Beyond Pharmacare Flashcards
What are some health system reforms that in recent decades have preoccupied provinces? (5)
- Chronic disease management.
- Align system with provincial objectives.
- Shift from hospital to community-based care.
- Integrate physicians into the system.
- Develop capacities for improvement.
There are persistent concerns with capacity of the health system to do what 3 things?
- Manage complex health problems;
- Support the coordination of care, and
- Promote physician integration
What are the biggest problems facing healthcare/what are the health care priorities (HCP) from the perspective of the physicians? (6)
- Not enough health care workers
- Long wait times for treatment
- Poor access and quality in LTC
- Poor access to mental health services
- Underperforming primary care
- Racism and cultural safety
According to the HCP, how can we address staffing issues beyond hiring more people? (3)
- Create a national workforce plan
- Put people where they’re needed. - Pan-Canadian licensure
- Support mobilization during emergencies. - Develop mental health supports
- Promote wellbeing and retention
Excessive delays accessing health care can lead to? (4)
- Disease progression
- Increased anxiety and depression
- Mental health flare-ups
- Worsening of patient outcomes
Long-term care (LTC) is referred to as “extended services” under the CHA, meaning there are no federal standards. What does that mean? (2)
- Each province sets its own standards resulting in very different approaches within each.
- Most provinces see government as supplementing rather than replacing the care provided by families and other informal caregivers.
What to note about LTC and unpaid labor? (2)
- Relies to a greater extent on the family members and friends of residents to provide a range of care services.
- Declining fertility rates, smaller families, and family members dispersed across the country mean fewer unpaid workers.
What are some negatives of long-term care homes? (4)
- Palliative services are often unavailable
– Unacceptably high rates of burdensome symptoms and inappropriate care at the end-of life - Homes are not structured or staffed to maintain or improve the functional status of residents.
- Staffing levels and mix linked to quality of life and the quality of work life
- Unregulated LTC workers such as care aides have limited formal training and manage high workloads with frequent interruptions.
When talking about Primary Care, relative to systems in comparable countries, Canada lags behind based on: (4)
- Timely access to care;
- Patients’ ability to communicate electronically with primary care providers;
- Development of interprofessional teams; and
- Communication across health care settings.
Why the slow, uneven progress when it comes to reforming/improving primary care in Canada? (2)
- Lack of a national strategy as each province and territory guards its authority (BNA Act)
- Ironically, also saw a greater centralizing of authority with constrained local decision making. - Relationship between physicians and governments (the bilateral axis) and the maintaining of historic payment models (fee-for-service) limit change.
- The central role of physicians along with clinical and financial autonomy concerns, and a general lack of trust, have impeded progress.
A number of factors are seen as contributing to the inability of many to receive mental health care. Such as? (8)
- Long wait times
- Shortage of accessible mental health professionals
- Cost of care (limited public and private funding).
- Lack of service integration and oversight
- Cultural and language barriers
- Inequities due to geographic and demographics (youth, rural, Indigenous)
- Concerns about stigma
- Not knowing where to go for help
Mental health services are severely under-resourced compared to acute care services. How might it be improved? (3)
- Need to expand public funding to psychologists and other providers qualified to provide mental health services.
- Increased funding is needed but on its own is not sufficient to address care gaps.
- Integrated mental services through primary care teams to enhance access and increase patient awareness. - Greater use of distance technologies (e-health) to overcome geographic isolation.
What is Joyce’s Principle?
Right to equal access to high quality physical and mental health services
