In Ontario, specialists are concentrated in larger cities, and Ontarians living in smaller cities and rural regions have challenges accessing specialist services. In Ontario, Local Health Integration Networks (LHINs) use non-financial incentives to try to attract specialists to practice in hospitals that serve rural areas, and provide telemedicine and outreach clinics for patients. In contrast, …
In Ontario, new ways of paying doctors have been introduced in an attempt to improve the quality of their services. One approach is pay-for-performance, which pays doctors for meeting certain treatment goals. However, there is little high quality evidence that pay-for-performance improves the quality of care, and it appears to have had limited impact in …
A recent study found that Ontario hospitals that used more resources and spent more money had better outcomes for acutely ill patients than hospitals that used fewer resources. These findings go against a previous study that looked at the same question in the United States and found that more resources didn’t impact outcomes. A better …
Concerns about quality and a fire at a Sandoz plant in Quebec exacerbated the current drug shortage in Canada. Many are asking why the shutdown of a single facility could threaten the nation’s supply of vital prescription medications. While federal and provincial governments have been eager to play the blame game, a shared sense of …
Ontario recently announced funding for two birth centres that will be led by midwives. The government has indicated it is opening birth centres partly to move care out of hospitals and save money. Although birth centres are probably safe and may improve maternity care, it is less clear whether Ontario’s birth centres will indeed reduce …
In Canada, doctors’ associations regularly incorporate new evidence about medications into clinical practice guidelines that are intended to influence patient care. The Ontario Ministry of Health and Long-Term Care reviews the same evidence to decide which medications it will pay for, and often comes to different conclusions. This results in doctors recommending medications which are …
In the last decade, efforts to improve access to primary care in Ontario have led to major changes to how family doctors practice and are paid. A recent report suggests that these newer models of primary care are not meeting the needs of vulnerable populations, and that Community Health Centres (an older model of care) do …
The Drummond Report recommended no increase in total compensation for Ontario’s doctors. A number of factors affect how much Ontario pays doctors including the number of doctors in practice, how many patients they see, and how much they are paid for each service. Achieving zero growth would require difficult decisions and trade-offs. The February 2012 …
Three quarters of our daily salt intake comes from prepared and manufactured foods. Experts suggest that the most effective approach to reducing salt consumption in a population is to more actively regulate the amount of salt in prepared foods. However, there is a debate about the best strategy to curb salt intake in Canada. Does …
The Ontario Ministry of Health and Long-Term Care is changing the way it funds hospitals for the upcoming fiscal year, which starts on April 1. The new funding formula is intended to improve efficiency. However, many hospitals are unprepared for the change. We spoke with hospital executives and other experts to better understand what is …
Shortened hospital lengths of stay, and a growing number of people living with chronic diseases has meant that more Ontarians than ever are receiving health care services in their homes. In 2010, the Ontario Auditor General raised concerns about the quality and value of home care services, some of which remain outstanding. Resolving these issues …
A recent report describes how Canada’s healthcare system performs compared to 13 other countries. Canada ranked at the bottom in access to care and use of electronic health records, and in the middle regarding costs and health outcomes. Thirty-eight percent of Canadians felt the system works well, 51% thought it needs fundamental change, and 10% believed …
There have been a number of recent reports of conflicts of interest in medical research. There are at least two types of conflicts of interest – financial conflicts, where researchers stand to gain financially from their work; and intellectual conflicts, where researchers stand to gain professionally. Ensuring that all conflicts of interest are declared and …
Each year thousands of medical students across Canada apply for, and are matched to, residency positions in a variety of medical specialties. The allocation of residency training positions among the various specialties is largely decided by academic doctors involved with medical education. Some experts believe that health system decision makers should exert greater influence over …
Improving access to primary care has been a key priority of the Ontario Ministry of Health and Long-Term Care for the past decade. The number of Ontarians who have a regular family doctor has increased dramatically. However, patients who are chronically ill continue to have problems accessing primary care. More family doctors and more rostered …
Ontario’s Information and Privacy Commissioner recently ordered Cancer Care Ontario to stop sending paper copies of screening reports containing personal health information to physicians. However, a massive amount of personal health information is mailed or faxed every day in Ontario. The implications of this order to information sharing and transfer across the health care …
Healthydebate.ca has run a series of stories on breast cancer screening mammography, stimulated by the recent guidelines from the Canadian Task Force on Preventive Health Care. This last story focuses on how women and policy makers must balance the benefits and harms of screening mammography. The issues raised in this series are relevant to screening …
Some breast cancers detected by screening mammography are cured and would have led to death had they not been detected early. Other breast cancers detected by screening can be treated just as effectively if diagnosed later, may not have needed treatment at all, or may be so advanced that treatment does not prevent death from …
The Canadian Task Force on Preventive Health Care recently released recommendations about screening for breast cancer. These recommendations have been criticized by some because they emphasize the results of randomized trials. This article explores the advantages and limitations of randomized trial evidence regarding screening mammography. The recent recommendations by the Canadian Task Force on Preventive …