No abstract

Objective: This study explored the care-giving and care-seeking behaviours of parents who took their children to the emergency department (ED) of a large urban hospital in Western Canada for non-urgent care.Method: Data were collected from a convenience sample of 114 parents during a twoweek period in January 1992, using a self-administered 53-item questionnaire. The data were analyzed using nonparametric statistics (Chi-square) and thematic content analysis.Results: Eighty-two percent of parents were unsure of or overestimated the seriousness of their child's illness or injury. Prior to attending the ED, 40% of parents administered comfort measures and 45% gave medications. Only 17% of parents used at-home reading materials, while 31% sought lay advice. Fifty-eight percent of parents did not try to contact their family physician or the ED by telephone before coming to the ED. Forty-eight percent of parents who phoned their family physician were unable to obtain advice, and those who did were almost always referred to the ED. Eighty-eight percent of those who phoned the ED were instructed to bring the child to the ED.

Background: An analysis of a provincial home care dataset, comparing home care client, service, and providers in 1991/92 through 2000/01, was undertaken to describe changes over the decade, and permit a more informed discussion of home care in relation to Canadian health policy developments and health system reforms. Methods: After data were obtained upon request from Alberta's Ministry of Health and Wellness, descriptive and comparative statistical analyses were undertaken using the SPSS computer program. Logistic regression was used to compare multiple client characteristics in the first and last years. Results: Home care clients doubled and the mean hours of care per client increased substantially, although the duration of care provision declined. The mean age of clients also declined. Home care continued to be primarily provided by Home Support Aides, with self-managed care increasing dramatically. Sustained geographical differences in home care were noted. Conclusion: Although home care has much potential for enabling early discharge from hospital, and for maintaining or improving health, few population-level studies of home care trends exist. In Alberta, although formal home care hours increased, home care expansion was not uniform across the province. Home Support Aides continued to be the primary care provider. In the face of substantial hospital downsizing, these observations could imply that the provision of home care has been off loaded to families. Moreover, home care increases do not appear to be related to an aging population. MeSH terms: Home care; population data; administrative data; trends; hospital downsizing; health system reform La traduction du résumé se trouve à la fin de l'article.

This report compares 20th-century Canadian hospital and nonhospital location-of-death trends and corresponding population mortality trends. One of the chief findings is a hospitalization-of-death trend, with deaths in hospital peaking in 1994 at 80.5% of all deaths. The rise in hospitalization was more pronounced in the years prior to the development of a national health care program (1966). Another key finding is a gradual reduction since 1994 in hospital deaths, with this reduction occurring across all sociodemographic variables. This suggests nonhospital care options are needed to support what may be an ongoing shift away from hospitalized death and dying.

No abstract