Introduction to the Special Issue: Precarious Solidarity—Preferential Access in Canadian Health Care

Reid, Lynette

doi:10.1007/s10728-016-0338-y

Cited by 5 publications

(3 citation statements)

References 17 publications

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“…(2020) used 13 Health Care in Canada (HCIC) surveys and found that the variation in the quality of care reported by the public is “narrow,” ranging from 52% in the Atlantic and Prairie provinces to 65% in Ontario in 2018, with waiting times being the largest source of dissatisfaction. A 2019 poll by The Angus Reid Institute found the level of dissatisfaction with access to health care among older people to be highest in Atlantic Provinces (at 35%), while in other provinces, the dissatisfaction was around 20%, Reid (2019). Cost differences stem largely from high costs in territories, while the variation in HCE across provinces is more narrow, ranging from $7773 to $9585 per person (in 2021 dollars) 12 .…”

Section: Canada's Public Health Care Systemmentioning

confidence: 99%

Health care expenditure and income in Canada: Evidence from panel data

Janko

Kakar

2023

Health Economics

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This paper investigates the long‐run relationship between health care expenditures (HCE) and income using Canadian provincial data spanning a period of 40 years from 1981 to 2020. We study the non‐stationary and cointegration properties of HCE and income and estimate the long‐run income elasticities of HCE. Using heterogeneous panel models that incorporate cross‐section dependence via unobserved common correlated factors to capture global shocks, we estimate long‐run income elasticities that lie in the 0.11–0.16 range. Our results indicate that health care is a necessity good for Canada. These elasticity estimates are much smaller than those estimated in other studies for Canada. We find that HCE and income in Canada are cointegrated and that short‐run changes in federal transfers significantly and positively affect HCE.

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Section: Canada's Public Health Care Systemmentioning

confidence: 99%

Health care expenditure and income in Canada: Evidence from panel data

Janko

Kakar

2023

Health Economics

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“…In 2013 the Vertes Commission judicial enquiry into queue jumping in Alberta provided a rare platform for discussing how routine processes and structures in Canadian health care lead to preferential and differential access. Vertes recommended that the public system needed to standardise and strengthen wait list management strategies, and referral triage and booking systems, including access via the emergency departments to specialist care (the so-called ‘private patient path’); better definition of queue jumping and protection for whistle blowers ( Reid, 2017 ).…”

Section: Waiting For Inpatient Treatment In Canadamentioning

confidence: 99%

Space, place and (waiting) time: reflections on health policy and politics

Sheard

2018

HEPL

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Health systems have repeatedly addressed concerns about efficiency and equity by employing trans-national comparisons to draw out the strengths and weaknesses of specific policy initiatives. This paper demonstrates the potential for explicit historical analysis of waiting times for hospital treatment to add value to spatial comparative methodologies. Waiting times and the size of the lists of waiting patients have become key operational indicators. In the United Kingdom, as National Health Service (NHS) financial pressures intensified from the 1970s, waiting times have become a topic for regular public and political debate. Various explanations for waiting times include the following: hospital consultants manipulate NHS waiting lists to maintain their private practice; there is under-investment in the NHS; and available (and adequate) resources are being used inefficiently. Other countries have also experienced ongoing tensions between the public and private delivery of universal health care in which national and trans-national comparisons of waiting times have been regularly used. The paper discusses the development of key UK policies, and provides a limited Canadian comparative perspective, to explore wider issues, including whether 'waiting crises' were consciously used by policymakers, especially those brought into government to implement new economic and managerial strategies, to diminish the autonomy and authority of the medical professional in the hospital environment.

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“…Large, nationally representative surveys have identified that most adult Canadians agree that there is need to improve the healthcare system [ 26 , 27 ]. A wide range of efforts have been undertaken by governments and polling companies to consult experts and gauge public opinion to address ongoing challenges with the Canadian healthcare system [ 28 – 30 ].…”

Section: Introductionmentioning

confidence: 99%

“We’re sinking”: a qualitative interview-based study on stakeholder perceptions of structural and process limitations to the Canadian healthcare system

Parsons Leigh,

Moss,

Mizen

et al. 2024

Arch Public Health

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Background Despite longstanding efforts and calls for reform, Canada’s incremental approach to healthcare changes has left the country lagging behind other OECD nations. Reform to the Canadian healthcare system is essential to develop a higher performing system. This study sought to gain a deeper understanding of the views of Canadian stakeholders on structural and process deficiencies and strategies to improve the Canadian healthcare system substantially and meaningfully. Methods We conducted individual, ~ 45-minute, semi-structured virtual interviews from May 2022 to August 2022. Using existing contacts and snowball sampling, we targeted one man and one woman from five regions in Canada across four stakeholder groups: (1) public citizens; (2) healthcare leaders; (3) academics; and (4) political decision makers. Interviews centered on participants’ perceptions of the state of the current healthcare system, including areas where major improvements are required, and strategies to achieve suggested enhancements; Donabedian’s Model (i.e., structure, process, outcomes) was the guiding conceptual framework. Interviews were audio-recorded, transcribed verbatim, and de-identified, and inductive thematic analysis was performed independently and in duplicate according to published methods. Results The data from 31 interviews with 13 (41.9%) public citizens, 10 (32.3%) healthcare leaders, 4 (12.9%) academics, and 4 (12.9%) political decision makers resulted in three themes related to the structure of the healthcare system (1. system reactivity; 2. linkage with the Canadian identity; and 3. political and funding structures), three themes related to healthcare processes (1. staffing shortages; 2. inefficient care; and 3. inconsistent care), and three strategies to improve short- and long-term population health outcomes (1. delineating roles and revising incentives; 2. enhanced health literacy; 3. interdisciplinary and patient-centred care). Conclusion Canadians in our sample identified important structural and process limitations to the Canadian healthcare system. Meaningful reforms are needed and will require addressing the link between the Canadian identity and our healthcare system to facilitate effective development and implementation of strategies to improve population health outcomes.

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Introduction to the Special Issue: Precarious Solidarity—Preferential Access in Canadian Health Care

Cited by 5 publications

References 17 publications

Health care expenditure and income in Canada: Evidence from panel data

Health care expenditure and income in Canada: Evidence from panel data

Space, place and (waiting) time: reflections on health policy and politics

“We’re sinking”: a qualitative interview-based study on stakeholder perceptions of structural and process limitations to the Canadian healthcare system

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