Archive for the ‘Health Delivery System’ Category

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Doug Ford’s health care ‘super agency’ is a solution in search of a problem

Wednesday, February 27th, 2019

a recent Conference Board of Canada comparative assessment of the provincial health systems ranked Ontario as the second-best performer in the country, behind only B.C. As is true with the analysis from the Ford government on a host of issues, the real story is more complex than they are letting on, and the fix is missing the bigger set of issues at stake, namely how to create an effective and responsive health care system.

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New Ontario Health agency would overhaul ‘disconnected’ medical system, minister says

Wednesday, February 27th, 2019

The promise to make a complicated system easier for patients to navigate came with the acknowledgement from Elliott and senior officials that the “transformation” will take at least three years — coinciding with the next provincial election — and with many details yet to be worked out… she announced between 30 and 50 “Ontario Health Teams” will form across the province to better co-ordinate all levels of care. Each will serve about 300,000 people in a geographic area or a specific group of patients across the province, such as children with fragile medical conditions.

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Doctors get new contract with province after 4-year battle

Wednesday, February 20th, 2019

… the board ordered that the two sides strike an “appropriateness working group” to eliminate or restrict inappropriate or overused physician services — $100 million worth in 2019-20 and another $360 million worth the following year… The arbitration decision provides doctors with redress, eliminating most but not all of the fee cuts imposed by the province in recent years, effective this coming April. As well, it awards physicians with increases of 0.75 per cent for 2017; 1.25 per cent for 2018; 1 per cent for 2019; and 1 per cent for 2020.

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Lab Testing Misuse Costs Billions

Tuesday, February 19th, 2019

“Reducing inappropriate use requires careful considerations of the trade-off between the effectiveness of interventions and their acceptability to physicians,” said Rosalie Wyonch. “Incorporating laboratory services in physician compensation formulas would be an effective tool to discourage unnecessary lab tests.” …  The report proposes a number of options for policymakers to reduce inappropriate laboratory testing:

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Doctors should follow patients beyond the hospital

Saturday, January 5th, 2019

As trainees, we learn to manage patients on medical wards and in office clinics. We become proficient at recognizing their maladies and manipulating their biology: our exams and training prepare us well for this. But we are less prepared to understand how community services — arguably the crucible of modern health care — will pick up where we have left off… Yet, most physicians get little to no exposure to rehabilitation institutions, long-term care facilities and nursing homes.

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Hatred of Big Pharma won’t get us better drug prices

Tuesday, October 23rd, 2018

Talking about the price of drugs is very 20th century; in the 21st century, and the impending era of personalized medicine, what matters is the value treatments provide. For drugs such as Remicade, we should be paying, and paying fairly, when the drug works, when it delivers on a specific treatment goal.

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How a blockbuster drug tells the story of why Canada’s spending on prescriptions is sky high

Monday, October 22nd, 2018

Canada pays the third-highest drug prices among the countries in the Organization for Economic Co-operation and Development, and spends more per capita on prescriptions than any country except the United States and Switzerland… Like generic drugs before them, biosimilars could free up money for governments and private insurers to cover the newest generation of miracle cures, including expensive gene therapies

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How One Researcher Is Blocking the Road from Hospital to Homelessness

Monday, October 15th, 2018

in her work as a researcher, Forchuk conducted a review of discharge processes in several Ontario hospitals and found that, as a result of changes in policy, discharges into homelessness were becoming more common… Her current project attempts to intervene in such cases, providing resources to those leaving medical wards so that they can continue healing…[It] has already helped keep dozens of people out of homelessness.

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Resources don’t match need for surgery

Friday, October 5th, 2018

We have just eight full-time neurosurgeons and four orthopedists serving the regional referral population of 2.4 million. Everybody has an elective wait list one to two years long. It is months before we can look after acutely disabled people. None of us in this province operates as much as we could under the resource restrictions of a system that has failed to match the simple growth of the population for decades, never mind the growth of technology and care options.

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One solution to hallway medicine: outpatient hip-replacements

Thursday, October 4th, 2018

Thirty years ago, this procedure would have required a hospital stay of up to seven days, and more recently it’s taken an average of three days… Women’s College is the only fully ambulatory hospital in Ontario, meaning it has no overnight beds. It describes itself as “a hospital designed to keep people out of hospital.” Part of its mission is to help improve the broader health system. One way it’s trying to do that is by spreading the word about the advantages of ambulatory, or outpatient, surgery.

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