉ Gagnon","doi":"10.12927/hcpol.2024.27353","DOIUrl":"10.12927/hcpol.2024.27353","url":null,"abstract":"<p><p>Lexchin and Sirrs (2024) proposed five relevant principles to guide the use of federal funding for expensive drugs for rare diseases, including funding of outcomes-based risk-sharing agreements (OBRSAs) and proactive commitment and participation in the generation of high-quality evidence in a transparent way. This rejoinder, however, questions whether the federal funding should be used only to buy new drugs or whether it could be used to develop new drugs as well. It also examines what OBRSAs would require in terms of institutional capacities to allow the collection of real-world evidence.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 4","pages":"27-31"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126833","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
Reasons for High Emergency Department Use Among Patients With Common Mental Disorders or Substance-Related Disorders. 常见精神障碍或药物相关障碍患者大量使用急诊科的原因。
Healthcare Policy Pub Date : 2024-08-01 DOI: 10.12927/hcpol.2024.27333
Karine-MichÈle Dion, Francine Ferland, Lambert Farand, Lise Gauvin, Marie-JosÉe Fleury
{"title":"Reasons for High Emergency Department Use Among Patients With Common Mental Disorders or Substance-Related Disorders.","authors":"Karine-MichÈle Dion, Francine Ferland, Lambert Farand, Lise Gauvin, Marie-JosÉe Fleury","doi":"10.12927/hcpol.2024.27333","DOIUrl":"10.12927/hcpol.2024.27333","url":null,"abstract":"<p><strong>Aims: </strong>This study examined the reasons for high emergency department (ED) use among patients with common mental disorders (MDs), substance-related disorders (SRDs) or co-occurring MDs-SRDs.</p><p><strong>Method: </strong>Following content analysis, 42 high ED users (three-plus visits/year) recruited in two Quebec EDs were interviewed.</p><p><strong>Results: </strong>The reasons included barriers to outpatient care, patient disabilities and professional practices. Patients with SRDs trust outpatient services less, those with MDs had important unmet needs and those with MDs-SRDs faced care coordination issues.</p><p><strong>Conclusion: </strong>Improvements such as ED use monitoring, consolidating MD-SRD practices and continuous training are needed in EDs and outpatient services to enhance access and continuity of care.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 4","pages":"55-69"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126891","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
Quality of Work Life and Mental Well-Being for Long-Term Care Staff in Nova Scotia. 新斯科舍省长期护理人员的工作生活质量和心理健康。
Healthcare Policy Pub Date : 2024-08-01 DOI: 10.12927/hcpol.2024.27348
Janice M Keefe, Amber Duynisveld, Susan Stevens, Carole Estabrooks
{"title":"Quality of Work Life and Mental Well-Being for Long-Term Care Staff in Nova Scotia.","authors":"Janice M Keefe, Amber Duynisveld, Susan Stevens, Carole Estabrooks","doi":"10.12927/hcpol.2024.27348","DOIUrl":"10.12927/hcpol.2024.27348","url":null,"abstract":"<p><p>This study assesses the quality of work life for Nova Scotian continuing care assistants (CCAs) (<i>n</i> = 266), nurses (<i>n</i> = 144) and managers (<i>n</i> = 45) from 10 long-term care (LTC) homes in late 2021. CCAs scored significantly worse than nurses and managers on measures of mental health and anxiety. All groups reported high levels of cynicism and emotional exhaustion; CCAs' scores were higher than nurses or managers. CCAs scored significantly higher on professional efficacy than other groups. CCAs can derive a strong sense of accomplishment from their work, but results raise concerns of a potential breaking point. This suggests the need for continued action to support LTC staff.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 4","pages":"32-41"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126890","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
Changes in Primary Care Health Services During the COVID-19 Pandemic: A Longitudinal Analysis of Data From Ontario. COVID-19 大流行期间初级保健服务的变化：安大略省数据纵向分析。
Healthcare Policy Pub Date : 2024-08-01 DOI: 10.12927/hcpol.2024.27362
Onlak Ruangsomboon, Adrina Zhong, Alexander Kopp, Beth Elston, Kirsten Eldridge, Samantha Lee, Erin Plenert, Andrew D Pinto, Richard H Glazier, Tara Kiran
{"title":"Changes in Primary Care Health Services During the COVID-19 Pandemic: A Longitudinal Analysis of Data From Ontario.","authors":"Onlak Ruangsomboon, Adrina Zhong, Alexander Kopp, Beth Elston, Kirsten Eldridge, Samantha Lee, Erin Plenert, Andrew D Pinto, Richard H Glazier, Tara Kiran","doi":"10.12927/hcpol.2024.27362","DOIUrl":"10.12927/hcpol.2024.27362","url":null,"abstract":"<p><p>The COVID-19 pandemic significantly impacted primary care, but its effect on quality of care is not well understood. We used health administrative data to understand the changes in quality-of-care measures for primary care between October 2018 and April 2022. We examined the following domains: cancer screening, chronic disease (diabetes) management, high-risk prescribing, continuity of care and capacity of primary care services. Colorectal and breast cancer screenings declined after the pandemic and had not returned to baseline by study end. In patients living with diabetes, in-person visits and up-to-date retinopathy screening rates declined after the pandemic declaration and did not return to baseline by study end, while statin prescribing remained stable. High-risk opioid prescribing decreased over time and was not affected by the pandemic. Physician continuity remained stable, though new patient enrollments decreased over the pandemic but returned to baseline by study end. Existing disparities in colorectal cancer screening by income and recent registration widened during the pandemic. In summary, COVID-19 had a variable impact on primary care, with the strongest influence on preventive and chronic disease care that was dependent on in-person visits.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 4","pages":"42-54"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126832","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
How Good Reforms Fail: The Warning Example of Alberta's Borderless EMS System. 好的改革是如何失败的：阿尔伯塔省无国界医疗服务系统的警示例子。
Healthcare Policy Pub Date : 2024-08-01 DOI: 10.12927/hcpol.2024.27476
Janna Newton, Travis Carpenter, Jennifer Zwicker
{"title":"How Good Reforms Fail: The Warning Example of Alberta's Borderless EMS System.","authors":"Janna Newton, Travis Carpenter, Jennifer Zwicker","doi":"10.12927/hcpol.2024.27476","DOIUrl":"10.12927/hcpol.2024.27476","url":null,"abstract":"<p><p>When ill, many Albertans' first interaction with their healthcare system is Alberta's centralized emergency medical services (EMS) system operated by Alberta Health Services (AHS). The media has become saturated with articles articulating concerns about lagging response time, limited ambulance availability and poor work conditions. As Alberta undergoes restructuring of the EMS system by Alberta Health and AHS, there are lessons to be learned from prior EMS restructuring. It is crucial that front-line paramedics are heard and their concerns addressed regarding implemented policies. Several policy recommendations focus on optimizing operations and improving the working environment for paramedics in the long term.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 1","pages":"47-54"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494116","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: Reducing the Mortality Gap for the Mentally Ill - Rethinking How and Where We Provide Care. 评论：减少精神疾病的死亡率差距-重新思考我们如何和在哪里提供护理。
Healthcare Policy Pub Date : 2024-08-01 DOI: 10.12927/hcpol.2024.27482
Nick Kates
{"title":"Commentary: Reducing the Mortality Gap for the Mentally Ill - Rethinking How and Where We Provide Care.","authors":"Nick Kates","doi":"10.12927/hcpol.2024.27482","DOIUrl":"10.12927/hcpol.2024.27482","url":null,"abstract":"<p><p>The mortality gap faced by Canadians living with a severe and persistent mental illness is a national scandal. If we are to change this and take advantage of the possibilities that <i>reverse integration</i> presents, we need to rethink the ways our systems of care function and remove barriers to accessing care while tapping the full potential of collaborative partnerships, moving to earlier interventions with this population and integrating poverty reduction into all our work. Above all, we need to be much more effective in bringing these issues into the public discourse.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 1","pages":"29-33"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494110","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
Whose Accountability Matters in Long-Term Care? 谁的责任在长期护理中重要？
Healthcare Policy Pub Date : 2024-08-01 DOI: 10.12927/hcpol.2024.27420
Michaella Miller, Ellen Maceachen
{"title":"Whose Accountability Matters in Long-Term Care?","authors":"Michaella Miller, Ellen Maceachen","doi":"10.12927/hcpol.2024.27420","DOIUrl":"10.12927/hcpol.2024.27420","url":null,"abstract":"<p><p>In response to quality issues within the long-term care (LTC) sector, the Government of Ontario implemented the <i>Fixing Long-Term Care Act,</i> 2021, and updated accountability and compliance measures, including doubling fines for non-compliance and investing in 193 new inspectors. However, enforcement tactics and inspection regimes may contribute to harm and neglect the root issues within the sector. Fines for non-compliance may create catch-22 situations in which homes lack the funds to fix the root issues. Governments also dictate and determine much of the resource allocation within the LTC sector. Accountability and quality improvement should involve addressing performance problems as a system.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 1","pages":"34-40"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494120","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
Are Small Teams a Viable Strategy to Deliver Early Psychosis Intervention Services in Rural Areas? An Ontario Fidelity Study. 小团队是在农村地区提供早期精神病干预服务的可行策略吗？安大略省的一项忠诚研究。
Healthcare Policy Pub Date : 2024-08-01 DOI: 10.12927/hcpol.2024.27421
Avra Selick, Gordon Langill, Sandy Brooks, Janet Durbin
{"title":"Are Small Teams a Viable Strategy to Deliver Early Psychosis Intervention Services in Rural Areas? An Ontario Fidelity Study.","authors":"Avra Selick, Gordon Langill, Sandy Brooks, Janet Durbin","doi":"10.12927/hcpol.2024.27421","DOIUrl":"10.12927/hcpol.2024.27421","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 1","pages":"59-68"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494107","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: The Canadian Healthcare Crisis and the Emerging Role of Paramedicine. 评论：加拿大医疗保健危机和辅助医学的新兴作用。
Healthcare Policy Pub Date : 2024-08-01 DOI: 10.12927/hcpol.2024.27484
Michael Feldman, Donald L Pierce
{"title":"Commentary: The Canadian Healthcare Crisis and the Emerging Role of Paramedicine.","authors":"Michael Feldman, Donald L Pierce","doi":"10.12927/hcpol.2024.27484","DOIUrl":"10.12927/hcpol.2024.27484","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 1","pages":"55-58"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494112","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
Implementing Active Offer of Services in Both Official Languages in a Hospital Setting in Ontario. 在安大略省的一家医院环境中以两种官方语言积极提供服务。
Healthcare Policy Pub Date : 2024-08-01 DOI: 10.12927/hcpol.2024.27485
Katrine Sauvé-Schenk, Jacinthe Savard, François Durand
{"title":"Implementing Active Offer of Services in Both Official Languages in a Hospital Setting in Ontario.","authors":"Katrine Sauvé-Schenk, Jacinthe Savard, François Durand","doi":"10.12927/hcpol.2024.27485","DOIUrl":"10.12927/hcpol.2024.27485","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 1","pages":"69-81"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504085","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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