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AARN applauds Romanow Report. Urges all levels of government to work together to improve health care.

https://arctichealth.org/en/permalink/ahliterature186148
Source
Alta RN. 2003 Jan;59(1):1, 4-5
Publication Type
Article
Date
Jan-2003

Access to care, health status, and health disparities in the United States and Canada: results of a cross-national population-based survey.

https://arctichealth.org/en/permalink/ahliterature169088
Source
Am J Public Health. 2006 Jul;96(7):1300-7
Publication Type
Article
Date
Jul-2006
Author
Karen E Lasser
David U Himmelstein
Steffie Woolhandler
Author Affiliation
Department of Medicine, The Cambridge Health Alliance and Harvard Medical School, Cambridge, Mass, USA. klasser@challiance.org
Source
Am J Public Health. 2006 Jul;96(7):1300-7
Date
Jul-2006
Language
English
Publication Type
Article
Keywords
Adult
Aged
Canada - epidemiology
Delivery of Health Care - economics - standards - utilization
Emigration and Immigration
Ethnic Groups
Female
Health Services Accessibility - economics - statistics & numerical data
Health services needs and demand - economics - statistics & numerical data
Health Status Indicators
Humans
Income
Life expectancy
Logistic Models
Male
Middle Aged
Multivariate Analysis
National Health Programs - economics - standards - utilization
Patient Satisfaction - ethnology
Quality of Health Care
Socioeconomic Factors
United States - epidemiology
Universal Coverage
Abstract
We compared health status, access to care, and utilization of medical services in the United States and Canada and compared disparities according to race, income, and immigrant status.
We analyzed population-based data on 3505 Canadian and 5183 US adults from the Joint Canada/US Survey of Health. Controlling for gender, age, income, race, and immigrant status, we used logistic regression to analyze country as a predictor of access to care, quality of care, and satisfaction with care and as a predictor of disparities in these measures.
In multivariate analyses, US respondents (compared with Canadians) were less likely to have a regular doctor, more likely to have unmet health needs, and more likely to forgo needed medicines. Disparities on the basis of race, income, and immigrant status were present in both countries but were more extreme in the United States.
United States residents are less able to access care than are Canadians. Universal coverage appears to reduce most disparities in access to care.
Notes
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PubMed ID
16735628 View in PubMed
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Access to emergency operative care: a comparative study between the Canadian and American health care systems.

https://arctichealth.org/en/permalink/ahliterature149522
Source
Surgery. 2009 Aug;146(2):300-7
Publication Type
Article
Date
Aug-2009
Author
Susan A Krajewski
S Morad Hameed
Douglas S Smink
Selwyn O Rogers
Author Affiliation
Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada. susankrajewski@post.harvard.edu
Source
Surgery. 2009 Aug;146(2):300-7
Date
Aug-2009
Language
English
Publication Type
Article
Keywords
Adult
Appendicitis - pathology - surgery
Canada
Emergency medical services
Ethnic Groups
Female
Health Services Accessibility
Healthcare Disparities
Humans
Income
Insurance, Health
Male
Medicaid
Medicare
Middle Aged
National Health Programs
Socioeconomic Factors
United States
Universal Coverage
Young Adult
Abstract
Canada provides universal health insurance to all citizens, whereas 47 million Americans are uninsured. There has not been a study comparing access to emergency operative care between the 2 countries. As both countries contemplate changes in health care delivery, such comparisons are needed to guide health policy decisions. The purpose of this study is to determine whether or not there is a difference in access to emergency operative care between Canada and the United States.
All patients diagnosed with acute appendicitis from 2001 to 2005 were identified in the Canadian Institute for Health Information database and the US Nationwide Inpatient Sample. Severity of appendicitis was determined by ICD-9 codes. Patients were further characterized by age, gender, insurance status, race, and socioeconomic status (SES; income). Univariate and multivariate analyses were performed to determine the odds of appendiceal perforation at different levels of SES in each country.
There were 102,692 Canadian patients and 276,890 American patients with acute appendicitis. In Canada, there was no difference in the odds of perforation between income levels. In the United States, there was a significant, inverse relationship between income level and the odds of perforation. The odds of perforation in the lowest income quartile were significantly higher than the odds of perforation in the highest income bracket (odds ratio, 1.20; 95% confidence interval, 1.16-1.24).
The results suggest that access to emergency operative care is related to SES in the United States, but not in Canada. This difference could result from the concern over the ability to pay medical bills or the lack of a stable relationship with a primary care provider that can occur outside of a universal health care system.
PubMed ID
19628089 View in PubMed
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Achievements and challenges of medicare in Canada: Are we there yet? Are we on course?

https://arctichealth.org/en/permalink/ahliterature173211
Source
Int J Health Serv. 2005;35(3):443-63
Publication Type
Article
Date
2005
Author
Stephen Birch
Amiram Gafni
Author Affiliation
Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada. birch@mcmaster.ca
Source
Int J Health Serv. 2005;35(3):443-63
Date
2005
Language
English
Publication Type
Article
Keywords
Canada
Health Expenditures - legislation & jurisprudence - statistics & numerical data
Health Policy
Health Services Accessibility
Health services needs and demand
Humans
National Health Programs - economics - utilization
Needs Assessment
Policy Making
Poverty
Program Evaluation
Universal Coverage
Abstract
Health care policy in Canada is based on providing public funding for medically necessary physician and hospital-based services free at the point of delivery ("first-dollar public funding"). Studies consistently show that the introduction of public funding to support the provision of health care services free at the point of delivery is associated with increases in the proportionate share of services used by the poor and in population distributions of services that are independent of income. Claims about the success of Canada's health care policy tend to be based on these findings, without reference to medical necessity. This article adopts a needs-based perspective to reviewing the distribution of health care services. Despite the removal of user prices, significant barriers remain to services being distributed in accordance with need-the objective of needs-based access to services remains elusive. The increased fiscal pressures imposed on health care in the 1990s, together with the failure of health care policy to encompass the changing nature of health care delivery, seem to represent further departures from policy objectives. In addition, there is evidence of increasing public dissatisfaction with the performance of the system. A return to modest increases in public funding in the new millennium has not been sufficient to arrest these trends. Widespread support for first-dollar public funding needs to be accompanied by greater attention to the scope of the legislation and the adoption of a needs-based focus among health care policymakers.
PubMed ID
16119569 View in PubMed
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Source
Crit Care Med. 2004 Dec;32(12):2564; author reply 2564
Publication Type
Article
Date
Dec-2004
Author
Robert E Moss
Source
Crit Care Med. 2004 Dec;32(12):2564; author reply 2564
Date
Dec-2004
Language
English
Publication Type
Article
Keywords
Canada
Cost Control
Critical Care - economics - standards
Health Expenditures
Health Services Accessibility - economics
Humans
Intensive Care Units
Outcome Assessment (Health Care)
Universal Coverage
Notes
Comment On: Crit Care Med. 2004 Jul;32(7):1504-915241095
Comment On: Crit Care Med. 2004 Jul;32(7):1614-515241116
PubMed ID
15599184 View in PubMed
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Aging in Canada: state of the art and science.

https://arctichealth.org/en/permalink/ahliterature118526
Source
Gerontologist. 2013 Feb;53(1):1-8
Publication Type
Article
Date
Feb-2013
Author
Debra J Sheets
Elaine M Gallagher
Author Affiliation
School of Nursing, University of Victoria, P.O. Box 1700, Victoria, V8W 2Y2, Canada. dsheets@uvic.ca
Source
Gerontologist. 2013 Feb;53(1):1-8
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Aging
Canada
Cooperative Behavior
Delivery of Health Care - organization & administration
Health Policy
Health services needs and demand
Health Services Research - organization & administration
Health Services for the Aged - standards
Humans
Public Policy
Universal Coverage
Abstract
Canada shares many similarities with other industrialized countries around the world, including a rapidly aging population. What sets Canada uniquely apart is the collaborative approach that has been enacted in the health care system and the aging research initiatives. Canada has tremendous pride in its publicly funded health care system that guarantees universal coverage for health care services on the basis of need, rather than ability to pay. It is also distinguished as a multicultural society that is officially bilingual. Aging research has developed rapidly over the past decade. In particular, the Canadian Longitudinal Study on Aging is one of the most comprehensive research platforms of its kind and is expected to change the landscape of aging research.
PubMed ID
23197394 View in PubMed
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An analysis of trends and determinants of health insurance and healthcare utilisation in the Russian population between 2000 and 2004: the 'inverse care law' in action.

https://arctichealth.org/en/permalink/ahliterature151304
Source
BMC Health Serv Res. 2009;9:68
Publication Type
Article
Date
2009
Author
Francesca Perlman
Dina Balabanova
Martin McKee
Author Affiliation
London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E7HT, UK. francesca.perlman@lshtm.ac.uk
Source
BMC Health Serv Res. 2009;9:68
Date
2009
Language
English
Publication Type
Article
Keywords
Adult
Cross-Sectional Studies
Female
Health Services - utilization
Health Services Research
Humans
Insurance Coverage - statistics & numerical data - trends
Insurance, Health - statistics & numerical data - trends
Logistic Models
Longitudinal Studies
Male
Medically Uninsured - statistics & numerical data
Poverty - economics
Private Sector - economics
Russia
Socioeconomic Factors
Universal Coverage - economics
Abstract
The break-up of the USSR brought considerable disruption to health services in Russia. The uptake of compulsory health insurance rose rapidly after its introduction in 1993. However, by 2000 coverage was still incomplete, especially amongst the disadvantaged. By this time, however, the state health service had become more stable, and the private sector was growing. This paper describes subsequent trends and determinants of healthcare insurance coverage in Russia, and its relationship with health service utilisation, as well as the role of the private sector.
Data were from the Russia Longitudinal Monitoring Survey, an annual household panel survey (2000-4) from 38 centres across the Russian Federation. Annual trends in insurance coverage were measured (2000-4). Cross-sectional multivariate analyses of the determinants of health insurance and its relationship with health care utilisation were performed in working-age people (18-59 years) using 2004 data.
Between 2000 and 2004, coverage by the compulsory insurance scheme increased from 88% to 94% of adults; however 10% of working-age men remained uninsured. Compulsory health insurance coverage was lower amongst the poor, unemployed, unhealthy and people outside the main cities. The uninsured were less likely to seek medical help for new health problems. 3% of respondents had supplementary (private) insurance, and rising utilisation of private healthcare was greatest amongst the more educated and wealthy.
Despite high population insurance coverage, a multiply disadvantaged uninsured minority remains, with low utilisation of health services. Universal insurance could therefore increase access, and potentially contribute to reducing avoidable healthcare-related mortality. Meanwhile, the socioeconomically advantaged are turning increasingly to a growing private sector.
Notes
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PubMed ID
19397799 View in PubMed
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An assessment of progress towards universal health coverage in Brazil, Russia, India, China, and South Africa (BRICS).

https://arctichealth.org/en/permalink/ahliterature260667
Source
Lancet. 2014 Dec 13;384(9960):2164-71
Publication Type
Article
Date
Dec-13-2014
Author
Robert Marten
Diane McIntyre
Claudia Travassos
Sergey Shishkin
Wang Longde
Srinath Reddy
Jeanette Vega
Source
Lancet. 2014 Dec 13;384(9960):2164-71
Date
Dec-13-2014
Language
English
Publication Type
Article
Keywords
Brazil
China
Delivery of Health Care - economics - organization & administration
Health Care Reform - organization & administration
Healthcare Financing
Humans
India
Russia
South Africa
Universal Coverage - economics - organization & administration - statistics & numerical data
Abstract
Brazil, Russia, India, China, and South Africa (BRICS) represent almost half the world's population, and all five national governments recently committed to work nationally, regionally, and globally to ensure that universal health coverage (UHC) is achieved. This analysis reviews national efforts to achieve UHC. With a broad range of health indicators, life expectancy (ranging from 53 years to 73 years), and mortality rate in children younger than 5 years (ranging from 10·3 to 44·6 deaths per 1000 livebirths), a review of progress in each of the BRICS countries shows that each has some way to go before achieving UHC. The BRICS countries show substantial, and often similar, challenges in moving towards UHC. On the basis of a review of each country, the most pressing problems are: raising insufficient public spending; stewarding mixed private and public health systems; ensuring equity; meeting the demands for more human resources; managing changing demographics and disease burdens; and addressing the social determinants of health. Increases in public funding can be used to show how BRICS health ministries could accelerate progress to achieve UHC. Although all the BRICS countries have devoted increased resources to health, the biggest increase has been in China, which was probably facilitated by China's rapid economic growth. However, the BRICS country with the second highest economic growth, India, has had the least improvement in public funding for health. Future research to understand such different levels of prioritisation of the health sector in these countries could be useful. Similarly, the role of strategic purchasing in working with powerful private sectors, the effect of federal structures, and the implications of investment in primary health care as a foundation for UHC could be explored. These issues could serve as the basis on which BRICS countries focus their efforts to share ideas and strategies.
PubMed ID
24793339 View in PubMed
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An international comparison of cancer survival: metropolitan Toronto, Ontario, and Honolulu, Hawaii.

https://arctichealth.org/en/permalink/ahliterature196369
Source
Am J Public Health. 2000 Dec;90(12):1866-72
Publication Type
Article
Date
Dec-2000
Author
K M Gorey
E J Holowaty
G. Fehringer
E. Laukkanen
N L Richter
C M Meyer
Author Affiliation
School of Social Work, University of Windsor, Ontario, Canada. gorey@uwindsor.ca
Source
Am J Public Health. 2000 Dec;90(12):1866-72
Date
Dec-2000
Language
English
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - mortality - therapy
Confounding Factors (Epidemiology)
Female
Hawaii - epidemiology
Health Benefit Plans, Employee - statistics & numerical data
Health Services Research
Humans
Income - statistics & numerical data
Insurance Coverage - statistics & numerical data
Insurance, Health - classification - statistics & numerical data
Male
Middle Aged
National Health Programs - statistics & numerical data
Ontario - epidemiology
Prostatic Neoplasms - mortality - therapy
Quality of Health Care
Single-Payer System - statistics & numerical data
Socioeconomic Factors
Survival Analysis
Universal Coverage - statistics & numerical data
Urban Health - statistics & numerical data
Abstract
Comparisons of cancer survival in Canadian and US metropolitan areas have shown consistent Canadian advantages. This study tests a health insurance hypothesis by comparing cancer survival in Toronto, Ontario, and Honolulu, Hawaii.
Ontario and Hawaii registries provided a total of 9190 and 2895 cancer cases (breast and prostate, 1986-1990, followed until 1996). Socioeconomic data for each person's residence at the time of diagnosis were taken from population censuses.
Socioeconomic status and cancer survival were directly associated in the US cohort, but not in the Canadian cohort. Compared with similar patients in Honolulu, residents of low-income areas in Toronto experienced 5-year survival advantages for breast and prostate cancer. In support of the health insurance hypothesis, between-country differences were smaller than those observed with other state samples and the Canadian advantage was larger among younger women.
Hawaii seems to provide better cancer care than many other states, but patients in Toronto still enjoy a significant survival advantage. Although Hawaii's employer-mandated health insurance coverage seems an effective step toward providing equitable health care, even better care could be expected with a universally accessible, single-payer system.
Notes
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PubMed ID
11111258 View in PubMed
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156 records – page 1 of 16.