Lecture Outline: Canadian Health Care - York University

Lecture Outline: Canadian Health Care - York University

Lecture Outline: Canadian Health Care Introduction: health care & national identity limits of state medicine health care crisis 1. Changing face of Canadian Health Care:

Hospitals 2. Changing face of Canadian Health Care: Health Workers 3. Changing face of Canadian Health Care: Prescription Drugs Conclusions: New

Directions in Canadian Health Care evidence-based policies primary health care people-centered medicine The Limits of State Medicine state medicine - a public

that is constantly shifting doctors + hospitals = medicine? 1974 Lalonde Report bias to technological, curative, individualized medicine The Limits of State Medicine state health care in late

20th century 1977 Bill C-37 - cut federal funding to provincial health care programs to 25% 1980s & 1990s - era of fiscal restraint, cutbacks, restructuring Crisis in Canadian Health Care

1980s & 1990s: userfees, private for-profit involvement, individual responsibility for care covert health care reforms 2001 Romanoff Commission & Report Crisis in Canadian Health Care

2001 Romanoff Commission & Report Big Question: How to keep universal health care alive & well in Canada? Challenges to sustainability: Aging Population; Health

Technologies; Care for rural & Aboriginal Canadians; Health Personnel Shortages Changing Face of Canadian Health Care The place of hospitals in the health care system

The roles & cost of health care workers The use & cost of prescription drugs 1. Canadian Hospitals cost of hospitals: 1994 acute care hospitals using 38% of health care resources cutbacks: reduced hospital stays & number

of beds, hospital closures & amalgamations 1. Canadian Hospitals hospitals as evolving institutions narrow view of patient antibiotic-resistant superbugs in hospitals

Caledonian Institute of Social Policy, 1999 Briony Penn, A Year on the Wild Side 2. Health Workers Personnel Statistics,19752000: doctors dropped from 15.1 to 13.5 cents;

other health workers professionals increased from 9 to 11.8 cents Personnel Statistics: 2000 - 1.5 million workers in health & social services CANADIAN NURSING STATISTICS: 50% drop in nursing graduates over the last

10 years 3 out of every 10 nursing graduates leave the profession within 5 years of graduating average age of Canadian RN in 2001 = 43.7 years most nurses retire in their 50s so a large exodus from the nursing profession is anticipated over the next decade

2. Health Workers Romanoff Report: nurses dissatisfied on personal & professional levels new work patterns lack of time for education & training, less patient time

3. Prescription Drugs Drug costs: 1975 - 8.8% health care costs; 2000 15.5% health care costs Drug inflation rate, 1980-90 - Canada = 4.4; USA = 3.8; European nations = decline Drug vs hospital costs 1991-93 per capita hospital

expenditures decreased by $17.08; drug expenditures increased by $20.96 3. Prescription Drugs why raising costs? drugs costs outside universal health care federal government Bill

C-91 increasing reliance on drug therapy, linked to early hospital release http://media.cbc.ca:8080/ramgen/newsworld/clips/rm-lo/macleod_pharmacare021128.rm macleod_pharmacare021128.rm

New Directions in Canadian Health Care evidence-based medicine & health care policy primary health care versus institutional care the place of people-centred medicine 1. Evidence-based policies

primary-care reform & tele-health community programs strategies to keep people out of institutions 2. Primary Health Care care in the community

basic medicine - World Health Organization model CLSC in Quebec 3. PeopleCentered Health Care Nursing is a preventative, educational,

restorative, and supportive health-related service, provided in a caring manner, for the purpose of enhancing a persons quality of life or, when life can no longer be sustained, assisting a person to a peaceful and dignified death. College of Nurses of Ontario, 1990

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