canadian law and public health Flashcards

1
Q

Canadian health act. primary objective

A

to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers.

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2
Q

what is medicare

A

the term used for canada’s publicly funded health care. Instead of there being 1 national plan they are different per province and territory. The provincial and territorial governments are responsible for the management, organization and delivery of health care services for their residents.

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3
Q

In terms of Medicare what is the canadian government responsible for?

A
  • setting and administering national standards for the health care system through the Canada Health Act
  • providing funding support for provincial and territorial health care services
  • supporting the delivery for health care services to specific groups
  • providing other health-related functions
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4
Q

5 standards of the Canadian Health Act.

A
public administration
comprehensiveness
universality
portability
accessibility
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5
Q

Public administration of the Canadian health act.

A

The provincial and territorial plans must be administered and operated on a non profit basis by a public authority

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6
Q

comprehensiveness of the canadian health act

A

The provincial and territorial plans must insure all medically necessary services provided by:

hospitals
physicians
dentists, when the service must be performed in a hospital
Medically necessary services are not defined in the Canada Health Act. The provincial and territorial health care insurance plans consult with their respective physician colleges or groups. Together, they decide which services are medically necessary for health care insurance purposes.

If a service is considered medically necessary, the full cost must be covered by the public health care insurance plan.

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7
Q

universality of the Canadian health act

A

The provincial and territorial plans must cover all residents.

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8
Q

Portability of the Canadian health Act.

A

The provincial and territorial plans must cover all residents when they travel within Canada. Limited coverage is also required for travel outside the country.

When a resident moves to another province, they can continue to use their original health care insurance card for 3 months. This gives them enough time to register for the new plan and receive their new health insurance card.

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9
Q

Accessibility of the canadian health act.

A

The provincial and territorial plans must provide all residents reasonable access to medically necessary services. Access must be based on medical need and not the ability to pay.

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10
Q

status indian

A

Canadian first nation who is registered under the indian act

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11
Q

treaty indian

A

Canadian first nation who signed a treaty with the Crown

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12
Q

Non staus indian

A

not registered under the indian act.

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13
Q

which indian receive non-insured health benefits

A

Status Indians receive non-insured health benefits coverage which helps cover cost for expenses such as medications, medical transports, vision care, dental, and counseling as a condition of their status and treaty. Other Indigenous groups, such as non-status Indians and Métis currently do not have this health coverage, but may be eligible in future because of a recent court ruling

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14
Q

services not included by medicare

A
medical examinations requested by third parties
cosmetic surgery
Medical's requested for legal purposes
dental care
vision care
limb prosthesis
wheelchairs
prescription medication
podiatry
chiropractics
AMBULANCES
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15
Q

Daniels Decision

A

In early 2013, the Federal Court of Canada ruled in a decision known as the “Daniels Decision” that Métis and non-status Indian peoples be considered “Indians” under section 91(24) of the Canadian Constitution Act, 1867 (CBC News,
2013). Although the full implications of the Daniels Decision are not yet clear, this decision potentially doubles the number of people considered status Indians under the 1876 Indian Act. The federal government appealed the decision and is unlikely to implement it while the case is under appeal, a process that could take several years.

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16
Q

AAA screening

A

We recommend one-time screening with ultrasound for abdominal aortic aneurysm for men aged 65 to 80.
(Weak recommendation; moderate quality of evidence)
We recommend not screening men older than 80 years of age for abdominal aortic aneurysm.
(Weak recommendation; low quality of evidence)
We recommend not screening women for abdominal aortic aneurysm.
(Strong recommendation; very low quality of evidence)

17
Q

Screening urinary bactereamia in pregnancy

A

We recommend screening pregnant women once during the first trimester with urine culture for asymptomatic bacteriuria
(weak recommendation; very low-quality evidence).

18
Q

Breast cancer screening

A

For women aged 40 to 49 years, we recommend not screening with mammography; the decision to undergo screening is conditional on the relative value a woman places on possible benefits and harms from screening. (Conditional recommendation; low-certainty evidence)
Some women aged 40 to 49 years may wish to be screened based on their values and preferences; in this circumstance, care providers should engage in shared decision-making with women who express an interest in being screened.
For women aged 50 to 69 years, we recommend screening with mammography every two to three years; the decision to undergo screening is conditional on the relative value that a woman places on possible benefits and harms from screening. (Conditional recommendation; very low-certainty evidence)
Care providers should engage in shared decision-making with women aged 50 to 69 as those who place a higher value on avoiding harms as compared to a modest absolute reduction in breast cancer mortality may choose to not undergo screening.
For women aged 70 to 74 years, we recommend screening with mammography every two to three years; the decision to undergo screening is conditional on the relative value that a woman places on possible benefits and harms from screening. (Conditional recommendation; very low-certainty evidence)
Care providers should engage in shared decision-making with women aged 70 to 74 as those who place a higher value on avoiding harms as compared to a modest absolute reduction in breast cancer mortality may choose to not undergo screening.

19
Q

Other modalities for breast screening

A

We recommend not using magnetic resonance imaging (MRI), tomosynthesis or ultrasound to screen for breast cancer in women not at increased risk. (Strong recommendation; no evidence)
We recommend not performing clinical breast examinations to screen for breast cancer. (Conditional recommendation; no evidence)
We recommend not advising women to practice breast self-examination to screen for breast cancer. (Conditional recommendation; low-certainty evidence)

20
Q

Cervical cancer screening

A

For women aged < 20 we recommend not routinely screening for cervical cancer
(Strong recommendation; high quality evidence)
For women aged 20 to 24 we recommend not routinely screening for cervical cancer.
(Weak recommendation; moderate quality evidence)
For women aged 25 to 29 we recommend routine screening for cervical cancer every 3 years.
(Weak recommendation; moderate quality evidence)
For women aged 30 to 69 we recommend routine screening for cervical cancer every 3 years.
(Strong recommendation; high quality evidence)
For women aged ≥ 70 who have been adequately screened (i.e., 3 successive negative Pap tests in the last 10 years), we recommend that routine screening may cease. For women aged 70 or over who have not been adequately screened we recommend continued screening until 3 negative test results have been obtained.
(Weak recommendation; low quality evidence)

21
Q

Cognitive impairment screening

A

We recommend not screening asymptomatic adults (≥65 years of age) for cognitive impairment
Strong recommendation, low quality evidence

22
Q

Colorectal cancer screening

A

We recommend screening adults aged 60 to 74 for CRC with FOBT (either gFOBT or FIT) every two years OR flexible sigmoidoscopy every 10 years.
(Strong recommendation; moderate quality evidence)
We recommend screening adults aged 50 to 59 for CRC with FOBT (either gFOBT or FIT) every two years OR flexible sigmoidoscopy every 10 years.
(Weak recommendation; moderate quality evidence)
We recommend not screening adults aged 75 years and over for CRC.
(Weak recommendation; low quality evidence)
We recommend not using colonoscopy as a screening test for CRC.
(Weak recommendation; low quality evidence)

23
Q

Depression screening

A

For adults at average risk of depression*, we recommend not routinely screening for depression.
(Weak recommendation; very-low-quality evidence)
For adults in subgroups of the population who may be at increased risk of depression†, we recommend not routinely screening for depression.
(Weak recommendation; very-low-quality evidence)

24
Q

Developmental delay screening

A

We recommend against screening1 for developmental delay using standardized tools in children aged 1 to 4 years with no apparent signs of developmental delay and whose parents and clinicians have no concerns about development.
(Strong recommendation; low quality evidence)

25
Q

Screening type 2 diabetes

A

For adults at low to moderate risk of diabetes (determined with a validated risk calculator1 2), we recommend not routinely screening for type 2 diabetes.
(Weak recommendation; low-quality evidence)
For adults at high risk of diabetes (determined with a validated risk calculator1 2), we recommend routinely screening every 3–5 years with A1C3.
(Weak recommendation; low-quality evidence)
For adults at very high risk of diabetes (determined with a validated risk calculator1 2), we recommend routine screening annually with A1C3.
(Weak recommendation; low-quality evidence)

26
Q

Hepatitis c screening

A

We recommend against screening for HCV in adults who are not at elevated risk.
(Strong recommendation, very low quality evidence)

27
Q

Hypertension screening

A

We recommend blood pressure measurement at all appropriate primary care visits [footnote]‘Appropriate’ visits may include new patient visits, periodic health exams; urgent office visits for neurological or cardiovascular related issues, medication renewal visits, and other visits where the Primary Care Practitioner deems it an appropriate opportunity to monitor blood pressure. It is not necessary to measure blood pressure on every patient at every office visit if not clinically indicated.[/footnote] [footnote]The frequency and timing of blood pressure screening may vary between patients. The risk of high blood pressure and the risk of stroke or heart disease change over a person’s natural lifespan and increases with age, comorbidities, and the presence of other risk factors. Therefore appropriate screening frequency may increase accordingly, especially in patients with more than one vascular risk factor. Adults identified as belonging to a high-risk ethnic group (South Asian, Aboriginal, African ancestry) may benefit from more frequent monitoring. Having recent consistently normal blood pressure measurements may decrease the need for monitoring, whereas a tendency toward high-normal blood pressure could indicate that more frequent monitoring is needed.[/footnote].
(Strong recommendation; moderate quality evidence)
We recommend that blood pressure be measured according to the current techniques described in the Canadian Hypertension Education Program CHEP recommendations for office and out-of-office (ambulatory) blood pressure measurement.
(Strong recommendation; moderate quality evidence)
For people who are found to have an elevated blood pressure during screening, the CHEP criteria for assessment and diagnosis of hypertension should be applied to determine whether the patient meets diagnostic criteria for hypertension.
(Strong recommendation; moderate quality evidence)

28
Q

Lung cancer screening

A

Low dose computed tomography (LDCT)
For adults aged 55-74 years with at least a 30 pack-year* smoking history who currently smoke or quit less than 15 years ago, we recommend annual screening with LDCT up to three consecutive times. Screening should ONLY be carried out in health care settings with expertise in early diagnosis and treatment of lung cancer.
Weak recommendation; low quality evidence.*pack-year defined as the (average number of cigarette packs smoked daily) x (number of years smoking)
For all other adults, regardless of age, smoking history or other risk factors, we recommend not screening for lung cancer with LDCT.
Strong recommendation; very low quality evidence.
Chest x-ray (CXR)
We recommend that chest x-ray not be used to screen for lung cancer, with or without sputum cytology.
Strong recommendation; low quality evidence.

29
Q

Prostate cancer screening

A

For men aged less than 55 years, we recommend not screening for prostate cancer with the prostate-specific antigen test.
(Strong recommendation; low quality evidence)
For men aged 55–69 years, we recommend not screening for prostate cancer with the prostate-specific antigen test.
(Weak recommendation; moderate quality evidence)
For men 70 years of age and older, we recommend not screening for prostate cancer with the prostate-specific antigen test.
(Strong recommendation; low quality evidence)

30
Q

Current teenage pregnancy rates

A

28% with half of teen pregnancies being carried to term.

31
Q

Risks associated with teenage pregnancies

A

Higher number of preterm infants
Very low birth weights <1.5g
Small for gestational age
Outcomes are associated with higher risk of neonatal mortality

32
Q

Factors most likely to change outcomes in children born to teenage mothers

A

None, no type of prevention factors have been shown to reduce adverse outcomes including maternal education

33
Q

Morphine is not a metabolite of methadone!

A

Morphine is not a metabolite of methadone

34
Q

Men vs women and coronary artery disease

A

More common in men but women have worse outcomes
Women display more atypical signs of cod and have other specific risk factors including…
Hormone replacement therapy, birth control pills, pregnancy related problems

35
Q

Prevalence of domestic violence in Canada

A

14-15%

36
Q

Domestic violence screening

A

RADAR - Routinely screen, Ask direct questions, Document findings, Assess safety, Respond and Refer

HITS - Hurt, Insult, Threatened, Screamed at