Health Institutions and Organizations in Canada Flashcards
How were hospitals in Canada in the 19th century
- Hospitals were for poor people with no houses, soldiers, and sailors (community housing)
- They were dirty, funded by charity, and most cases of infections from physicians & last stop before death
- Used patients as subjects in exchange of receiving care
What did the Laboratory Era entail?
In Germany, they removed patient from the generation of medical knowledge
- only looked at diseases & cell pathology
How does funding in hospitals in Ontario work? Through what acts/agreements?
- Federal Funding through:
- Canada Health Act
- Usually based on past fundings - Ontario MOHLTC through:
- Local Health System Integration Act
- Ministry LHIN performance agreement (MLPA) - LHINS through:
- Hospital Service Accountability Agreements (HSAA)
(contains financial performance obligations - Hospitals
What are the legislative changes and regulatory changes for Ontario’s journey to build a connected and coordinated public healthcare system
Legislative changes
- Connecting Care Act 2019
- The people’s health care act 2019
- Excellent Care for all Act 2010
Regulatory changes
- Personal Health information and Protection Act 2004
- Excellent Care for All act 2010
What occurred in the Health system Funding Reform? What did MOHLTC change their funding to and how was it allocated?
Changed funding to Patient based funding, includes:
- Health based allocation model (HBAM): distributes funding based on volume and type of patients (40%)
- Quality-Based Procedures (QBP): funding for surgeries (30%)
- Global budget (30%)
- 15-20% of hospital funding comes from their own revenue
Explain the hospital expenditures in Ontario. Where does most of the expenses go? How are MDs funded?
- Most expenses go toward compensation and benefits
- MDs recieve funding for insured medical services from OHIP based on a fee-for-service basis (except the On-Call program)
How are the majority of hospitals operated in terms of governance
Mostly private, non-profit
Is Accreditation mandatory for hospitals in Ontario?
When is it mandatory? Are results released?
Accreditation is voluntary
- Mandatory for teaching hospitals
- Results are not released (optional)
How are hospital pharmacies licensed?
Through OCP
Are physicians under authorization of admin within the hospital? Why? Who are?
Physicians bill provincial governments therefore are not under authorization of admin
- Nurses, Pharmacists, and other staff are
What effect does total institution have on a patient?
Does more care mean higher life expectancy?
- depersonalization
- no
How was the government tried to save money in hospitals?
- Merging and closing hospitals, reduce number of acute beds, shorten length of stay, offer same-day surgery
- Cut salaried hospital employees and cut laundry and food services
- Reduce nurses and pharmacists
What is the future of the Alternate level of Care patients. Explain Better Care Act, 2022
- Acute beds ($842) cost the most in the hospital and more than 7500 (10%) beds are occupied by ALC patients.
- LTC ($126) and home care ($42) is cheaper
Act
- patients can be transferred to LTC in a range of 70km (southern ON) or 150km (northern ON)
- If they refuse they will have to $400/day to stay in hospital
What are pharmacist’s role in hospitals
Clinical services
- Focus on decrease hospital readmission
- Med reconciliation
Administrative services
Describe the different types of LTC homes (3) and their levels of support
Residential care
- minimal support
- privately owned, client pays full rent, food, and services
Supportive housing
- Moderate support
- government-funded personal services + rent-geared to income coverage
- 24/7 support services
Long-term care facilities
- High supports
- government funds services, residents pay for accommodation
- 24/7 nursing and personal services
- All have a contracted pharmacist
