Canadian Healthcare System Flashcards
What was the responsibility of government levels of the British North America Act for healthcare? Who paid?*
Responsibility was on provincial government for healthcare and federal government just oversaw everything
All healthcare was paid out of pocket - doctors came to people’s homes and cared for them there
How did the Great Depression impact healthcare?*
Everyone was still paying out of pocket and they couldn’t afford it anymore, so many people became sick
What government funding/financial responsibilities changed with the medical care insurance act?*
Provinces and territories were to share health care costs equally with the federal government
They negotiated a plan where doctors would be paid by the government rather than the individual
What negative outcome resulted from the medical care insurance act? Which health act did this lead to?*
Due to the provincial governments having to take on more costs, they began adding additional fees
The Canada Health Act banned extra billing or user fees
What is the current federal jurisdiction in regard to funding (4)?*
- Set/administer Canada Health Act principles
- Assist in funding/financing
- Deliver health services for specific groups
- Promote national policy and programming to support/promote health and prevent disease
What is the current provincial jurisdiction in regard to funding (4)?*
- Develop/administer health care insurance plan
- Manage/finance/plan health care services
- Determine organization and location of health care facilities and services
- Reimburse physicians and hospital expenses
What are the 5 principles of the Canada Health Act? And the additional 6th?*
- Public administration
- Comprehensiveness
- Universality
- Portability
- Accessibility
- Sustainability
Define public administration*
Provincial/territorial plans operate on a nonprofit basis through a public authority
Define comprehensiveness*
Covers medically necessary services (hospital and physician services)
Determine which services are considered medically necessary - differs across Canada
Define universality*
Services provided free of discrimination
However, the individual must be a Canadian citizen
Define portability*
Insured residents can receive services in another province/territory without cost or penalty
Provide continuous coverage if resident relocates within Canada for up to 3 months
Define accessibility
Provide access to health care facilities and providers based on medical need regardless of ability to pay
Define sustainability*
Not yet adopted as the 6th principle - desire to make the health care system sustainability
Describe the medical approach and which century it was most popular in*
Focused on maintenance of physiological, functional, and social norms - focused on treatment for disease and sees medical intervention as the way to restore health
Little emphasis given to health promotion or disease prevention
Dominant throughout the 20th century
Which approach was challenged by the Lalonde report?*
Medical approach
What did the Lalonde report promote/advocate?*
Promoted individual responsibility for health
Shifted focus away from seeing health problems solely as physiological risk factors that conveyed disease
Introduced idea of casual influences (determinants of health) that also played a role in health
Describe behavioural approach*
De-emphasized medical intervention for the restoration of health
Placed responsibility for health on the individual - proposed new ideas of health promotion and disease prevention
What initiatives did the behavioural approach lead to? Why?*
Saw education as a key to improving people’s behaviour or lifestyle and thereby their health
Led to Canada Food Guide and ParticipACTION
What was one negative outcome of the behavioural approach?*
Led to some victims blaming issues - if you were still unhealthy after being taught not how to be, it is their fault
What was the Epp Report?*
Outlined several health promotion initiatives - proposed there were many other factors that influence an individual’s health
What was the Ottawa Charter?*
Expanded the list of determinants of health and included social and political factors; this list renamed as the SDOH
Describe the socioenvrionmental approach. What is it based on and what is its goal?*
Acknowledges many social factors that influence the health and health choices of individuals
Based on ideas coming out of Ottawa Charter and Epp Report
Goal is to promote health equity for all people
What is one limitation of the socioenvironmental approach?*
Does not look at how certain SDOH are out of individuals’ control
Describe primary health care and which services it includes?*
An approach to health and a spectrum of services beyond the traditional health care system - emphasizes the SDOH and strategies to advance individual and population health
Includes all services that play a part in health, such as income, housing, education, and environment
What is the dual function of PHC?
- direct provision of first-contact services
- A coordinating function to ensure continuity and ease of movement across the system
What is the primary/main focus of PHC and who is it currently delivered by mostly?*
Main focus is on diagnosis and treatment of disease/injury
Currently delivered chiefly by family physicians and general medical practitioners
List and describe the four pillars of PHC*
- Teams - teams or networks deliver patient-centred care, which improves access through collaboration, coordination, continuity, and quality
- Access - attempts to address issues with accessing family physicians, especially in urgent or after-hours situations
- Information - uses technology to improve efficiency and quality of care provision, and increase access to individual and general health information
- Healthy living - embraces strategies of prevention, chronic illness management, and self-care
What are two individual-level barriers to PHC?*
- Lack of role clarity - makes it unclear who exactly you are supposed to see or speak with to address health concerns
- Lack of trust - attributed to lack of knowledge, scope of practice, or competency of other team members
What are two practice-level barriers to PHC?
- Hierarchical issues in governance and leadership
- Team attributes and skills
What are 4 system-level barriers to PHC?
- lack of interprofessional education and collaboration
- lack of funding
- lack of monitoring and evaluation - no metrics or reviews to determine if the system is actually working
- focus on illness care, instead of wellness care, by Canadian populace - only accessing the doctor when ill instead of accessing healthcare for general wellness/health promotion
List the 5 levels of health care in Canada*
- health promotion
- disease & injury prevention
- diagnosis and treatment
- rehabilitation
- supportive care
Define health promotion (level 1) and provide examples*
Enabling people to increase control over or improve their health
Ex. anti-smoking education, anti-bullying campaign, heart healthy menu options
List and describe the 5 health promotion strategies that extend from the Ottawa Charter
- building healthy public policy - no smoking policies on campuses
- creating supportive environments - workplaces that are positive and less stressful, OH&S
- strengthening community action
- developing personal skills - educational skills to teach people self-management
- reorienting health care services - shifting toward socioenvrionmental and PHC focuses
Describe disease and injury prevention and provide examples*
Reduces risk factors for illness and injury
Ex. cervical cancer screening, immunizations, support groups, it’s your move
Describe the differences between primary, secondary, and tertiary prevention*
Primary - prevent disease or injury before it occurs (i.e., use of seatbelts)
Secondary - promote early detection of disease once pathogenesis has occurred or slow the progress of injury (i.e., mammograms)
Tertiary - directed toward minimizing disability from disease or injury and helping people to live with limitations (i.e., cardiac or stroke rehab programs)
List and describe the three levels of care in diagnosis and treatment (level 3)*
- Primary care - first contact with health care such as family physician or NP
- Secondary care - provision of specialized medical services in hospital or home settings; often referred to specialized practitioner for further diagnosis/care
- Tertiary care - specialized and highly technical care usually provided in hospitals with advanced care equipment/practitioners
Ex. Goes to a doctor with chest pain (primary), physician says you need to get lab work (secondary), come back to physician with results and he says you need to see a cardiologist (secondary), then the cardiologist says “I need to perform an angioplasty” which he performs (tertiary)
Describe the rehabilitation level and provide examples*
Promote independence and self-care; improve health and quality of life for those facing life-altering conditions
Ex. physiotherapy, occupational and speech therapy, social services
Describe the supportive care level and provide examples*
Clients with chronic illness, progressive illness, or disability - goal is no longer recovery but rather quality of life/comfort focused
Ex. long-term care, respite care, palliative care, home care
What are the 4 on-going issues needing to be addressed in Canadian health care?
- Lack of continuity among providers and institutions - are all practitioners providing the same type of care based on same evidence-informed practices
- Health system access problems
- Lack of care in rural and remote areas of Canada
- Quality of work life for health care providers
What was the Romanow report and how many recommendations did it contain?*
Tasked with evaluating the healthcare system to see if it was sustainable – argued it was not sustainable and provided recommendations for change but the government has not implemented many of the changes suggested
47 recommendations
