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The 2012 SAGE wait times program: Survey of Access to GastroEnterology in Canada.

https://arctichealth.org/en/permalink/ahliterature115731
Source
Can J Gastroenterol. 2013 Feb;27(2):83-9
Publication Type
Article
Date
Feb-2013
Author
Desmond Leddin
David Armstrong
Mark Borgaonkar
Ronald J Bridges
Carlo A Fallone
Jennifer J Telford
Ying Chen
Palma Colacino
Paul Sinclair
Source
Can J Gastroenterol. 2013 Feb;27(2):83-9
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Adult
Canada
Colonoscopy - statistics & numerical data
Female
Gastroenterology - statistics & numerical data - trends
Health Care Surveys
Health Services Accessibility - statistics & numerical data - trends
Humans
Male
Mass Screening - methods - statistics & numerical data
Questionnaires
Referral and Consultation - statistics & numerical data
Time Factors
Waiting Lists
Abstract
Periodically surveying wait times for specialist health services in Canada captures current data and enables comparisons with previous surveys to identify changes over time.
During one week in April 2012, Canadian gastroenterologists were asked to complete a questionnaire (online or by fax) recording demographics, reason for referral, and dates of referral and specialist visits for at least 10 consecutive new patients (five consultations and five procedures) who had not been seen previously for the same indication. Wait times were determined for 18 indications and compared with those from similar surveys conducted in 2008 and 2005.
Data regarding adult patients were provided by 173 gastroenterologists for 1374 consultations, 540 procedures and 293 same-day consultations and procedures. Nationally, the median wait times were 92 days (95% CI 85 days to 100 days) from referral to consultation, 55 days (95% CI 50 days to 61 days) from consultation to procedure and 155 days (95% CI 142 days to 175 days) (total) from referral to procedure. Overall, wait times were longer in 2012 than in 2005 (P
Notes
Cites: Can J Gastroenterol. 2006 Jun;20(6):411-2316779459
Cites: Colorectal Dis. 2006 Jul;8(6):480-316784466
Cites: Am J Gastroenterol. 2007 Mar;102(3):478-8117335442
Cites: Can J Gastroenterol. 2008 Feb;22(2):155-6018299734
Cites: Can J Gastroenterol. 2008 Feb;22(2):161-718299735
Cites: Healthc Q. 2009;12(3):72-919553768
Cites: Health Manag Technol. 2012 Mar;33(3):12-322515048
Cites: Can J Gastroenterol. 2010 Jan;24(1):33-920186354
Cites: Qual Saf Health Care. 2010 Oct;19(5):e2720584706
Cites: Can J Gastroenterol. 2011 Feb;25(2):78-8221321678
Cites: Can J Gastroenterol. 2011 Oct;25(10):547-5422059159
Cites: Can J Gastroenterol. 2012 Jan;26(1):17-3122308578
Cites: Can J Gastroenterol. 2010 Jan;24(1):20-520186352
PubMed ID
23472243 View in PubMed
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Access to pediatric rheumatology subspecialty care in British Columbia, Canada.

https://arctichealth.org/en/permalink/ahliterature153253
Source
J Rheumatol. 2009 Feb;36(2):410-5
Publication Type
Article
Date
Feb-2009
Author
Natalie J Shiff
Reem Abdwani
David A Cabral
Kristin M Houghton
Peter N Malleson
Ross E Petty
Victor M Espinosa
Lori B Tucker
Author Affiliation
Division of Rheumatology, BC Children's Hospital, Room K4-120, 4480 Oak Street, Vancouver, BC V6H 3V4. nshiff@cw.bc.ca
Source
J Rheumatol. 2009 Feb;36(2):410-5
Date
Feb-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Ambulatory Care Facilities
British Columbia
Child
Child, Preschool
Female
Health Personnel - statistics & numerical data - trends
Health Services Accessibility - statistics & numerical data - trends
Humans
Male
Medicine - statistics & numerical data - trends
National Health Programs - statistics & numerical data - trends
Parents
Pediatrics - statistics & numerical data - trends
Quality of Health Care - statistics & numerical data - trends
Questionnaires
Referral and Consultation
Rheumatic Diseases - diagnosis - therapy
Specialization
Time Factors
Abstract
Early recognition and treatment of pediatric rheumatic diseases is associated with improved outcome. We documented access to pediatric rheumatology subspecialty care for children in British Columbia (BC), Canada, referred to the pediatric rheumatology clinic at BC Children's Hospital, Vancouver.
An audit of new patients attending the outpatient clinic from May 2006 to February 2007 was conducted. Parents completed a questionnaire through a guided interview at the initial clinic assessment. Referral dates were obtained from the referral letters. Patients were classified as having rheumatic disease, nonrheumatic disease, or a pain syndrome based on final diagnosis by a pediatric rheumatologist.
Data were collected from 124 of 203 eligible new patients. Before pediatric rheumatology assessment, a median of 3 healthcare providers were seen (range 1-11) for a median of 5 visits (range 1-39). Overall, the median time interval from symptom onset to pediatric rheumatology assessment was 268 days (range 13-4989), and the median time interval from symptom onset to referral to pediatric rheumatology was 179 days (range 3-4970). Among patients ultimately diagnosed with rheumatic diseases (n = 53), there was a median of 119 days (range 3-4970) from symptom onset to referral, and 169 days (range 31-4989) from onset to pediatric rheumatology assessment.
Children and adolescents with rheumatic complaints see multiple care providers for multiple visits before referral to pediatric rheumatology, and there is often a long interval between symptom onset and this referral.
PubMed ID
19132779 View in PubMed
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The accumulated challenges of long-term care.

https://arctichealth.org/en/permalink/ahliterature146298
Source
Health Aff (Millwood). 2010 Jan-Feb;29(1):29-34
Publication Type
Article
Author
David Barton Smith
Zhanlian Feng
Author Affiliation
Center for Health Equality, School of Public Health, at Drexel University, in Philadelphia, Pennsylvania, USA. david.b.smith@drexel.edu
Source
Health Aff (Millwood). 2010 Jan-Feb;29(1):29-34
Language
English
Publication Type
Article
Keywords
Chronic Disease
Cost Control - methods
Health Policy - trends
Health Services Accessibility - statistics & numerical data - trends
Health Services for the Aged
Health Services, Indigenous - economics - supply & distribution
Healthcare Disparities
Humans
Long-Term Care - methods - organization & administration - standards - trends
Medicaid
Organizational Objectives
Quality of Health Care - standards
United States
Abstract
During the past century, long-term care in the United States has evolved through five cycles of development, each lasting approximately twenty years. Each, focusing on distinct concerns, produced unintended consequences. Each also added a layer to an accumulation of contradictory approaches--a patchwork system now pushed to the breaking point by increasing needs and financial pressures. Future policies must achieve a better synthesis of approaches inherited from the past, while addressing their unintended consequences. Foremost must be assuring access to essential care, delivery of high-quality services in an increasingly deinstitutionalized system, and a reduction in social and economic disparities.
PubMed ID
20048357 View in PubMed
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Change and persistence in healthcare inequities: access to elective surgery in Finland in 1992--2003.

https://arctichealth.org/en/permalink/ahliterature153333
Source
Scand J Public Health. 2009 Mar;37(2):131-8
Publication Type
Article
Date
Mar-2009
Author
Kristna Manderbacka
Martti Arffman
Alastair Leyland
Alison McCallum
Ilmo Keskimäki
Author Affiliation
Health Services Research, STAKES (National Research and Development Centre for Welfare and Health), Helsinki, Finland. kristiina.manderbacka@stakes.fi
Source
Scand J Public Health. 2009 Mar;37(2):131-8
Date
Mar-2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Female
Finland
Health Services Accessibility - statistics & numerical data - trends
Humans
Male
Middle Aged
Registries
Socioeconomic Factors
Surgical Procedures, Elective - methods - statistics & numerical data - trends
Abstract
Many countries experience persistent or increasing socioeconomic disparities in specialist care. This study examines the socioeconomic distribution of elective surgery from 1992 to 2003 in Finland.
Administrative registers were used to identify common elective procedures performed in all public and private hospitals in Finland in 1992-2003. Patients' individual sociodemographic data came from 1990-2003 census and employment statistics databases. First coronary revascularisation, hip and knee replacement, lumbar disc operation, cataract extraction, hysterectomy and prostatectomy on residents aged 25-84 years were analysed. Age-standardized procedure rates by income quintile were calculated for both genders, and concentration indices were developed and applied to age-standardized procedure rates in 5% income groups for each study year.
Most procedure rates increased during the study period. Three trends emerged: declining inequality for coronary revascularisations, an increase and then a decline in cataract extractions and primary knee replacements among men, and positive relationships between income and treatment for hysterectomy and lumbar disc operations.
Our results suggest that structural features - uneven availability, co-payments and plurality of provision - sustain inequity in access; decreasing inequities reflect directed service expansion. Increased attention to collective, prospective funding of primary and specialist ambulatory care is required to increase equity of access to elective surgery.
Notes
Cites: Eur J Public Health. 2004 Mar;14(1):58-6215080393
Cites: Ann Rheum Dis. 2004 Nov;63(11):1483-915479899
Cites: Soc Sci Med. 2003 Apr;56(7):1517-3012614702
Cites: J Health Econ. 1997 Feb;16(1):93-11210167346
Cites: Eur J Epidemiol. 1997 Jun;13(4):403-159258546
Cites: BMJ. 1999 May 1;318(7192):1198-20010221951
Cites: Health Policy. 1999 Apr;47(1):1-1710387807
Cites: N Engl J Med. 1999 Oct 28;341(18):1359-6710536129
Cites: Eur J Cardiovasc Prev Rehabil. 2005 Apr;12(2):132-715785298
Cites: Heart. 2005 May;91(5):635-4015831650
Cites: BMJ. 2005 May 28;330(7502):123315911537
Cites: J Epidemiol Community Health. 2005 Aug;59(8):700-516020649
Cites: CMAJ. 2006 Jan 17;174(2):177-8316415462
Cites: Clin Experiment Ophthalmol. 2006 May-Jun;34(4):317-2316764650
Cites: Arthritis Rheum. 2002 Dec;46(12):3331-912483740
Cites: J Epidemiol Community Health. 2003 Mar;57(3):178-8512594194
PubMed ID
19124597 View in PubMed
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Current practice in administration and clinical criteria of emergent EEG.

https://arctichealth.org/en/permalink/ahliterature194168
Source
J Clin Neurophysiol. 2001 Mar;18(2):162-5
Publication Type
Article
Date
Mar-2001
Author
M. Quigg
B. Shneker
P. Domer
Author Affiliation
Department of Neurology, University of Virginia, Charlottesville, Virginia 22908, USA.
Source
J Clin Neurophysiol. 2001 Mar;18(2):162-5
Date
Mar-2001
Language
English
Publication Type
Article
Keywords
Brain Death - diagnosis
Brain Diseases - diagnosis
Canada
Coma - diagnosis
Electroencephalography - economics - utilization
Emergency Treatment - standards
Health Care Surveys
Health Services Accessibility - statistics & numerical data - trends
Humans
Laboratories, Hospital - manpower - organization & administration - utilization
Physician's Practice Patterns - statistics & numerical data - trends
Referral and Consultation - statistics & numerical data
Status Epilepticus - diagnosis
Time and Motion Studies
United States
Abstract
Policies of administration and availability of EEG offered during nonbusiness hours vary widely among EEG laboratories. The authors surveyed medical directors of accredited EEG laboratories (n = 84) to determine the ranges of availability and clinical indications for approval of continuously available emergent EEG (E-EEG). Of 46 respondents, 37 (80%) offered E-EEG. Two centers recently lost funding for E-EEG. Availability was not associated with the total number of EEGs performed annually. The mean estimated response time from request to expert interpretation was 3 +/- 4 hours (range, 1-24 hours). The five clinical indications for which most respondents approved E-EEGs were possible nonconvulsive status epilepticus (100%), treatment of status epilepticus (84%), cerebral death exam (81%), diagnosis of convulsive status epilepticus (79%), and diagnosis of coma or encephalopathy (70%). Respondents disagreed widely when asked which clinical situations merited E-EEG, with some approving all requests and others denying all except for nonconvulsive status epilepticus. The wide range of current practice suggests that research focused on outcomes of aggressive, EEG-aided patient evaluation and treatment are needed to define better the costs and benefits of a continuously available EEG service.
PubMed ID
11435807 View in PubMed
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Effect of widespread restrictions on the use of hospital services during an outbreak of severe acute respiratory syndrome.

https://arctichealth.org/en/permalink/ahliterature162937
Source
CMAJ. 2007 Jun 19;176(13):1827-32
Publication Type
Article
Date
Jun-19-2007
Author
Michael J Schull
Thérèse A Stukel
Marian J Vermeulen
Merrick Zwarenstein
David A Alter
Douglas G Manuel
Astrid Guttmann
Andreas Laupacis
Brian Schwartz
Author Affiliation
Institute for Clinical Evaluative Sciences, Toronto, Ont. mjs@ices.on.ca
Source
CMAJ. 2007 Jun 19;176(13):1827-32
Date
Jun-19-2007
Language
English
Publication Type
Article
Keywords
Angioplasty, Balloon, Coronary - utilization
Coronary Artery Bypass - utilization
Disease Outbreaks - prevention & control
Emergencies - classification
Emergency Service, Hospital - utilization
Health Services Accessibility - statistics & numerical data - trends
Humans
Ontario - epidemiology
Outpatient Clinics, Hospital - utilization
Patient Admission - statistics & numerical data - trends
Severe Acute Respiratory Syndrome - epidemiology - prevention & control
Surgical Procedures, Elective - utilization
Abstract
Restrictions on the nonurgent use of hospital services were imposed in March 2003 to control an outbreak of severe acute respiratory syndrome (SARS) in Toronto, Ont. We describe the impact of these restrictions on health care utilization and suggest lessons for future epidemics.
We performed a retrospective population-based study of the Greater Toronto Area (hereafter referred to as Toronto) and unaffected comparison regions (Ottawa and London, Ont.) before, during and after the SARS outbreak (April 2001-March 2004). We determined the adjusted rates of hospital admissions, emergency department and outpatient visits, diagnostic testing and drug prescribing.
During the early and late SARS restriction periods, the rate of overall and medical admissions decreased by 10%-12% in Toronto; there was no change in the comparison regions. The rate of elective surgery in Toronto fell by 22% and 15% during the early and late restriction periods respectively and by 8% in the comparison regions. The admission rates for urgent surgery remained unchanged in all regions; those for some acute serious medical conditions decreased by 15%-21%. The rates of elective cardiac procedures declined by up to 66% in Toronto and by 71% in the comparison regions; the rates of urgent and semi-urgent procedures declined little or increased. High-acuity visits to emergency departments fell by 37% in Toronto, and inter-hospital patient transfers fell by 44% in the circum-Toronto area. Drug prescribing and primary care visits were unchanged in all regions.
The restrictions achieved modest reductions in overall hospital admissions and substantial reductions in the use of elective services. Brief reductions occurred in admissions for some acute serious conditions, high-acuity visits to emergency departments and inter-hospital patient transfers suggesting that access to care for some potentially seriously ill patients was affected.
Notes
Cites: Science. 1973 Dec 14;182(4117):1102-84750608
Cites: Hum Biol. 1966 Sep;38(3):309-175977534
Cites: Biometrics. 1986 Mar;42(1):121-303719049
Cites: Health Care Financ Rev. 1988 Summer;9(4):53-6210312632
Cites: J Clin Epidemiol. 1991;44(9):881-81890430
Cites: JAMA. 1992 Nov 4;268(17):2388-941404795
Cites: Stroke. 1994 Dec;25(12):2348-557974572
Cites: Physiother Can. 1994 Summer;46(3):145-6, 148-5110142878
Cites: Ann Intern Med. 1997 Oct 15;127(8 Pt 2):666-749382378
Cites: Acad Emerg Med. 2006 Nov;13(11):1228-3116807399
Cites: Pediatrics. 2000 Oct;106(4 Suppl):942-811044148
Cites: Med Care. 2001 Jun;39(6):551-6111404640
Cites: N Engl J Med. 2001 Aug 30;345(9):663-811547721
Cites: Can J Cardiol. 2003 May;19(6):655-6312772015
Cites: Can J Clin Pharmacol. 2003 Summer;10(2):67-7112879144
Cites: Prehosp Emerg Care. 2004 Apr-Jun;8(2):223-3115060861
Cites: N Engl J Med. 1984 Aug 2;311(5):295-3006429534
PubMed ID
17576979 View in PubMed
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Escalating levels of access to in-hospital care and stroke mortality.

https://arctichealth.org/en/permalink/ahliterature156221
Source
Stroke. 2008 Sep;39(9):2522-30
Publication Type
Article
Date
Sep-2008
Author
Gustavo Saposnik
Jiming Fang
Martin O'Donnell
Vladimir Hachinski
Moira K Kapral
Michael D Hill
Author Affiliation
Stroke Research Unit, Division of Neurology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, M5C 1R6, Canada. saposnikg@smh.toronto.on.ca
Source
Stroke. 2008 Sep;39(9):2522-30
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Canada - epidemiology
Cohort Studies
Cost of Illness
Female
Health Services Accessibility - statistics & numerical data - trends
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Outcome Assessment (Health Care) - methods
Patient Care Team - statistics & numerical data
Quality of Health Care - statistics & numerical data
Registries
Stroke - mortality - rehabilitation
Survival Rate - trends
Abstract
Organized stroke care is an integrated approach to managing stroke to improve stroke outcomes by ensuring that optimal treatment is offered. However, limited information is available comparing different levels of organized care. Our aim was to determine whether escalating levels of organized care can improve stroke outcomes.
Cohort study including patients with acute ischemic stroke between July 2003 and March 2005 in the Registry of the Canadian Stroke Network (RCSN). The RCSN is the largest clinical database of patients with acute stroke patients seen at selected acute care hospitals in Canada. As stroke unit admission does not automatically imply receipt of comprehensive care, we created the organized care index to represent different levels of access to organized care ranging from 0 to 3 as determined by the presence of occupational therapy/physiotherapy, stroke team assessment, and admission to a stroke unit. The primary end point was early stroke mortality. Secondary end points include 30-day and 1-year mortality.
Overall, 3631 ischemic stroke patients were admitted to 11 hospitals. Seven day stroke mortality was 6.9% (249/3631), 30-day stroke mortality was 12.6% (457/3631), and 1-year stroke mortality was 23.6% (856/3631). Risk-adjusted 7-day mortality was 2.0%, 3.2%, 7.8%, and 22.5% for organized care index of 3, 2, 1, and 0. Higher level of care was associated with lower adjusted mortality (for organized care index 3, OR 0.03, 95% CI 0.02 to 0.07 for 7-day mortality; OR 0.09, 95% CI 0.05 to 0.17 for 30-day mortality; and OR 0.40, 95% CI 0.25 to 0.64 for 1-year mortality).
Higher level of access to care was associated with lower stroke mortality rates. Establishing a well-organized and multidisciplinary system of stroke care will help improve the quality of service delivered and reduce the burden of stroke.
Notes
Comment In: Stroke. 2008 Nov;39(11):e18618802201
PubMed ID
18617667 View in PubMed
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How are immigrant background and gender associated with the utilisation of psychiatric care among adolescents?

https://arctichealth.org/en/permalink/ahliterature257040
Source
Soc Psychiatry Psychiatr Epidemiol. 2013 May;48(5):693-9
Publication Type
Article
Date
May-2013
Author
Anna-Karin Ivert
Juan Merlo
Robert Svensson
Marie Torstensson Levander
Author Affiliation
Faculty of Health and Society, Malmö University, 20506 Malmö, Sweden. anna-karin.ivert@mah.se
Source
Soc Psychiatry Psychiatr Epidemiol. 2013 May;48(5):693-9
Date
May-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Psychiatry
Developing Countries - economics
Emigrants and Immigrants - psychology
Female
Health Services Accessibility - statistics & numerical data - trends
Healthcare Disparities - ethnology
Humans
Longitudinal Studies
Male
Mental Health Services - utilization
Parents
Regression Analysis
Sex Factors
Social Class
Sweden - ethnology
Abstract
To investigate how parental country of birth and individual gender affect utilisation of psychiatric care in adolescents.
On the basis of data from the Longitudinal Multilevel Analysis in Scania database, the article employs logistic regression to analyse the utilisation of psychiatric care among adolescents aged 13-18 (n = 92203) who were living in the southern Swedish county of Scania in 2005.
Adolescents whose parents were born in middle- or low-income countries presented lower levels of psychiatric outpatient care utilisation than those with native parents. Initially, no associations were found between the utilisation of psychiatric inpatient care and parental country of birth. Following adjustment for socio-demographic variables, it was found that adolescents with parents born in low-income countries were less likely to utilise psychiatric inpatient care. Girls presented higher levels of psychiatric care utilisation, but controls for possible interactions revealed that this was true primarily for girls with parents born in Sweden or other high-income countries.
The different utilisation patterns found among adolescents with different backgrounds should be taken into consideration when planning and designing psychiatric care for adolescents, and when allocating resources. Our results may indicate lower levels of mental health problems among adolescents with parents born in middle- or low-income countries implying that protective factors compensate other stressors implicated in mental health problems. On the other hand, our findings may indicate an unmet health-care need as a result of problems accessing care.
PubMed ID
23001409 View in PubMed
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Immunomodulatory treatment of multiple sclerosis in Norway.

https://arctichealth.org/en/permalink/ahliterature164230
Source
Acta Neurol Scand Suppl. 2007;187:46-50
Publication Type
Article
Date
2007
Author
Ø. Torkildsen
N. Grytten
K-M Myhr
Author Affiliation
The Multiple Sclerosis National Competence Center, Haukeland University Hospital, Department of Clinical Medicine, Section for Neurology, University of Bergen, Bergen, Norway. oivind.torkildsen@gmail.com
Source
Acta Neurol Scand Suppl. 2007;187:46-50
Date
2007
Language
English
Publication Type
Article
Keywords
Guideline Adherence
Health Services Accessibility - statistics & numerical data - trends
Humans
Immunologic Factors - therapeutic use
Interferon-beta - therapeutic use
Mitoxantrone - therapeutic use
Multiple Sclerosis - drug therapy - epidemiology - immunology
Norway - epidemiology
Peptides - therapeutic use
Physician's Practice Patterns
Prevalence
Quality of Health Care - statistics & numerical data - trends
Abstract
National guidelines for immunomodulatory treatment in multiple sclerosis (MS) were established in Norway in 2001. However, the nation-wide treatment practice has not been evaluated since. We therefore obtained information of all patients who have received prescriptions for the approved immunomodulatory medications, interferon-beta (Betaferon, Avonex, Rebif) and glatiramer acetate (Copaxone) registered in the Norwegian Prescription Database (Reseptregisteret). We also made a survey of patients treated with mitoxantrone (Novantrone) as well as patients supplied with immunomodulatory drugs in treatment trials. To further calculate the treatment frequency, a nation-wide prevalence of MS in Norway was estimated, based on available prevalence studies.
The estimated frequency of MS was approximately 150/100,000 in southern Norway and 100/100,000 in northern Norway. The treatment frequencies varied from 15% to 47% between the different counties with a frequency of 28% for the whole country.
Substantial differences in treatment frequencies between counties were detected, reflecting major differences in clinical practice within the country. This calls for increased focus on clinical application of the established treatment guidelines.
PubMed ID
17419828 View in PubMed
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Impact of rural hospital closures in Saskatchewan, Canada.

https://arctichealth.org/en/permalink/ahliterature194680
Source
Soc Sci Med. 2001 Jun;52(12):1793-804
Publication Type
Article
Date
Jun-2001
Author
L. Liu
J. Hader
B. Brossart
R. White
S. Lewis
Author Affiliation
Health Services Utilization and Research Commission (HSURC), Saskatoon, Saskatchewan, Canada. liul@sdh.sk.ca
Source
Soc Sci Med. 2001 Jun;52(12):1793-804
Date
Jun-2001
Language
English
Publication Type
Article
Keywords
Attitude to Health
Community Health Planning - organization & administration - trends
Community-Institutional Relations
Consumer Participation
Health Care Reform
Health Facility Closure - statistics & numerical data
Health Policy
Health Services Accessibility - statistics & numerical data - trends
Health status
Hospital Bed Capacity, under 100
Hospitals, Rural - trends - utilization
Humans
Organizational Innovation
Saskatchewan - epidemiology
Abstract
Canada's health care system has undergone major changes since 1990. In Saskatchewan, 52 small rural hospitals funded for less than eight beds stopped receiving funding for acute care services in 1993. Most were subsequently converted to primary health care centers. Since then, concerns have been raised about the impact of the changes on rural residents' access to care, their health status, and the viability of rural communities. To assess the impact of hospital closures on the affected communities, we conducted a multi-faceted, province-wide study. We looked at hospital use patterns, health status, rural residents' perceptions of the impact of these hospital closures, and how communities responded to the changes. We found the hospital closures did not adversely affect rural residents' health status or their access to inpatient hospital services. Despite widespread fears that health status would decline, residents in these communities reported that hospital closures did not adversely affect their own health. Although some communities continue to struggle with changes to health care delivery, others appear to have adapted as a result of strong community leadership, the development of widely accepted alternative services, and local support for creating innovative solutions. Good rural health care does not depend on the presence of a very small hospital that cannot, in today's environment, provide genuinely acute care. It requires creative approaches to the provision of primary care, good emergency services, and good communication with the public on the intent and outcomes of change.
PubMed ID
11352406 View in PubMed
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20 records – page 1 of 2.