Neonatal intensive care units (NICUs) and intensive care units (ICUs) provide care for newborns in need of specialized medical attention. Across Canada, rates of NICU/ICU admission vary. Due to the high cost of monitoring and interventions these admissions cost more than general newborn stays - whether the newborn is in a specialized NICU or in an ICU in those facilities without specialized units for newborns. This study explores the variation in NICU/ICU admissions and the characteristics of mothers and newborns associated with an increased likelihood of NICU/ICU admission. We focus further on the association between NICU/ICU admission and Caesarean section (C-section). After excluding multiple births, preterm births, small for gestational age births and those delivered by women with select complications, we find an increased risk for NICU/ICU admission for babies born by C-section as their only indication. NICU/ICU admission following C-section alone may not represent the most desirable pathway of care for these newborns.
Given the rise in obesity rates, increasing capacity for bariatric surgery has become a focus for some provincial planners. Four types of bariatric procedures are now performed in Canada; however, funding for the procedures varies by jurisdiction. This article provides an update to our previous article documenting the volume of in-patient bariatric procedures but focuses on the extent to which Canadians are increasingly receiving bariatric procedures in day surgery settings.
There are limited data on the quality and safety of care for residents in continuing care settings. An analysis of the main reasons why residents, 75 and older, of continuing care facilities are transferred to acute care demonstrates that two of the top three reasons for transfers result from potentially avoidable events.
Although the general hospital remains an important place for stabilizing crises, most services for mental illnesses are provided in outpatient/community settings. In the absence of comprehensive data at the community level, data that are routinely collected from general hospitals can provide insights on the performance of mental health services for people living with mental illness or poor mental health. This article describes three new indicators that provide a snapshot on the performance of the mental health system in Canada: self-injury hospitalization rate, 30-day readmission rate for mental illness and percentage of patients with repeat hospitalizations for mental illness. Findings suggest a need for the early detection and treatment of mental illnesses and for optimal transitions between general hospitals and community services.
"Are there enough health professionals in Canada, and will they be there when I need them? " Answers to these two seemingly simple questions cover a variety of complex and interrelated factors that are not fully understood, as the report about Canada's Healthcare Providers (CIHI 2001) makes clear. The report appears at a time when Canadian political leaders, healthcare organizations, caregivers and others involved with the healthcare system are looking for creative solutions to the human resources challenges facing the health system. Many of the issues are not new; over the last 50 years they have been raised by various groups and government commissions. But there is a sense of urgency today as options for renewing and sustaining Canada's health system are actively being explored. This essay offers highlights from the report, providing a portrait of what is known (and not known) about the people who work in healthcare across the country. It makes clear that whether there are (or are not) enough healthcare providers is not simply a question of numbers of health professionals. From changes in health and healthcare to shifts in the worklife and practice patterns of professionals, a better understanding of the wide range of factors affecting healthcare providers is essential to further the important debates taking place.