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Engaging Canadians in Health Policy Is no Trivial Matter. 让加拿大人参与卫生政策并非小事一桩。
Healthcare Policy Pub Date : 2024-09-01 DOI: 10.12927/hcpol.2024.27418
Jason M Sutherland
{"title":"Engaging Canadians in Health Policy Is no Trivial Matter.","authors":"Jason M Sutherland","doi":"10.12927/hcpol.2024.27418","DOIUrl":"10.12927/hcpol.2024.27418","url":null,"abstract":"<p><p>There are many challenges with stewarding a public healthcare delivery system in Canada. The system is a beast with its own momentum. The public shares sad experiences with accessing emergency departments or securing a primary care physician on a daily basis. Provinces, territories and the federal government are all acutely aware that their delivery systems perform poorly in contrast with other countries.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 SP","pages":"6-9"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477006","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
Ethical and Transformative Scholarly Public Engagement: Pitfalls, Possibilities and Promises. 伦理和变革性学术公众参与：陷阱、可能性和承诺》。
Healthcare Policy Pub Date : 2024-09-01 DOI: 10.12927/hcpol.2024.27409
Jamila Michener
{"title":"Ethical and Transformative Scholarly Public Engagement: Pitfalls, Possibilities and Promises.","authors":"Jamila Michener","doi":"10.12927/hcpol.2024.27409","DOIUrl":"10.12927/hcpol.2024.27409","url":null,"abstract":"<p><p>At its core, public engagement is geared toward transformative ends - to change the world for the better. Yet, the means are also critical. Scholars who engage communities and public processes should do so ethically, in ways that comport with core values. Despite good intentions, however, researchers seeking to engage the public face substantial challenges. This paper highlights the pitfalls and perils associated with scholarly public engagement and points to the promise of ethical and transformative engagement - that is, engagement for sound reasons carried out in effective ways. I make the case that ethical and transformative public engagement requires that researchers remain aware of their position, attentive to who is being engaged and discerning about how to engage.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 SP","pages":"94-102"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477007","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
Trends in Government-Initiated Public Engagement in Canadian Health Policy From 2000 to 2021. 2000 年至 2021 年加拿大卫生政策中由政府发起的公众参与趋势。
Healthcare Policy Pub Date : 2024-09-01 DOI: 10.12927/hcpol.2024.27416
Roma Dhamanaskar, Katherine Boothe, Joanna Massie, Jeonghwa You, Danielle Just, Grace Kuang, Julia Abelson
{"title":"Trends in Government-Initiated Public Engagement in Canadian Health Policy From 2000 to 2021.","authors":"Roma Dhamanaskar, Katherine Boothe, Joanna Massie, Jeonghwa You, Danielle Just, Grace Kuang, Julia Abelson","doi":"10.12927/hcpol.2024.27416","DOIUrl":"10.12927/hcpol.2024.27416","url":null,"abstract":"<p><strong>Introduction: </strong>Canada has a rich history of public engagement in health policy; however, shifts in engagement practices over time have not been critically examined.</p><p><strong>Methodology: </strong>We searched for cases of government-initiated public engagement in Canadian health policy from 2000 to 2021 at the federal, provincial (Ontario, British Columbia, Nova Scotia) and pan-Canadian levels. Government databases, portals and platforms for engagement were searched, followed by academic and grey literature using relevant search terms. A coding scheme was iteratively developed to categorize cases by target population, recruitment method and type of engagement.</p><p><strong>Results: </strong>We identified 132 cases of government-initiated public engagement. We found a predominance of feedback and consultation engagement types and self-selection recruitment, especially at the federal level from 2016 onward. Engagements that targeted multiple populations (patients, public and other stakeholders) were favoured overall and over time. Just over 10% of cases in our survey mentioned efforts to engage with equity-deserving groups.</p><p><strong>Conclusion: </strong>Overall, our results identify a heavy reliance over time on more passive, indirect engagement approaches, which limit opportunities for collaborative problem solving and fail to include equity-deserving populations. Those overseeing the design and implementation of government-initiated public engagement will draw valuable lessons from this review to inform the design of engagement initatives.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 SP","pages":"17-35"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477011","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
"Whatever Job I'm In, I'm Going to Find a Way to Make a Difference" - A Black Community Leader's Perspective on Engagement and Advocacy. "无论我从事什么工作，我都要想方设法有所作为"--一位黑人社区领袖对参与和宣传的看法。
Healthcare Policy Pub Date : 2024-09-01 DOI: 10.12927/hcpol.2024.27412
Camille Orridge
{"title":"\"Whatever Job I'm In, I'm Going to Find a Way to Make a Difference\" - A Black Community Leader's Perspective on Engagement and Advocacy.","authors":"Camille Orridge","doi":"10.12927/hcpol.2024.27412","DOIUrl":"10.12927/hcpol.2024.27412","url":null,"abstract":"<p><p>Camille Orridge is a patient and community-focused healthcare leader who has passionately and tirelessly worked for more than 50 years to address systemic barriers in the healthcare system, creating innovative equitable health solutions for underserved populations. She has founded a number of key initiatives, including Pathways to Education, the Canadian Home Care Association and the Black Coalition for AIDS Prevention (Black CAP) and has served on numerous boards, as a volunteer and in her capacity as the CEO of the Toronto Central Local Health Integration Network. In this oral history narrative, Camille reflects on her extensive 50-year journey as a healthcare advocate, identifying victories but also areas that continue to be barriers for historically marginalized communities, such as Black communities. In so doing, she discusses the complexities that she has encountered while pushing boundaries and reimagining a more equitable healthcare system in Ontario and reveals key historical touchpoints in the health equity and advocacy space.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 SP","pages":"74-78"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477003","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
Public Deliberation for Ethically Complex Policies: The Case of Medical Assistance in Dying in Canada. 伦理复杂政策的公共审议：加拿大临终医疗援助案例》。
Healthcare Policy Pub Date : 2024-09-01 DOI: 10.12927/hcpol.2024.27410
Roma Dhamanaskar, Julia Abelson
{"title":"Public Deliberation for Ethically Complex Policies: The Case of Medical Assistance in Dying in Canada.","authors":"Roma Dhamanaskar, Julia Abelson","doi":"10.12927/hcpol.2024.27410","DOIUrl":"10.12927/hcpol.2024.27410","url":null,"abstract":"<p><p>Almost 50,000 people in Canada have had a medically assisted death since federal legislation was passed in 2016. Still, the debate about the permissibility of medical assistance in dying (MAiD) continues to rage. The central role of shared values and ethics in public policy making emphasizes the importance of engaging the public, particularly around heavily value-laden issues such as MAiD. Public deliberation, a mode of engagement that fosters sustained and reasoned discussion between participants, is well-suited to addressing such ethically contentious policy issues. In this paper, we review recent efforts to engage the public on assisted dying within and outside Canada and explain how public deliberation could contribute substantively to MAiD policy making.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 SP","pages":"83-93"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477008","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
Whom Do I Trust to Represent Me? Long-Term Care Resident and Family Perspectives on Legitimate Representation. 我相信谁会代表我？长期护理居民和家庭对合法代表的看法。
Healthcare Policy Pub Date : 2024-09-01 DOI: 10.12927/hcpol.2024.27414
Jeonghwa You, Katherine Boothe, Rebecca Ganann, Michael Wilson, Julia Abelson
{"title":"Whom Do I Trust to Represent Me? Long-Term Care Resident and Family Perspectives on Legitimate Representation.","authors":"Jeonghwa You, Katherine Boothe, Rebecca Ganann, Michael Wilson, Julia Abelson","doi":"10.12927/hcpol.2024.27414","DOIUrl":"10.12927/hcpol.2024.27414","url":null,"abstract":"<p><strong>Introduction: </strong>Public engagement in long-term care policy making in Canada has primarily focused on \"intermediary agents\" who speak on behalf of long-term care (LTC) residents and their family caregivers. Yet the legitimacy of these intermediaries, as perceived by those they represent, has gone largely unexplored. This study examines LTC resident and family perspectives on who can legitimately represent them in LTC policy making.</p><p><strong>Methodology: </strong>We used an interpretive description design, drawing on semi-structured interviews with LTC residents and family caregivers in Ontario, Canada. Data were analyzed using inductive thematic analysis.</p><p><strong>Results: </strong>Eighteen interviews were conducted with 19 participants. Three key characteristics of legitimate representatives were identified: (1) willingness to act in the best interests of residents and families, (2) having the necessary skills and capacity to participate in LTC policy making and (3) engaging directly with residents and families.</p><p><strong>Conclusion: </strong>Governments and civil society organizations seeking to establish and maintain legitimacy in the eyes of LTC residents and family members can pursue this goal by supporting intermediaries who mirror the identities or experiences of those they represent, who are dedicated to serving their interests and who routinely and directly engage with them to understand the realities of LTC.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 SP","pages":"48-61"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477012","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 Canadian Call for Addressing Physical Health in Specialized Mental Health Settings. 加拿大呼吁在专门的心理健康环境中解决身体健康问题。
Healthcare Policy Pub Date : 2024-08-01 DOI: 10.12927/hcpol.2024.27475
Cara Evans, Christopher Canning, Munazzah Ambreen, Brian Lo, Mary Rose Van Kesteren, Caroline M E Walker, Vicky Stergiopoulous
{"title":"A Canadian Call for Addressing Physical Health in Specialized Mental Health Settings.","authors":"Cara Evans, Christopher Canning, Munazzah Ambreen, Brian Lo, Mary Rose Van Kesteren, Caroline M E Walker, Vicky Stergiopoulous","doi":"10.12927/hcpol.2024.27475","DOIUrl":"10.12927/hcpol.2024.27475","url":null,"abstract":"<p><p>People with serious mental illness experience poorer physical health and higher mortality rates than the general population. One option for responding to this disparity is <i>reverse integration</i>, which promotes physical health monitoring in secondary and tertiary mental health settings. Health leaders in Canada can learn from reverse integration approaches that have been adopted or proposed in other jurisdictions. We conducted a jurisdictional scan and applied the 3I framework for policy analysis to suggest that Canadian adaptations of existing approaches should foreground equity, build on existing infrastructure and human resources and prioritize leadership of people with lived experience.</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 1","pages":"19-28"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494105","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
Does Productivity in Healthcare Matter? An Unfortunate Post-Pandemic Legacy. 医疗保健行业的生产力重要吗？大流行后的不幸遗产。
Healthcare Policy Pub Date : 2024-08-01 DOI: 10.12927/hcpol.2024.27521
Jason M Sutherland
{"title":"Does Productivity in Healthcare Matter? An Unfortunate Post-Pandemic Legacy.","authors":"Jason M Sutherland","doi":"10.12927/hcpol.2024.27521","DOIUrl":"10.12927/hcpol.2024.27521","url":null,"abstract":"<p><p>In speeches this year, a bank of canada official announced that our country experienced no growth in productivity over the past two years (Rogers 2024a, 2024b). To improve this predicament, the bank says businesses should focus on adding value and being more efficient. These recommendations should be heeded by healthcare - the industry exceeds 12% of Canada's gross domestic product and is growing (CIHI 2024b).</p>","PeriodicalId":39389,"journal":{"name":"Healthcare Policy","volume":"20 1","pages":"6-18"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494114","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: 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
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