What do you first think of when you learn that a loved one has been hospitalized? Most of us worry about our loved one getting the best treatment, having appropriate follow-up care and being sent home when they are well. As the person’s family doctor, I may connect with the team in the hospital to …
Biologic drugs have revolutionized treatments for diseases from cancer to multiple sclerosis. But because they’re developed out of living organisms, they’re more expensive than conventional drugs, adding to the strain on publicly funded drug plans. Fortunately, a new shift should make them cheaper. Many biologics will soon have their patents expire. That means Subsequent Entry Biologics (SEB) – which are …
For years, health care spending in Canada (both public and private) grew much faster than the economy. Until very recently, this trend was expected to continue, casting doubt on the sustainability of Canada’s health care system. However, recent data from the Canadian Institute for Health Information shows that growth in health care spending in 2013 …
Prescription drugs provide important benefits to patients, and are an essential component of the health care system. They also have significant costs: Canadians spent roughly $35 billion on drugs in 2013, or about 16% of total health care spending. Drug costs have put significant strain on provincial budgets. In response, most of Canada’s provinces and …
Can health care learn from assembly lines? Manitoba’s St. Boniface General Hospital thinks so. It’s been using Lean, a system inspired by Toyota, on processes around the institution. Last year, one of its projects was to reduce wait times for CT scans. Staff ran a Rapid Improvement Event, where a team mapped out patient flow and …
This month’s provincial budget renews a pledge to eliminate Ontario’s $12.5-billion deficit in the next four years. The commitment ensures that health care, which accounts for almost half of provincial spending, will continue to be under the microscope and the search to make the system more efficient will continue. The challenge is that much of …
The tsunami metaphor is more and more often used in commentaries about the effect of aging on health care spending in Canada. It musters up images of devastation and irresistible strength submersing any levees the system might try to mount to oppose it. It is a powerful but misleading metaphor. There is a worrying rise …
The United States began releasing the Medicare payments it made to individual doctors on April 9, a move that sparked sensational headlines and debates about privacy. The data offer insights into the $77 billion paid by Medicare’s fee-for-service program to more than 880,000 health care professionals in 2012. Should Canadian provinces follow the U.S.’s lead and publicly …
Expenditures on public health care in Canada appear to be slowing raising the possibility that the health care cost curve is finally being bent and the system transformed. Numbers from the Canadian Institute for Health Information show that real per capita public sector health spending peaked in 2010 at $2,687 (1997 constant dollars) and is …
There’s a common catch phrase used by those championing efforts to prevent childhood obesity: “This may be the first generation of kids to not outlive their parents.” Sounds terrifying – except that so far, there is little evidence to support this idea. Over the past several decades we have seen a remarkable increase in adult …
Caesarian sections (C-sections) are among the most common surgical procedures performed on women of child-bearing age. Canada’s C-section rate has increased dramatically in the past two decades. The national C-section rate has increased from 17% of all births in 1995 to nearly 27% in 2010. In Ontario, nearly 29% of births in 2011/12 were by C-section, with a similar rate in Alberta of …
When the human genome was mapped in the 90s, everybody from scientists to Silicon Valley CEOs believed it would revolutionize medicine by making it personalized. This carried enormous medical and financial opportunities, as well as ethical and legal challenges. But after decades of research, it has become evident that our genome is not nearly as …
Prenatal testing is a routine part of pregnancy care in much of the world. Every pregnant woman in Canada is offered blood tests and ultrasounds to evaluate the health of her pregnancy. When testing suggests potential genetic abnormalities, doctors offer a further test such as amniocentesis to make a definitive diagnosis. While amniocentesis is very …
Across Canada, health system leaders are recognizing the need to provide more effective and more efficient care to the highest users of the health care system. In December 2012, the Ontario government launched an ambitious Health Links strategy to better address the needs of the top 5% of health system users, who consume two thirds …
The Canadian health care system is inefficient. It will come to no one’s surprise. Most Canadians agree that we need to improve the efficiency of the health system and get better value from the dollars invested in health care. In fact, all countries struggle with this challenge. We were interested in getting a better understanding …
Vaccination programs are based on the old adage that an ounce of prevention is worth a pound of cure. Since 2007 Canada has had a vaccination program for the Human Papillomavirus (HPV) administered to girls, although the age of vaccination varies by province: Grade 5 in Alberta and Grade 8 (with catch up until Grade …
While on call on the internal medicine service at my hospital, I recently admitted a 47-year old woman overnight, who had increased swelling in her ankles and a fluid collection in her abdomen. After taking a thorough clinical history and performing a complete physical examination, I presumed the cause to be alcoholic liver cirrhosis. I …
People with end-stage kidney disease have two treatment options: dialysis or transplantation. Dialysis is the process of removing waste and excess water from the blood, by hooking up to a machine that mimics the function of the kidney. Transplantation, however, is the optimal treatment for end-stage kidney disease, because it reduces a patient’s risk of …
There are many pre-conceived notions about private drug coverage in Canada that are really myths. There are also significant differences between public and private drug plan coverage that result in different coverage decisions. It is important to understand these myths and differences to better understand the overall Canadian healthcare system. Myth #1 – Public and …