Patient care classification in Canada in the past has been largely dictated by insurance coverage and the fiscal policies of the individual provinces. In recent years, however, the Canadian Department of Health and Welfare has been promoting the development of a standard patient care classification based on assessment of client or patient needs in regard to the category, type, and level of care. Experimentation with the proposed classification system in several provinces confirms the need in long-term care to include assessment of nursing requirements, physical functioning, and psychosocial assets and liabilities, and points to the importance of using such a classification for planning and evaluating patient care as well as for administrative purposes.
Recent research in the field of mental retardation has pointed to a better-defined population with exacting prevalence of the basic pathology and related disabilities. Advances in the areas of prevention and treatment have further reduced the prevalence and incidence of mental retardation. Current legislation and legislative procedures have led to a more equitable and fairer application of human rights to all citizens. However, discrepancies and ambiguities still remain with respect to interpretation of the spirit of the law as related to the retarded. Financial restraints and serious economic hardship have impacted on social and political attitudes and created two-tier systems of the rich and poor with the retarded referred to as "surplus population." This situation has, in turn, influenced the availability of resources, manpower, training, and research in this field. The future could be brighter if sociologic and philosophic changes parallel technologic advances. It is our duty and commitment to continue and further the developments in all spheres relevant to the retarded in order to maximize human potential whenever possible.
To retrospectively examine the barriers faced and opportunities for improvement during the 2009 H1N1 pandemic response experienced by participants responsible for the delivery of health care services in 3 remote and isolated Subarctic First Nation communities of northern Ontario, Canada.
A qualitative community-based participatory approach.
Semi-directed interviews were conducted with adult key informants (n=13) using purposive sampling of participants representing the 3 main sectors responsible for health care services (i.e., federal health centres, provincial hospitals and Band Councils). Data were manually transcribed and coded using deductive and inductive thematic analysis.
Primary barriers reported were issues with overcrowding in houses, insufficient human resources and inadequate community awareness. Main areas for improvement included increasing human resources (i.e., nurses and trained health care professionals), funding for supplies and general community awareness regarding disease processes and prevention.
Government bodies should consider focusing efforts to provide more support in terms of human resources, monies and education. In addition, various government organizations should collaborate to improve housing conditions and timely access to resources. These recommendations should be addressed in future pandemic plans, so that remote western James Bay First Nation communities of Subarctic Ontario and other similar communities can be better prepared for the next public health emergency.