Archive for the ‘Health Delivery System’ Category

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Ontario’s response to the opioid crisis? Offer less help, and fewer answers

Monday, April 1st, 2019

Using Orwellian doublespeak – plus a dash of Trumpian random capitalization – the government was not announcing that it was “continuing to build a connected mental health and addictions treatment system”, but rather that it was cutting the legs from under four badly-needed overdose prevention sites, rejecting two others, and continuing to drag its feet on funding of additional sites.

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On Pharmacare, the Liberals offer big questions and small investments

Wednesday, March 20th, 2019

… If [the federal government] were to directly fund and manage drug coverage, there would be less integration in the management of overall health care costs and provinces would have less incentive for cost-effective choices between drugs and other inputs to health care… One hopes that the final report on the Implementation of National Pharmacare will… clarify the intended scope of public drug coverage and Ottawa’s intended role in a new national pharmacare system.

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A glimpse into the future of health care in Ontario

Sunday, March 3rd, 2019

St. Joseph’s Healthcare in Hamilton, specifically at its Integrated Comprehensive Care (ICC) program… started as a pilot back in 2012. Known then as the “bundled care” program, it was designed to connect surgical patients with a single team of clinicians who could care for them before, during and after their operations… It has resulted in a savings of up to $4,000 per patient, a 30 per cent reduction in emergency department visits and 30 per cent reduction in hospital readmissions, a savings of more than 30,000 bed days and an increase in patient satisfaction, according to the hospital.

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The Ford government’s health reform is clear as mud

Friday, March 1st, 2019

The possibility that these teams, which might include doctors and hospitals, along with home care agencies and long-term care homes, could share one budget has the potential to deliver positive change. It would provide a clearer incentive to ensure that patients can access the right care in the right place, which generally costs far less than waiting for things to escalate into crisis. But if this is also the government’s way to shave dollars out of the health budget, that potential goes right out the window.

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Is it too late to reconsider Ontario’s new health care super agency?

Thursday, February 28th, 2019

… the government will create a super agency called Ontario Health, which will become the single point of accountability for all health services in the province… It seems our ministry is forecasting several years of turgid inertia while Ontario Health and Ontario Health Teams organize their new structures… Massive new bureaucracy, maintenance of old bureaucracy and a low rules environment where we will design the future of Ontario health systems “on the fly.”

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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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