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Rural-Urban Differences in Healthcare Use in Persons With Dementia Between 2000 and 2019: A Quebec Population-Based Study. 2000 年至 2019 年痴呆症患者使用医疗服务的城乡差异：一项基于魁北克人口的研究。
Healthcare Policy Pub Date : 2024-02-01 DOI: 10.12927/hcpol.2024.27281
Geneviève Arsenault-Lapierre, Claire Godard-Sebillotte, Tammy Bui, Nadia Sourial, Louis Rochette, Victoria Massamba, Caroline Sirois, Julie Kosteniuk, Debra Morgan, Amélie Quesnel-Vallée, Isabelle Vedel
{"title":"Rural-Urban Differences in Healthcare Use in Persons With Dementia Between 2000 and 2019: A Quebec Population-Based Study.","authors":"Geneviève Arsenault-Lapierre, Claire Godard-Sebillotte, Tammy Bui, Nadia Sourial, Louis Rochette, Victoria Massamba, Caroline Sirois, Julie Kosteniuk, Debra Morgan, Amélie Quesnel-Vallée, Isabelle Vedel","doi":"10.12927/hcpol.2024.27281","DOIUrl":"10.12927/hcpol.2024.27281","url":null,"abstract":"<p><strong>Background: </strong>Rural persons with dementia face medical services gaps. This study compares the health service utilization of rural and urban community-dwelling individuals with incident dementia.</p><p><strong>Methods: </strong>This study used a repeated annual cross-sectional cohort design spanning a period from 2000 to 2019 analyzing age-adjusted rates for 20 indicators of service use and mortality one year after diagnosis in Quebec administrative databases.</p><p><strong>Results: </strong>Of 237,259 persons, 20.1% were rural. Most rural persons had more emergency department visits and hospitalizations, shorter stays, less alternate level of care and fewer family physicians' and cognition specialists' visits. All groups had similar long-term care and mortality rates.</p><p><strong>Conclusion: </strong>Policy implications of these disparities are discussed.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 3","pages":"78-95"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892663","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
Five Years After Cannabis Legalization, Is It Time to Ease Restrictions on Promotion? 大麻合法化五年后，是否到了放松促销限制的时候？
Healthcare Policy Pub Date : 2024-02-01 DOI: 10.12927/hcpol.2024.27241
Jean-François Crépault, Sergio Rueda, Victor Tang
{"title":"Five Years After Cannabis Legalization, Is It Time to Ease Restrictions on Promotion?","authors":"Jean-François Crépault, Sergio Rueda, Victor Tang","doi":"10.12927/hcpol.2024.27241","DOIUrl":"10.12927/hcpol.2024.27241","url":null,"abstract":"<p><p>In the spring of 2024, the federal government is expected to report on its legislative review of the <i>Cannabis Act</i> (2018). One of the most contentious issues is whether to relax restrictions on cannabis promotion. This commentary describes the tension between the public health aims of legalization and the secondary aim of displacing the illicit market. We maintain that among jurisdictions that have legalized cannabis, Canada stands out as having the stated primary objective of safeguarding public health, and its restrictions on promotion are evidence-based and innovative. These measures must be preserved, even in the face of growing industry pressure to loosen them.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 3","pages":"21-28"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892619","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
Methadone Prescribing Regulation for Opioid Use Disorder in Canada: Evidence for an East-West Policy Divide. 加拿大针对阿片类药物使用障碍的美沙酮处方条例：东西方政策分歧的证据》。
Healthcare Policy Pub Date : 2024-02-01 DOI: 10.12927/hcpol.2024.27228
Chloe Campbell, Kellia Chiu, Abhimanyu Sud
{"title":"Methadone Prescribing Regulation for Opioid Use Disorder in Canada: Evidence for an East-West Policy Divide.","authors":"Chloe Campbell, Kellia Chiu, Abhimanyu Sud","doi":"10.12927/hcpol.2024.27228","DOIUrl":"10.12927/hcpol.2024.27228","url":null,"abstract":"<p><p>Opioid agonist therapy (OAT) is a key element in the response to opioid-related harms in Canada. In May 2018, Health Canada rescinded the requirement for obtaining a federal exemption for methadone prescribing. This comparative analysis examined provincial OAT policies and policy changes in response to this federal policy change. Policies and changes were regionalized; despite having lower rates of opioid-related harms, eastern provinces had looser regulatory regimes compared with western provinces, which became even looser after the federal policy change. Diverse knowledge and policy networks need to be fostered to bridge this east-west divide in substance use care policy.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 3","pages":"49-61"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892641","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 Conflict Between Protecting Public Health and Raising Tax Revenue. 评论：保护公众健康与增加税收之间的矛盾。
Healthcare Policy Pub Date : 2024-02-01 DOI: 10.12927/hcpol.2024.27263
Wayne Hall
{"title":"Commentary: The Conflict Between Protecting Public Health and Raising Tax Revenue.","authors":"Wayne Hall","doi":"10.12927/hcpol.2024.27263","DOIUrl":"10.12927/hcpol.2024.27263","url":null,"abstract":"<p><p>When Canada created a legal market for cannabis, it gave priority to public health by restricting marketing using branding and promotion via social and other media sources. These restrictions to protect the public from harmful use are under increasing pressure from the legal cannabis industry, which claims that they prevent them from outcompeting and replacing the illicit market. Public health advocates are reasonably concerned that these restrictions will not hold given our experience with alcohol, tobacco and gambling where governments' fiscal dependence on tax revenue favours the liberalization of regulation.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 3","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892613","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 Call for Bigger Thinking and Meaningful Improvements in Health and Well-Being: Time to Move on From Small-Scale Changes. 呼吁以更宏大的思维和更有意义的方式改善健康和福祉：是时候摆脱小规模变革了。
Healthcare Policy Pub Date : 2024-02-01 DOI: 10.12927/hcpol.2024.27316
Jason M Sutherland
{"title":"A Call for Bigger Thinking and Meaningful Improvements in Health and Well-Being: Time to Move on From Small-Scale Changes.","authors":"Jason M Sutherland","doi":"10.12927/hcpol.2024.27316","DOIUrl":"10.12927/hcpol.2024.27316","url":null,"abstract":"<p><p>Effective reforms to provinces' and territories' healthcare delivery systems are needed to generate meaningful changes in population-based health and well-being outcomes in Canada. These reforms include transformations that slow the decline of health and improve the quality of life - such as those relevant to long-term care and aged care - and are expansive enough to include prevention and health promotion.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 3","pages":"6-20"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892556","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: Achieving Health Equity - The Role of Learning Health Systems. 评论：实现卫生公平--学习型卫生系统的作用。
Healthcare Policy Pub Date : 2023-11-01 DOI: 10.12927/hcpol.2023.27236
Arlene S Bierman, Kamila B Mistry
{"title":"Commentary: Achieving Health Equity - The Role of Learning Health Systems.","authors":"Arlene S Bierman, Kamila B Mistry","doi":"10.12927/hcpol.2023.27236","DOIUrl":"10.12927/hcpol.2023.27236","url":null,"abstract":"<p><p>Achieving health equity, for decades a domain of high-performing health systems, has been elevated to a priority and recognized as a central objective of health system transformation and quality improvement efforts. By prioritizing health equity; developing, implementing and evaluating models of care that optimize individual and population health; developing strong partnerships with patients and communities; conducting research to generate evidence on the effectiveness of interventions across diverse populations; implementing strategies to integrate clinical care, public health and social care; and participating in multisector collaborations to address social needs, learning health systems can play a pivotal role in eliminating health inequities.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 2","pages":"21-27"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10751753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138806247","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
Fairness for Whom? Learning Health Systems' Approach to Equity in Healthcare. 对谁公平？学习医疗系统实现医疗公平的方法。
Healthcare Policy Pub Date : 2023-11-01 DOI: 10.12927/hcpol.2023.27237
Nakia K Lee-Foon, Robert J Reid, Adalsteinn Brown
{"title":"Fairness for Whom? Learning Health Systems' Approach to Equity in Healthcare.","authors":"Nakia K Lee-Foon, Robert J Reid, Adalsteinn Brown","doi":"10.12927/hcpol.2023.27237","DOIUrl":"10.12927/hcpol.2023.27237","url":null,"abstract":"<p><p>Many healthcare systems use \"equity\" as a catch-all term to underscore their commitment to delivering care matching users' needs. Despite its ubiquity, it is often haphazardly used and applied to care and improvement efforts. As the learning health systems (LHSs) approach gains prominence, LHS researchers have sought to embed equity into their work while navigating systems with differing views of equity. We examine several components of equity, its definitions within LHSs and knowledge from LHSs' equity approach that could be implemented across systems. We conclude by suggesting various ways in which readers can embed equity into their respective LHSs.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 2","pages":"15-20"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10751759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138806787","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
Training in Team-Based Practices: A Descriptive Analysis of Family Medicine Postgraduate Site Distribution across Canada. 以团队为基础的实践培训：对加拿大全科医学研究生院分布的描述性分析。
Healthcare Policy Pub Date : 2023-11-01 DOI: 10.12927/hcpol.2023.27233
Asiana Elma, Laurie Yang, Irene Chang, Lawrence Grierson
{"title":"Training in Team-Based Practices: A Descriptive Analysis of Family Medicine Postgraduate Site Distribution across Canada.","authors":"Asiana Elma, Laurie Yang, Irene Chang, Lawrence Grierson","doi":"10.12927/hcpol.2023.27233","DOIUrl":"10.12927/hcpol.2023.27233","url":null,"abstract":"<p><strong>Background: </strong>College of Family Physicians of Canada accreditation policies contemplate exemplary ratings for postgraduate family medicine programs that train residents in sites aligned with the Patient's Medical Home (PMH) vision. This may overrepresent the PMH in training relative to what is available in independent practice.</p><p><strong>Methods: </strong>We appraised training sites to describe the degree to which PMH features are present in family medicine education across the country.</p><p><strong>Results: </strong>More than half (70.7%) of Canadian training sites reflect PMH features.</p><p><strong>Conclusion: </strong>Education policy that incentivizes PMH in training may create downstream tension for physicians who find these practices unavailable upon graduation.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 2","pages":"48-62"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10751758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138807194","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
Distribution and Migration of Recent Healthcare Graduates in Canada. 加拿大医疗保健专业应届毕业生的分布和迁移情况。
Healthcare Policy Pub Date : 2023-11-01 DOI: 10.12927/hcpol.2023.27234
Ruolz Ariste
{"title":"Distribution and Migration of Recent Healthcare Graduates in Canada.","authors":"Ruolz Ariste","doi":"10.12927/hcpol.2023.27234","DOIUrl":"10.12927/hcpol.2023.27234","url":null,"abstract":"<p><strong>Introduction: </strong>Although data on new graduates are available and typically included in the health workforce planning (HWP) model, information on their interprovincial migration pattern is less known. This paper aims to understand the mobility pattern of recent healthcare graduates - family physicians and regulated nurses - across the different Canadian jurisdictions.</p><p><strong>Methodology: </strong>Health workforce data from the Canadian Institute for Health Information (CIHI) were used to identify recent family physician and regulated nurse graduates. We identified new graduates (between 2015 and 2019) in a particular province and distributed them according to the province/territory in which they registered to practise.</p><p><strong>Results: </strong>The jurisdiction where they are trained is a key factor in determining their migration rates. For both professions, Ontario and British Columbia have the lowest rates of new graduate out-migration and the highest rates of in-migration, leaving them with a positive net interprovincial migration.</p><p><strong>Discussion: </strong>This analysis can be used to inform better HWP at the jurisdictional level in these professions.</p><p><strong>Conclusion: </strong>Working and community conditions matter to keep and attract new graduates.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 2","pages":"36-47"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10751756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138806419","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
Practice- and System-Based Interventions to Reduce COVID-19 Transmission in Primary Care Settings: A Qualitative Study. 基于实践和系统的干预措施，减少 COVID-19 在基层医疗机构的传播：定性研究。
Healthcare Policy Pub Date : 2023-11-01 DOI: 10.12927/hcpol.2023.27232
Maria Mathews, Tiffany Liu, Dana Ryan, Lindsay Hedden, Julia Lukewich, Emily Gard Marshall, Richard Buote, Leslie Meredith, Lauren R Moritz, Sarah Spencer, Shabnam Asghari, Judith B Brown, Thomas R Freeman, Paul S Gill, Shannon Sibbald
{"title":"Practice- and System-Based Interventions to Reduce COVID-19 Transmission in Primary Care Settings: A Qualitative Study.","authors":"Maria Mathews, Tiffany Liu, Dana Ryan, Lindsay Hedden, Julia Lukewich, Emily Gard Marshall, Richard Buote, Leslie Meredith, Lauren R Moritz, Sarah Spencer, Shabnam Asghari, Judith B Brown, Thomas R Freeman, Paul S Gill, Shannon Sibbald","doi":"10.12927/hcpol.2023.27232","DOIUrl":"10.12927/hcpol.2023.27232","url":null,"abstract":"<p><p>Using qualitative interviews with 68 family physicians (FPs) in Canada, we describe practice- and system-based approaches that were used to mitigate COVID-19 exposure in primary care settings across Canada to ensure the continuation of primary care delivery. Participants described how they applied infection prevention and control procedures (risk assessment, hand hygiene, control of environment, administrative control, personal protective equipment) and relied on centralized services that directed patients with COVID-19 to settings outside of primary care, such as testing centres. The multi-layered approach mitigated the risk of COVID-19 exposure while also conserving resources, preserving capacity and supporting supply chains.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"19 2","pages":"63-78"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10751755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138806889","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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