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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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Adopting and implementing nutrition guidelines in recreational facilities: public and private sector roles. A multiple case study.

https://arctichealth.org/en/permalink/ahliterature124044
Source
BMC Public Health. 2012;12:376
Publication Type
Article
Date
2012
Author
Dana Lee Olstad
Kim D Raine
Linda J McCargar
Author Affiliation
Alberta Institute for Human Nutrition, 4-126 Li Ka Shing Centre, 8606 112 St, University of Alberta, Edmonton, AB T6G 2E1, Canada.
Source
BMC Public Health. 2012;12:376
Date
2012
Language
English
Publication Type
Article
Keywords
Canada
Child
Food - standards
Guideline Adherence - statistics & numerical data
Guidelines as Topic
Humans
Nutrition Policy
Obesity - prevention & control
Private Sector - organization & administration
Public Facilities
Qualitative Research
Recreation
Abstract
Recreational facilities are an important community resource for health promotion because they provide access to affordable physical activities. However, despite their health mandate, many have unhealthy food environments that may paradoxically increase the risk of childhood obesity. The Alberta Nutrition Guidelines for Children and Youth (ANGCY) are government-initiated, voluntary guidelines intended to facilitate children's access to healthy food and beverage choices in schools, childcare and recreational facilities, however few recreational facilities are using them.
We used mixed methods within an exploratory multiple case study to examine factors that influenced adoption and implementation of the ANGCY and the nature of the food environment within three cases: an adopter, a semi-adopter and a non-adopter of the ANGCY. Diffusion of Innovations theory provided the theoretical platform for the study. Qualitative data were generated through interviews, observations, and document reviews, and were analysed using directed content analysis. Set theoretic logic was used to identify factors that differentiated adopters from the non-adopter. Quantitative sales data were also collected, and the quality of the food environment was scored using four complementary tools.
The keys to adoption and implementation of nutrition guidelines in recreational facilities related to the managers' nutrition-related knowledge, beliefs and perceptions, as these shaped his decisions and actions. The manager, however, could not accomplish adoption and implementation alone. Intersectoral linkages with schools and formal, health promoting partnerships with industry were also important for adoption and implementation to occur. The food environment in facilities that had adopted the ANGCY did not appear to be superior to the food environment in facilities that had not adopted the ANGCY.
ANGCY uptake may continue to falter under the current voluntary approach, as the environmental supports for voluntary action are poor. Where ANGCY uptake does occur, changes to the food environment may be relatively minor. Stronger government measures may be needed to require recreational facilities to improve their food environments and to limit availability of unhealthy foods.
Notes
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PubMed ID
22632384 View in PubMed
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An antibiotic's journey from marketing authorization to use, Norway.

https://arctichealth.org/en/permalink/ahliterature286114
Source
Bull World Health Organ. 2017 Mar 01;95(3):220-226
Publication Type
Article
Date
Mar-01-2017
Author
Christine Årdal
Hege Salvesen Blix
Jens Plahte
John-Arne Røttingen
Source
Bull World Health Organ. 2017 Mar 01;95(3):220-226
Date
Mar-01-2017
Language
English
Publication Type
Article
Keywords
Anti-Bacterial Agents - economics
Costs and Cost Analysis
Drug Approval - organization & administration
Drug Resistance, Bacterial
Drug Utilization
Health Policy
Humans
Insurance, Health, Reimbursement
Marketing - organization & administration
Norway
Practice Guidelines as Topic
Private Sector - organization & administration
Abstract
Here we describe in detail marketing authorization and reimbursement procedures for medicinal products in Norway, with particular reference to nine novel antibiotics that received marketing authorization between 2005 and 2015. The description illustrates that, in places like Norway, with effective antibiotic stewardship policies and an associated low prevalence of antibiotic-resistant bacterial infection, there is little need for newer, more expensive antibiotics whose therapeutic superiority to existing compounds has not been demonstrated. Since resistance begins to emerge as soon as an antibiotic is used, Norway's practice of leaving newer antibiotics on the shelf is consistent with the goal of prolonging the effectiveness of newer antibiotics. An unintended consequence is that the country has signalled to the private sector that there is little commercial value in novel antibiotics, which may nevertheless still be needed to treat rare or emerging infections. Every country aims to improve infection control and to promote responsible antibiotic use. However, as progress is made, antibiotic-resistant bacteria should become less common and, consequently, the need for, and the commercial value of, novel antibiotics will probably be reduced. Nevertheless, antibiotic innovation continues to be essential. This dilemma will have to be resolved through the introduction of alternative reward systems for antibiotic innovation. The DRIVE-AB (Driving re-investment in research and development and responsible antibiotic use) research consortium in Europe has been tasked with identifying ways of meeting this challenge.
Notes
Cites: Lancet. 2005 Feb 12-18;365(9459):579-8715708101
Cites: J Antimicrob Chemother. 2015;70(6):1604-725673635
Cites: J Antimicrob Chemother. 2013 Sep;68(9):2144-5323674762
Cites: Lancet Infect Dis. 2016 Feb;16(2):161-826603172
Cites: Antimicrob Agents Chemother. 2010 Sep;54(9):3564-820547788
PubMed ID
28250535 View in PubMed
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Cooperation Between Occupational Health Services and Small-Scale Enterprises in Norway and Sweden: A Provider Perspective.

https://arctichealth.org/en/permalink/ahliterature290101
Source
Workplace Health Saf. 2017 Aug; 65(8):355-364
Publication Type
Journal Article
Date
Aug-2017
Author
Stig Vinberg
Lisa Torsdatter Markussen
Bodil J Landstad
Author Affiliation
1 Mid Sweden University.
Source
Workplace Health Saf. 2017 Aug; 65(8):355-364
Date
Aug-2017
Language
English
Publication Type
Journal Article
Keywords
Cooperative Behavior
Health services needs and demand
Humans
Industry - organization & administration - statistics & numerical data
Norway
Occupational Health Services - organization & administration - statistics & numerical data
Private Sector - organization & administration - statistics & numerical data
Surveys and Questionnaires
Sweden
Abstract
Although small-scale enterprises (SSEs) dominate the private enterprise sector, knowledge about support for these organizations from occupational health services (OHSs) is insufficient. The aim of this research was to study OHS services provided and staff cooperation with SSEs in Norway and Sweden. In total, 87 Norwegian and 51 Swedish OHS providers answered a survey on their experiences providing requested services from and cooperation with SSEs. Based on survey questions and constructed indices, providers in the two countries were compared using independent sample t tests and non-parametric tests. Open-ended questions were analyzed using qualitative content analysis. The results showed that SSEs, particularly in industrial, construction, and trade sectors, commonly contract for Norwegian and Swedish OHSs, and these contracts have increased in the last 12 months. Norwegian providers state that SSEs request broader organizationally- based services; their Swedish counterparts request more individual-based health-related services. Improvements concerning specific strategies for OHS collaboration with SSEs may be needed.
PubMed ID
28056210 View in PubMed
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Factors associated with health service orientation and active product marketing orientation in Finnish community pharmacies: a nationwide study among private pharmacy owners.

https://arctichealth.org/en/permalink/ahliterature305279
Source
BMC Health Serv Res. 2020 Jul 20; 20(1):667
Publication Type
Journal Article
Date
Jul-20-2020
Author
Lenita Jokinen
Inka Puumalainen
Marja Airaksinen
Author Affiliation
Runosmäki Pharmacy, Turku, Finland. lenita.jokinen@gmail.com.
Source
BMC Health Serv Res. 2020 Jul 20; 20(1):667
Date
Jul-20-2020
Language
English
Publication Type
Journal Article
Keywords
Community Pharmacy Services - organization & administration
Cross-Sectional Studies
Finland
Health Services - statistics & numerical data
Health Services Research
Humans
Marketing - methods - statistics & numerical data
Private Sector - organization & administration
Surveys and Questionnaires
Abstract
Little is known about pharmacy owners' commitment to public health and health policy goals in the strategic planning of their business. The aim of this study was to explore factors associated with health service orientation and active product marketing orientation of Finnish community pharmacy owners.
A national cross-sectional e-mail survey was sent to private community pharmacy owners in Finland (n = 581) in 2013. Based on the structured, Likert-type survey instrument, two sum scales measuring strategic orientation towards health service provision (13 items, score range 0-26) and active product marketing (8 items, score range 0-16) were developed (Cronbach's Alpha 0.836 and 0.699, respectively). Characteristics of the pharmacy owners and their pharmacy business as well as actual service provision were used as background variables.
Concerning health service orientation, 50% of the respondents received at least 20 points out of the maximum 26 points (score range: 0-26). For active product marketing orientation, 75% of the pharmacy owners had at least 14 points and 44% received full 16 points (score range: 0-16). The score distribution was skewed towards strong health service orientation, but the actual service score was heavily skewed towards few services or no services. Two-thirds of the pharmacy owners reported having available 2 or less services. The health service orientation was not influenced by any of the background variables used, but three of them influenced active product marketing orientation, namely business location, annual prescription volume and belonging to a marketing chain of individual community pharmacies.
Large pharmacies located close to rivals and belonging to marketing chains of individual community pharmacies differentiated as those having a high product marketing orientation. The health service orientation was not influenced by any of the explanatory variables used in this study. The discrepancy between high health service orientation scores and low actual service provision scores needs further investigation. The contradiction that exists between pharmaceutical policy goals and the generation of income of pharmacies should also be examined as a contributing factor in this respect.
PubMed ID
32690013 View in PubMed
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Focal aspects of co-operation between the private, public and third sectors in a sparsely populated area in northern Finland.

https://arctichealth.org/en/permalink/ahliterature172052
Source
Int J Circumpolar Health. 2005 Sep;64(4):346-53
Publication Type
Article
Date
Sep-2005
Author
Leena Paasivaara
Marjo Suhonen
Author Affiliation
Department of Nursing and Health Administration, University of Oulu, Finland. leena.paasivaara@oulu.fi
Source
Int J Circumpolar Health. 2005 Sep;64(4):346-53
Date
Sep-2005
Language
English
Publication Type
Article
Keywords
Community Networks - organization & administration
Cooperative Behavior
Finland
Focus Groups
Humans
Models, organizational
Organizational Culture
Power (Psychology)
Private Sector - organization & administration
Public Sector - organization & administration
Qualitative Research
Rural Population
Abstract
The purpose of this study was to describe and analyze the focal aspects of co-operation between the private, public and third sectors in a sparsely populated area of northern Finland. The study is part of a larger research and development project, which produced a model of co-operation between the sectors in a sparsely populated area of northern Finland.
The study was qualitative. An expert group (n = 12), consisting of representatives from the private (n = 4), public (n = 4) and third sectors (n = 4), was recruited.
The data were collected using the focus groups method. The focus group method was feasible here because the development of co-operation between the different sectors was new, and the aim was to find novel operating models.
The focal aspects of co-operation between the different sectors consisted of the objectives of operation, the client's perspective, the structures, the contents of operation and the operating culture.
An expert group of representatives from the different sectors was a functional starting-point for the development of co-operation. The group also made it possible to reach representatives of the sectors more widely by means of the questionnaire survey. The operation of the expert group clearly involved elements of network management, because the group aimed to take into account the interests of all network actors. Network management at this stage of the project can be considered successful. To maintain co-operation at the concrete level, shared self-guided activities between the sectors will be needed.
PubMed ID
16277119 View in PubMed
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Governing Health Care through Free Choice: Neoliberal Reforms in Denmark and the United States.

https://arctichealth.org/en/permalink/ahliterature276196
Source
J Health Polit Policy Law. 2015 Oct;40(5):941-70
Publication Type
Article
Date
Oct-2015
Author
Lars Thorup Larsen
Deborah Stone
Source
J Health Polit Policy Law. 2015 Oct;40(5):941-70
Date
Oct-2015
Language
English
Publication Type
Article
Keywords
Choice Behavior
Culture
Denmark
Economic Competition - organization & administration
Health Care Rationing - organization & administration
Health Care Reform - legislation & jurisprudence - organization & administration
Health Care Sector - legislation & jurisprudence - organization & administration
Humans
Medicare Part C - legislation & jurisprudence
Politics
Private Sector - organization & administration
Public Sector - organization & administration
United States
Universal Coverage - organization & administration
Waiting Lists
Abstract
We compare free choice reforms in Denmark and the United States to understand what ideas and political forces could generate such similar policy reforms in radically different political contexts. We analyze the two cases using our own interpretation of neoliberalism as having "two faces." The first face seeks to expand private markets and shrink the public sector; the second face seeks to strengthen the public sector's capacity to govern through incentives and competition. First, we show why these two most-different cases offer a useful comparison to understand similar policy tools. Second, we develop our theoretical framework of the two faces of neoliberalism. Third, we examine Denmark's introduction of a free choice of hospitals in 2002, a policy that for the first time allowed some patients to receive care either in a public hospital outside their local area or in a private hospital. Fourth, we examine the introduction of free choice among private managed care plans into the US Medicare program in 1997. We show how policy makers in both countries used neoliberal reform as a mechanism to make their public health care sectors governable. Fifth, on the basis of our analysis, we draw five lessons about neoliberal policy reforms.
PubMed ID
26195602 View in PubMed
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Home care in Canada: passing the buck.

https://arctichealth.org/en/permalink/ahliterature190742
Source
Can J Nurs Res. 2001 Sep;33(2):11-25
Publication Type
Article
Date
Sep-2001
Author
P C Coyte
P. McKeever
Author Affiliation
Department of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada. peter.coyte@utoronto.ca
Source
Can J Nurs Res. 2001 Sep;33(2):11-25
Date
Sep-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Canada
Child
Child, Preschool
Female
Financing, Government - organization & administration
Forecasting
Health Expenditures - statistics & numerical data - trends
Health Policy - economics - trends
Health Services Accessibility - organization & administration
Health Services Research
Home Care Services - economics - trends - utilization
Humans
Infant
Male
Middle Aged
National Health Programs - economics - trends - utilization
Needs Assessment
Politics
Practice Guidelines as Topic
Private Sector - organization & administration
Sex Distribution
Abstract
This paper provides an overview of Canadian home-care utilization, highlights the health-policy assumptions that have resulted in an increasing reliance on in-home services, and assesses the current roles of the private and public sectors in the financing of home care. Significant interprovincial variations in per capita home-care expenditures and potential inequalities in access to home care call for resolution by federal and provincial governments. There is a need for consensus with respect to medically and socially necessary services that are subject to national standards, irrespective of the setting in which services are sought, received, and delivered. The development and enforcement of national home-care standards that complement the principles of the Canada Health Act would be a useful first step in ensuring that the Canadian health-care system is ready to confront the challenges of the new millennium.
PubMed ID
11928333 View in PubMed
Less detail
Source
Nurs Leadersh (Tor Ont). 2006 Mar;19(1):1-3
Publication Type
Article
Date
Mar-2006
Author
Dorothy Pringle
Source
Nurs Leadersh (Tor Ont). 2006 Mar;19(1):1-3
Date
Mar-2006
Language
English
Publication Type
Article
Keywords
Canada
Community Health Nursing - organization & administration
Forecasting
Health services needs and demand
Home Care Services - organization & administration
Humans
Models, organizational
National health programs - organization & administration
Nursing Evaluation Research
Private Sector - organization & administration
Public Sector - organization & administration
Notes
Comment In: Nurs Leadersh (Tor Ont). 2007;20(1):4-517472135
Comment On: Nurs Leadersh (Tor Ont). 2006 Mar;19(1):56-6816610298
Comment On: Nurs Leadersh (Tor Ont). 2005 Dec;18(4):26-816463640
Comment On: Nurs Leadersh (Tor Ont). 2006 Mar;19(1):44-5516610297
PubMed ID
16610291 View in PubMed
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Hospital restructuring initiatives in Canada.

https://arctichealth.org/en/permalink/ahliterature207502
Source
Med Care. 1997 Oct;35(10 Suppl):OS62-9
Publication Type
Article
Date
Oct-1997
Author
J. Shamian
E Y Lightstone
Author Affiliation
WHO Collaborating Centre, Mount Sinai Hospital, Toronto, Ontario, Canada.
Source
Med Care. 1997 Oct;35(10 Suppl):OS62-9
Date
Oct-1997
Language
English
Publication Type
Article
Keywords
Canada
Community Health Planning
Community-Institutional Relations - trends
Continuity of Patient Care - organization & administration
Health Care Reform - organization & administration - trends
Health Services Research
Hospital Restructuring - manpower - organization & administration - trends
Humans
National Health Programs
Nursing Staff, Hospital - organization & administration - standards - supply & distribution
Private Sector - organization & administration - trends
Public Sector - organization & administration - trends
Quality of Health Care
Abstract
Recent changes in the organization, staffing, and utilization of acute hospitals in Canada are reviewed with regard to the potential implications for quality of care, national nurse workforce requirements, and research.
Available national and selected provincial data and trends in hospital utilization, capacity, and staffing are synthesized.
Health system reform in Canada has resulted in lower utilization of acute inpatient resources, excess hospital capacity, and increased budgetary constraints in the hospital sector. In response, there is widespread hospital restructuring, which includes modifications in nurse staffing ratios and skill mix. Little is known about the potential impact of these changes on patient outcomes. From a workforce perspective, changes in the hospital sector have reduced demand for registered nurses but nursing schools have not modified enrollments. As a result, new graduates are experiencing difficulty obtaining registered nurse positions.
Research should be undertaken to evaluate the impact of changes in the organization and staffing of hospitals on patient outcomes, and on the future requirements for nurses.
PubMed ID
9339777 View in PubMed
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21 records – page 1 of 3.