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2020 healthcare management in Canada: a new model home next door.

https://arctichealth.org/en/permalink/ahliterature184152
Source
Healthc Manage Forum. 2003;16(1):6-10, 44-9
Publication Type
Article
Date
2003
Author
D Wayne Taylor
Author Affiliation
Michael G. DeGroote School of Business, McMaster University.
Source
Healthc Manage Forum. 2003;16(1):6-10, 44-9
Date
2003
Language
English
French
Publication Type
Article
Keywords
Canada
Cost Sharing
Efficiency
Employment - statistics & numerical data - trends
Health Care Reform
Health Expenditures - trends
Health Services Needs and Demand - trends
Humans
Models, organizational
National Health Programs - economics - organization & administration - trends
Politics
Population Dynamics
Social Change
Social Values
Taxes - trends
Abstract
The Commission on the Future of Health Care in Canada asked whether Medicare is sustainable in its present form. Well, Medicare is not sustainable for at least six reasons. Given a long list of factors, such as Canada's changing dependency ratio, the phenomenon of diminishing returns from increased taxation, competing provincial expenditure needs, low labour and technological productivity in government-funded healthcare, the expectations held by baby boomers, and the evolving value sets of Canadians--Medicare will impoverish Canada within the next couple of decades if not seriously recast. As distasteful as parallel private-pay, private-choice healthcare may be to some policy makers and providers who grew up in the 1960s, the reality of the 2020s will dictate its necessity as a pragmatic solution to a systemic problem.
PubMed ID
12908160 View in PubMed
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Assessing the contribution of unstable employment to mortality in posttransition Russia: prospective individual-level analyses from the Russian longitudinal monitoring survey.

https://arctichealth.org/en/permalink/ahliterature149009
Source
Am J Public Health. 2009 Oct;99(10):1818-25
Publication Type
Article
Date
Oct-2009
Author
Francesca Perlman
Martin Bobak
Author Affiliation
London School of Hygiene and Tropical Medicine, Keppel Street, London, UK. francesca.perlman@lshtm.ac.uk
Source
Am J Public Health. 2009 Oct;99(10):1818-25
Date
Oct-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Confidence Intervals
Data Collection
Employment - statistics & numerical data - trends
Female
Humans
Logistic Models
Longitudinal Studies
Male
Middle Aged
Mortality
Occupations - statistics & numerical data
Proportional Hazards Models
Prospective Studies
Risk factors
Russia
Social Class
Time Factors
Unemployment - statistics & numerical data
Young Adult
Abstract
We used the Russia Longitudinal Monitoring Survey (RLMS) to investigate associations between employment, socioeconomic position, and mortality.
Data were from working-age respondents in 8 rounds (1994-2003) of the RLMS. We measured associations between education, occupation, unemployment, and insecure employment and mortality with Cox proportional hazards analyses.
Of 4465 men and 4158 women who were currently employed, 251 men and 34 women died. A third of employed respondents experienced wage arrears, and 10% experienced compulsory leave and payment in consumer goods. Insecure employment, more common among the less-educated and manual workers, fluctuated with macroeconomic measures. Mortality was significantly associated with payment in consumer goods among men (hazard ratio [HR] = 1.46; 95% confidence interval [CI] = 1.03, 2.07), compulsory unpaid leave among women (HR = 3.79; 95% CI = 1.82, 7.88), and male unemployment (HR = 1.88; 95% CI = 1.38, 2.55). Associations with death within 1 year of entry were generally somewhat stronger than the association with mortality over the whole study period.
Unemployment and job insecurity predicted mortality, suggesting that they contributed to Russia's high mortality during the transition from communism.
Notes
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PubMed ID
19696378 View in PubMed
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Association between the decline in workers' compensation claims and workforce composition and job characteristics in Ontario, Canada.

https://arctichealth.org/en/permalink/ahliterature165379
Source
Am J Public Health. 2007 Mar;97(3):453-5
Publication Type
Article
Date
Mar-2007
Author
F Curtis Breslin
Emile Tompa
Cameron Mustard
Ryan Zhao
Peter Smith
Sheilah Hogg-Johnson
Author Affiliation
Institute for Work & Health, Toronto, Ontario, Canada. cbreslin@iwh.on.ca
Source
Am J Public Health. 2007 Mar;97(3):453-5
Date
Mar-2007
Language
English
Publication Type
Article
Keywords
Accidents, Occupational - economics - statistics & numerical data
Adolescent
Adult
Age Distribution
Demography
Employment - statistics & numerical data - trends
Female
Humans
Industry - classification - economics - manpower
Linear Models
Male
Middle Aged
Occupational Diseases - economics - epidemiology
Ontario - epidemiology
Safety
Work - physiology
Workers' Compensation - utilization
Abstract
We examined associations between workforce demographics and job characteristics, grouped by industrial sector, and declines in workers' compensation claim rates in Ontario, Canada, between 1990 and 2003. Gender, age, occupation, and job tenure were predictors for claim rates in 12 industrial sectors. The decline in claims was significantly associated with a decline in the proportion of employment in occupations with high physical demands. These findings should generate interest in economic incentives and regulatory policies designed to encourage investment in safer production processes.
Notes
Cites: Am J Public Health. 2003 Aug;93(8):1283-612893615
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Cites: Occup Environ Med. 2004 Jul;61(7):616-2115208378
Cites: Chronic Dis Can. 2004 Summer-Fall;25(3-4):127-3715841853
Cites: Am J Public Health. 1998 Dec;88(12):1827-339842381
Cites: Spine (Phila Pa 1976). 1999 Apr 1;24(7):691-710209800
Cites: Occup Environ Med. 2004 Sep;61(9):750-615317915
PubMed ID
17267716 View in PubMed
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Change in employment status of 5-year cancer survivors.

https://arctichealth.org/en/permalink/ahliterature128165
Source
Eur J Public Health. 2013 Feb;23(1):116-22
Publication Type
Article
Date
Feb-2013
Author
Steffen Torp
Roy A Nielsen
Sophie D Fosså
Saevar B Gudbergsson
Alv A Dahl
Author Affiliation
Department of Health Promotion, Vestfold University College, Norway. steffen.torp@hive.no
Source
Eur J Public Health. 2013 Feb;23(1):116-22
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Case-Control Studies
Employment - statistics & numerical data - trends
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasms - diagnosis - mortality - psychology
Norway - epidemiology
Prospective Studies
Registries
Regression Analysis
Sex Distribution
Socioeconomic Factors
Survival Rate
Survivors - psychology - statistics & numerical data
Young Adult
Abstract
To follow the employment status of 5-year cancer survivors for 5 years after diagnosis with their first lifetime invasive cancer and to identify socio-demographic, work-related and cancer-related predictors of employment status after 5 years.
This prospective registry study concerned all 3278 people in Norway (18-61 years old) diagnosed with their first lifetime invasive cancer in 1999 and alive in 2004 and a cancer-free control group (n = 6368) matched by sex, age, educational level and employment status in 1998.
The employment rate among male cancer survivors declined steadily every year, from 94% the year before diagnosis (1998) to 77% 5 years after diagnosis (2004). This change did not differ significantly from that of male controls. The employment rate of female survivors also declined steadily, from 87% (1998) to 69% (2004). This decline was greater than that among female controls, and in 2004 survivors had a significantly lower employment rate. For both men and women, the significant pre-diagnosis predictors of being employed in 2004 concerned higher socio-economic position. For both sexes, lung cancer survivors had the highest decline in employment rate, and male skin cancer survivors had a lower decline in employment rate than controls. Socio-demographic and work-related factors explained more of the variance in employment status than did cancer diagnosis.
The employment rate among 5-year cancer survivors did not change significantly except for female survivors. Low socio-economic position is a risk factor for decline in employment rate and should be focused on to prevent cancer-related inequity.
PubMed ID
22227027 View in PubMed
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Changing health inequalities in a changing society? Sweden in the mid-1980s and mid-1990s.

https://arctichealth.org/en/permalink/ahliterature71890
Source
Scand J Public Health Suppl. 2001;55:31-9
Publication Type
Article
Date
2001
Author
O. Lundberg
F. Diderichsen
M A Yngwe
Author Affiliation
Swedish Institute for Social Research, Stockholm. olle.lundberg@sofi.su.se
Source
Scand J Public Health Suppl. 2001;55:31-9
Date
2001
Language
English
Publication Type
Article
Keywords
Adult
Chronic Disease - epidemiology
Educational Status
Employment - statistics & numerical data - trends
Female
Health Status Indicators
Humans
Male
Middle Aged
Perception
Self Assessment (Psychology)
Social Change
Social Class
Social Welfare - economics - trends
Socioeconomic Factors
Sweden - epidemiology
Abstract
Whereas the end of the 1980s was characterized by an economic boom, the early 1990s saw the worst recession since the 1930s. In Sweden, the crisis that started in the fall of 1991 and culminated in 1995 meant dramatically increased unemployment rates followed by cutbacks in welfare state programs. In addition, other major changes in economic and political conditions have taken place during this period, including tax reforms and EU membership. Although public health as well as health inequalities are likely to be linked with these kinds of macro changes, it is unclear what types of changes in health and health inequalities one would expect. In this paper analyses of Swedish data on health inequalities in the periods 1986-87 and 1994-95 are undertaken on the basis of the Swedish Surveys of Living Conditions. The main finding is that overall health levels as well as differences in health between men and women, different age groups, educational groups, social classes, and employment status groups have remained constant.
PubMed ID
11482794 View in PubMed
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Convergence or divergence of male and female physicians' hours of work and income.

https://arctichealth.org/en/permalink/ahliterature214619
Source
Med Care. 1995 Aug;33(8):796-805
Publication Type
Article
Date
Aug-1995
Author
N. Dedobbeleer
A P Contandriopoulos
S. Desjardins
Author Affiliation
Groupe de recherche interdisciplinaire en santé, Faculty of Medicine, Université de Montreal, Quebec, Canada.
Source
Med Care. 1995 Aug;33(8):796-805
Date
Aug-1995
Language
English
Publication Type
Article
Keywords
Adult
Aged
Employment - statistics & numerical data - trends
Female
Humans
Income - statistics & numerical data - trends
Male
Medicine
Middle Aged
Physicians, Women - economics - statistics & numerical data - utilization
Professional Practice - economics - statistics & numerical data - trends
Quebec
Regression Analysis
Sex Factors
Specialization
Time Factors
Workload - statistics & numerical data
Abstract
This article verifies if the increase in the percentage of women in the medical profession led to the convergence of male and female physicians' hours of work as well as income. Active physicians in Quebec in 1978 were compared to the ones in 1988. Data were obtained from the computerized files of the Quebec Corporation of Physicians and the Régie d'assurance-maladie du Quebec. Despite the increasing representation of women in the medical profession, gender differences in hours worked and income remained. However, results also showed a tendency toward a convergence in total hours of work, more behavioral variation among women physicians and some behavioral change among men. The experience of the past should thus not be used as the basis for projections of future physician productivity or for medical manpower planning purposes without a careful analysis of trends in behavioral changes.
PubMed ID
7637402 View in PubMed
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Effort-reward imbalance at work and risk of long-term sickness absence in the Danish workforce.

https://arctichealth.org/en/permalink/ahliterature115194
Source
J Occup Environ Med. 2013 Apr;55(4):454-9
Publication Type
Article
Date
Apr-2013
Author
Maj Britt D Nielsen
Ida E H Madsen
Ute Bültmann
Birgit Aust
Hermann Burr
Reiner Rugulies
Author Affiliation
National Research Centre for the Working Environment, Copenhagen, Denmark. mbn@nrcwe.dk
Source
J Occup Environ Med. 2013 Apr;55(4):454-9
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Adult
Confidence Intervals
Denmark
Employee Incentive Plans
Employment - statistics & numerical data - trends
Female
Humans
Male
Middle Aged
Proportional Hazards Models
Questionnaires
Sick Leave - statistics & numerical data - trends
Abstract
To examine whether effort-reward imbalance (ERI) at work predicts onset of register-based long-term sickness absence (LTSA) in a representative sample of the Danish workforce.
We measured effort, reward, ERI, and covariates with self-administered questionnaires in a sample of 4775 employees. LTSA during 12-months of follow-up was assessed with a national register. We calculated hazard ratios (HRs) with Cox proportional hazard models.
The HR of LTSA for a one-SD increase in ERI was 1.03 (95% confidence interval [CI], 0.93-1.15) in the most-adjusted model. For effort, the HR for a one-SD increase was 0.95 (95% CI, 0.85-1.06) and for reward the HR for a one-SD decrease was 1.14 (95% CI, 1.03-1.26).
ERI was not associated with onset of LTSA. Low reward, however, predicted LTSA.
PubMed ID
23532196 View in PubMed
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From care to education and work? Education and employment trajectories in early adulthood by children in out-of-home care.

https://arctichealth.org/en/permalink/ahliterature308373
Source
Child Abuse Negl. 2019 12; 98:104144
Publication Type
Journal Article
Date
12-2019
Author
Antti Kääriälä
Pasi Haapakorva
Elina Pekkarinen
Reijo Sund
Author Affiliation
Faculty of Social Sciences, University of Helsinki, P.O. Box 18, FI-00014, Helsinki, Finland. Electronic address: antti.kaariala@helsinki.fi.
Source
Child Abuse Negl. 2019 12; 98:104144
Date
12-2019
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Child
Child, Foster
Cohort Studies
Employment - statistics & numerical data - trends
Female
Finland
Foster Home Care
Humans
Male
Peer Group
Social Welfare - statistics & numerical data
Unemployment - statistics & numerical data
Vulnerable Populations
Young Adult
Abstract
Temporal dynamics during the early adulthood transition among children in out-of-home care is a neglected research area, leaving the possibility of coping with childhood adversity over time a poorly understood topic.
To explore early adulthood education and employment trajectories among young adults who experienced out-of-home care during childhood and to examine how various care history factors predict these trajectories.
We use longitudinal birth cohort data comprising individual-level information from national registers of all children born in Finland in 1987 (N?=?59,476, of whom 1893 were in care).
We use trajectory clustering from a previous study on the 1987 birth cohort to compare trajectories between children in care and a propensity score-matched group of peers never in care. We investigated the association between care history factors and trajectories with multinomial logistic regression modeling.
Compared with the matched peer group, children in care were less likely to enter trajectories characterized by education and employment (38%) and more likely to enter trajectories involving early parenthood (14%) or long periods of fragmented social assistance benefit receipt and unemployment (21%). Those on early parenthood trajectories were almost exclusively women, whereas those receiving social assistance benefits and experiencing unemployment for lengthy periods were mostly men. Entering disadvantaged trajectories was associated with, inter alia, placement as an adolescent, residential care, and aging out of care.
The study demonstrates the relevance of examining longitudinal trajectories in children in care's early adulthood. Many young adults with care experience need support in education and employment beyond young adult age.
PubMed ID
31678608 View in PubMed
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Hospital reform and nursing labor market trends in Canada.

https://arctichealth.org/en/permalink/ahliterature207499
Source
Med Care. 1997 Oct;35(10 Suppl):OS124-31
Publication Type
Article
Date
Oct-1997
Author
A J Baumgart
Author Affiliation
School of Nursing, Queen's University, Kingston, Ontario, Canada.
Source
Med Care. 1997 Oct;35(10 Suppl):OS124-31
Date
Oct-1997
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Canada
Educational Status
Employment - statistics & numerical data - trends
Female
Health Care Reform - statistics & numerical data - trends
Hospital Restructuring - manpower - statistics & numerical data - trends
Humans
Middle Aged
National Health Programs
Nursing Staff, Hospital - economics - statistics & numerical data - supply & distribution - utilization
Personnel Staffing and Scheduling
Salaries and Fringe Benefits - statistics & numerical data
Abstract
Trends in the Canadian registered nurse (RN) workforce during the past 3 decades are examined, and the implications of current hospital sector retrenchment for RN employment are considered.
A descriptive review using relevant literature and existing databases on the nurse workforce is presented.
From the 1960s through the 1980s, the Canadian RN workforce grew exponentially, fueled by expansions in the health-care delivery system under Medicare, rising inpatient acuity and skill-intensive patient care, enhanced access to nursing education, and increases in the numbers of women entering the workforce. Acute care hospitals have and continue to be the predominant employer of RNs. However, the 1990s have witnessed considerable hospital retrenchment, and with that retrenchment the growth of the hospital RN workforce has slowed dramatically.
The ultimate outcomes of hospital retrenchment for the RN workforce remain unclear. Some speculate that the quality of care and working conditions will deteriorate in hospitals, as hospital administrators replace RN staff with lesser trained personnel to reduce costs. Others see change in the hospital sector as an opportunity for RNs to expand their scope of practice and responsibility in outpatient settings. The need for national and international research on the outcomes of hospital restructuring on patient care and the work of RNs is critical to sound policy making.
PubMed ID
9339783 View in PubMed
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How do macro-level contexts and policies affect the employment chances of chronically ill and disabled people? Part II: The impact of active and passive labor market policies.

https://arctichealth.org/en/permalink/ahliterature132184
Source
Int J Health Serv. 2011;41(3):415-30
Publication Type
Article
Date
2011
Author
Paula Holland
Lotta Nylén
Karsten Thielen
Kjetil A van der Wel
Wen-Hao Chen
Ben Barr
Bo Burström
Finn Diderichsen
Per Kragh Andersen
Espen Dahl
Sharanjit Uppal
Stephen Clayton
Margaret Whitehead
Author Affiliation
Division of Health Research, Lancaster University, England.
Source
Int J Health Serv. 2011;41(3):415-30
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Canada
Chronic Disease
Disabled Persons
Educational Status
Employment - statistics & numerical data - trends
Europe
Female
Health Surveys
Humans
Male
Middle Aged
Organizational Culture
Organizational Policy
Public Policy
Regression Analysis
Social Justice
Social Welfare
Abstract
The authors investigate three hypotheses on the influence of labor market deregulation, decommodification, and investment in active labor market policies on the employment of chronically ill and disabled people. The study explores the interaction between employment, chronic illness, and educational level for men and women in Canada, Denmark, Norway, Sweden, and the United Kingdom, countries with advanced social welfare systems and universal health care but with varying types of active and passive labor market policies. People with chronic illness were found to fare better in employment terms in the Nordic countries than in Canada or the United Kingdom. Their employment chances also varied by educational level and country. The employment impact of having both chronic illness and low education was not just additive but synergistic. This amplification was strongest for British men and women, Norwegian men, and Danish women. Hypotheses on the disincentive effects of tighter employment regulation or more generous welfare benefits were not supported. The hypothesis that greater investments in active labor market policies may improve the employment of chronically ill people was partially supported. Attention must be paid to the differential impact of macro-level policies on the labor market participation of chronically ill and disabled people with low education, a group facing multiple barriers to gaining employment.
PubMed ID
21842571 View in PubMed
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24 records – page 1 of 3.