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Academic Alternate Relationship Plans for internal medicine: a lever for health care transformation.

https://arctichealth.org/en/permalink/ahliterature129973
Source
Open Med. 2011;5(1):e28-32
Publication Type
Article
Date
2011
Author
Allison Bichel
Maria Bacchus
Jon Meddings
John Conly
Author Affiliation
Department of Medicine, Calgary Health Region, and University of Calgary, Calgary, Alberta.
Source
Open Med. 2011;5(1):e28-32
Date
2011
Language
English
Publication Type
Article
Keywords
Alberta
Diffusion of Innovation
Health Care Reform - methods
Health Care Surveys
Health Services Accessibility - organization & administration
Health services needs and demand
Humans
Internal Medicine - education
Poisson Distribution
Program Development
Schools, Medical - organization & administration - trends
Notes
Cites: Can Fam Physician. 2000 Jul;46:1438-4410925758
Cites: Can Respir J. 2009 Mar-Apr;16(2):49-5419399308
Cites: Can J Cardiol. 2008 Mar;24(3):195-818340388
Cites: CMAJ. 1999 Jun 15;160(12):1710-410410632
PubMed ID
22046217 View in PubMed
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Accessing timely rehabilitation services for a global aging society? Exploring the realities within Canada's universal health care system.

https://arctichealth.org/en/permalink/ahliterature145394
Source
Curr Aging Sci. 2010 Jul;3(2):143-50
Publication Type
Article
Date
Jul-2010
Author
Michel D Landry
Sudha Raman
Elham Al-Hamdan
Author Affiliation
Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. mike.landry@utoronto.ca
Source
Curr Aging Sci. 2010 Jul;3(2):143-50
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aging
Canada
Cooperative Behavior
Delivery of Health Care, Integrated - organization & administration
Health Services Accessibility - organization & administration
Health Services Needs and Demand - organization & administration
Health Services for the Aged - organization & administration
Humans
Interinstitutional Relations
National health programs - organization & administration
Organizational Objectives
Physical Therapy Modalities - organization & administration
Private Sector - organization & administration
Public Sector - organization & administration
Time Factors
World Health
Abstract
The proportion of older persons is increasing in developed and developing countries: this aging trend can be viewed as a two-edged sword. On the one hand, it represents remarkable successes regarding advances in health care; and on the other hand, it represents a considerable challenge for health systems to meet growing demand. A growing disequilibrium between supply and demand may be particularly challenging within publicly funding health systems that 'guarantee' services to eligible populations. Rehabilitation, including physical therapy, is a service that if provided in a timely manner, can maximize function and mobility for older persons, which may in turn optimize efficiency and effectiveness of overall health care systems. However, physical therapy services are not considered an insured service under the legislative framework of the Canadian health system, and as such, a complex public/private mix of funding and delivery has emerged. In this article, we explore the consequences of a public/private mix of physical therapy on timely access to services, and use the World Health Organization (WHO) health system performance framework to assess the extent to which the emerging system influences the goal of aggregated and equitable health. Overall, we argue that a shift to a public/private mix may not have positive influences at the population level, and that innovative approaches to deliver services would be desirable to strengthening rather than weaken the publicly funded system. We signal that strategies aimed at scaling up rehabilitation interventions are required in order to improve health outcomes in an evolving global aging society.
PubMed ID
20158495 View in PubMed
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Access to adult liver transplantation in Canada: a survey and ethical analysis.

https://arctichealth.org/en/permalink/ahliterature212821
Source
CMAJ. 1996 Feb 1;154(3):337-42
Publication Type
Article
Date
Feb-1-1996
Author
M A Mullen
N. Kohut
M. Sam
L. Blendis
P A Singer
Author Affiliation
University of Toronto Joint Centre for Bioethics, Ont.
Source
CMAJ. 1996 Feb 1;154(3):337-42
Date
Feb-1-1996
Language
English
Publication Type
Article
Keywords
Adult
Canada
Data Collection
Health Care Rationing - organization & administration
Health Services Accessibility - organization & administration
Humans
Liver Transplantation
Organizational Policy
Patient Selection
Resource Allocation
Waiting Lists
Abstract
To describe the substantive and procedural criteria used for placing patients on the waiting list for liver transplantation and for allocating available livers to patients on the waiting list; to identify principal decision-makers and the main factors limiting liver transplantation in Canada; and to examine how closely cadaveric liver allocation resembles theoretic models of source allocation.
Mailed survey.
Medical directors of all seven Canadian adult liver transplantation centres, or their designates. Six of the questionnaires were completed.
Relative importance of substantive and procedural criteria used to place patients in the waiting list for liver transplantation and to allocate available livers. Identification of principal decision-makers and main limiting factors to adult liver transplantation.
Alcoholism, drug addiction, HIV positivity, primary liver cancer, noncompliance and hepatitis B were the most important criteria that had a negative influence on decisions to place patients on the waiting list for liver transplantation. Severity of disease and urgency were the most important criteria used for selecting patients on the waiting list for transplantation. Criteria that were inconsistent across the centres included social support (for deciding who is placed on the waiting list) and length of time on the waiting list (for deciding who is selected from the list). Although a variety of people were reported as being involved in these decisions, virtually all were reported to be health to be health care professionals. Thirty-seven patients died while waiting for liver transplantation in 1991; the scarcity of cadaveric livers was the main limiting factor.
Criteria for resource allocation decisions regarding liver transplantation are generally consistent among the centres across Canada, although some important inconsistencies remain. Because patients die while on the waiting list and because the primary limiting factor is organ supply, increased organ acquisition efforts are needed.
Notes
Cites: Psychosomatics. 1993 Jul-Aug;34(4):314-238351306
Cites: Arch Intern Med. 1990 Mar;150(3):523-72178581
Cites: BMJ. 1990 Jul 7;301(6742):15-72383700
Cites: N Engl J Med. 1991 Oct 24;325(17):1243-61845039
PubMed ID
8564903 View in PubMed
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Access to health services by Canadians who are chronically ill.

https://arctichealth.org/en/permalink/ahliterature174970
Source
West J Nurs Res. 2005 Jun;27(4):465-86
Publication Type
Article
Date
Jun-2005
Author
Shannon M Spenceley
Author Affiliation
University of Alberta, Canada.
Source
West J Nurs Res. 2005 Jun;27(4):465-86
Date
Jun-2005
Language
English
Publication Type
Article
Keywords
Attitude to Health
Canada - epidemiology
Chronic Disease - epidemiology - psychology - therapy
Data Collection - standards
Data Interpretation, Statistical
Health Care Reform - organization & administration
Health Services Accessibility - organization & administration
Health Services Research - organization & administration
Humans
National health programs - organization & administration
Needs Assessment - organization & administration
Research Design - standards
Abstract
Access to health care services in Canada has been identified as an urgent priority, and chronic disease has been suggested as the most pressing health concern facing Canadians. Access to services for Canadians living with chronic disease, however, has received little emphasis in the research literature or in health policy reform documents. A systematic review of research into factors impeding or facilitating access to formal health services for people in Canada living with chronic illness is presented. The review includes 31 studies of Canadian populations published between 1990 and 2002; main results were analyzed for facilitators and barriers to access for people experiencing chronic disease. An underlying organizing construct of symmetry between consumers, providers, and the larger Canadian system is suggested as a relevant lens from which to view the findings. Finally, a discussion of the relationship between identified factors and the principles of primary health care is offered.
PubMed ID
15870244 View in PubMed
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Source
Can Fam Physician. 2008 Dec;54(12):1702
Publication Type
Article
Date
Dec-2008
Author
Jyoti A Kotecha
Richard V Birtwhistle
Author Affiliation
Centre for Studies in Primary Care, Queen's University, Kingston, ON, Canada.
Source
Can Fam Physician. 2008 Dec;54(12):1702
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Canada
Health Services Accessibility - organization & administration
Home Care Services - organization & administration
Humans
Program Evaluation - methods
PubMed ID
19074713 View in PubMed
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Access to specialized health care for asthmatic children in Norway: the significance of parents' educational background and social network.

https://arctichealth.org/en/permalink/ahliterature82112
Source
Soc Sci Med. 2006 Sep;63(5):1316-27
Publication Type
Article
Date
Sep-2006
Author
Finnvold Jon Erik
Author Affiliation
Statistics Norway, Oslo. jef@ssb.no
Source
Soc Sci Med. 2006 Sep;63(5):1316-27
Date
Sep-2006
Language
English
Publication Type
Article
Keywords
Asthma - therapy
Child
Child Health Services - organization & administration
Child, Preschool
Educational Status
Female
Health Services Accessibility - organization & administration
Hospitals, Public
Humans
Male
Norway
Parents
Severity of Illness Index
Social Support
Abstract
What determines access to the Voksentoppen Children's Asthma and Allergy Centre, the most specialized health care facility for asthmatic children in Norway? This publicly funded national institution is mandated to serve all segments of the population equally. The paper reports from the experiences of families with children having a confirmed diagnosis of moderate to severe asthma. The study population was selected from a national register of state cash-benefit recipients. Within this register, all families with a child under the age of 9 and with the diagnosis of asthma at the end of 1997 were selected (N = 2564). Further information about the population was gathered in a postal survey. It was found that access to the facility, measured as at least one admission during the period of the disease, was primarily determined by variations in morbidity. In particular, measures of health condition that presupposed a professional's evaluation of the child's health condition were significant. In addition, access was influenced by several factors not directly related to the need for treatment. Notably, children from families in which parents had a graduate education were over-represented among those with access to the top level of the institution's medical hierarchy. Multivariate analysis was used to search for causal mechanisms. It was found that families with a doctor in their social network had greater likelihood of access, and this in part accounted for the observed association between education and access. The pattern of access was also influenced by geographical factors, but not in a way that reduced the significance of educational background. Membership of, and participation in, patient organizations also increased the families' chances of receiving top-level professional treatment. The results depart from professional norms and officially stated health policy in Norway, which assert that health condition is the only valid criterion for allocating scarce medical goods.
PubMed ID
16725246 View in PubMed
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Addressing the realities [correction of realties] of health care in northern aboriginal communities through participatory action research.

https://arctichealth.org/en/permalink/ahliterature175481
Source
J Interprof Care. 2004 Nov;18(4):360-8
Publication Type
Article
Date
Nov-2004
Author
Bruce Minore
Margaret Boone
Mae Katt
Peggy Kinch
Stephen Birch
Author Affiliation
Center for Rural and Northern Health Research, Lakehead University, Thunder Bay, Ontario, Canada. bruce.minore@lakeheadu.ca
Source
J Interprof Care. 2004 Nov;18(4):360-8
Date
Nov-2004
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Community Health Services - economics - supply & distribution
Consumer Participation
Continuity of Patient Care - economics - organization & administration
Diabetes Mellitus - ethnology - therapy
Female
Health Services Accessibility - organization & administration
Humans
Indians, North American
Male
Mental Health Services - supply & distribution
Neoplasms - ethnology - therapy
Rural Health Services - economics - supply & distribution
Abstract
To address concerns about disruptions in the continuity of health care delivered to residents in three remote aboriginal communities in northern Ontario, Canada, the local health authority initiated a study in collaboration with the department of Health Canada responsible for ensuring that aboriginal reserves receive mandatory health services, and an inter-disciplinary team of researchers from two universities. The study focussed on the delivery of oncology, diabetes and mental health care, specifically, as well as systems issues such as recruitment and retention of health human resources and financial costs. The paper discusses the procedures involved, the benefits derived and the challenges encountered in doing this as a community driven participatory action research project. It also summarizes the findings that led to community formulated policy and program recommendations.
PubMed ID
15801551 View in PubMed
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Air ambulance nurses as expert supplement to local emergency services.

https://arctichealth.org/en/permalink/ahliterature261647
Source
Air Med J. 2014 Jan-Feb;33(1):40-3
Publication Type
Article
Author
Torben Wisborg
Bjørn Bjerkan
Source
Air Med J. 2014 Jan-Feb;33(1):40-3
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Air Ambulances - organization & administration
Child
Child, Preschool
Critical Care Nursing
Health Services Accessibility - organization & administration
Humans
Infant
Infant, Newborn
Norway
Nurse Anesthetists
Prospective Studies
Abstract
Flight nurses in the Norwegian National Air Ambulance Service are specialist nurse anesthetists or intensive care nursing specialists. For air ambulance bases far from hospitals, these nurses present otherwise unavailable competencies. This study reports a 6-year experience with flight nurse participation in local emergencies beyond the transportation phase.
The fixed-wing air ambulance base in Alta, Northern Norway (20,000 inhabitants), with 2 aircraft and 2 on-call teams is 150 km by road from the nearest hospital. We did a prospective registration of all emergency nonflight missions near the air ambulance base from January 1, 2005, to December 31, 2010.
The 217 completed missions corresponded to 3 missions per month, half during daytime. Twenty-three percent of patients were under age 18, injury rate was high (36%), 63% had potentially or manifest life-threatening conditions, and 11% died during treatment. One third of all missions (67/217) resulted in an air ambulance flight to the hospital.
Mission frequency did not significantly reduce flight availability, and precision in case selection for this special service was good. The use of flight nurses in the local community promotes equal access to advanced medical services for populations far from hospitals.
PubMed ID
24373476 View in PubMed
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The Alaska Native Women's Wellness Project.

https://arctichealth.org/en/permalink/ahliterature3977
Source
Health Care Women Int. 1999 Sep-Oct;20(5):487-92
Publication Type
Article
Author
B. Stillwater
Author Affiliation
Southcentral Foundation, Anchorage, AK 99508, USA.
Source
Health Care Women Int. 1999 Sep-Oct;20(5):487-92
Language
English
Publication Type
Article
Keywords
Alaska
Attitude to Health - ethnology
Female
Health Promotion - organization & administration
Health Services Accessibility - organization & administration
Humans
Indians, North American - psychology
Mass Screening - organization & administration
Middle Aged
Neoplasms - prevention & control
Program Evaluation
Women's health
Abstract
Alaska Native women have encountered many obstacles in the health care system which deter them from adhering to cancer screening recommendations. To improve access, it was necessary for us to listen to them and their attitudes about health care. As a result of this assessment, we changed our approach resulting in an overall increase in screening rates from 14% to 62%. A case example is presented to demonstrate barriers to cancer screening and our techniques for overcoming them.
PubMed ID
10776117 View in PubMed
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The Alberta Cardiac Access Collaborative: improving the cardiac patient journey.

https://arctichealth.org/en/permalink/ahliterature146165
Source
Healthc Q. 2009;13 Spec No:85-90
Publication Type
Article
Date
2009
Author
Robyn Blackadar
Mishaela Houle
Author Affiliation
Alberta Cardiac Access Collaborative.
Source
Healthc Q. 2009;13 Spec No:85-90
Date
2009
Language
English
Publication Type
Article
Keywords
Alberta
Angioplasty, Balloon, Coronary
Benchmarking - organization & administration
Continuity of Patient Care - organization & administration
Coronary Artery Bypass
Evidence-Based Practice
Health Care Reform - organization & administration
Health Plan Implementation
Health Services Accessibility - organization & administration
Heart Diseases - therapy
Humans
National health programs - organization & administration
Organizational Case Studies
Program Development
Program Evaluation
Regional Health Planning - organization & administration
Systems Integration
Total Quality Management - organization & administration
Waiting Lists
Abstract
The Alberta Cardiac Access Collaborative (ACAC) is a joint initiative of Alberta's health system to improve access to adult cardiac services across the patient journey. ACAC has created new care delivery models and implemented best practices across Alberta in four streams across the continuum: heart attack, patient navigation, heart failure and arrhythmia. Emergency medical providers, nurses, primary care physicians, hospitals, cardiac specialists and clinicians are all working together to integrate services, bridge jurisdictions and geography with one aim--improving the patient journey for adults in need of cardiac care.
PubMed ID
20057256 View in PubMed
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220 records – page 1 of 22.