Kicking off the 2020s with Healthcare Policy

C hange is inevitable as we turn an important page in healthcare policy. Dr. Zelmer was welcomed as the second editor-in-chief of Healthcare Policy more than a decade ago succeeding Dr. Brian Hutchison who was the journal' s inaugural editor-in-chief. At that time, we invited her to continue building on the foundation laid by her predecessor-establishing Healthcare Policy as Canada' s preeminent scholarly journal of health services and policy research. No doubt readers will agree that Dr. Zelmer and her team of editors have accomplished that and much more during her tenure as the editor-in-chief, and for that, Longwoods Publishing is grateful. As editor-in-chief, Dr. Zelmer worked with a Canadian and international network of scholars, and built relationships within the healthcare and health research community. This support was invaluable in ensuring the journal' s ability to respond to existing and emerging issues such as quality improvement and patient safety, primary care reform, pharmacare and new services delivery models, among others. With her team, Dr. Zelmer has addressed these issues and offered a venue for opinions, facts, debates, research and insight to be expressed through the journal.

mentioning

confidence: 99%

A Note from the Publisher

Hart¹

2020

Comparing Childhood Cancer Care Costs in Two Canadian Provinces

McBride¹,

Oliveira

Ross

et al. 2020

Background: Cancer in children presents unique issues for diagnosis, treatment and survivorship care. Phase-specific comparative cost estimates are important for informing healthcare planning. Objectives: The aim of this paper is to compare direct medical costs of childhood cancer by phase of care in British Columbia (BC) and Ontario (ON). Methods: For cancer patients diagnosed at <15 years of age and propensity-score-matched non-cancer controls, we applied standard costing methodology using population-based healthcare administrative data to estimate and compare phase-based costs by province. Results: Phase-specific cancer-attributable costs were 2%–39% higher for ON than for BC. Leukemia pre-diagnosis costs and annual lymphoma continuing care costs were >50% higher in ON. Phase-specific in-patient hospital costs (the major cost category) represented 63%–82% of ON costs, versus 43%–73% of BC costs. Phase-specific diagnostic tests and procedures accounted for 1.0%–3.4% of ON costs and 2.8%–13.0% of BC costs. Conclusions: There are substantial cost differences between these two Canadian provinces, BC and ON, possibly identifying opportunities for healthcare planning improvement.

The Mosaic of Primary Care Nurses in Rural and Remote Canada: Results from a National Survey

Martin-Misener¹,

MacLeod²,

Kosteniuk³

et al. 2020

Background and objective: Nurses provide essential primary care (PC) in rural and remote Canada. We examined the practice context and responsibilities of this little-known understudied workforce. Method: Data from Nursing Practice in Rural and Remote Canada II, a 2014 to 2015 pan-Canadian survey, were analyzed. Results: Of 3,822 respondents, 192 identified that PC was their only practice focus (PC-Only), and for 111, it was one focus among others (PC-Plus). Proportionally more PC-Only than PC-Plus nurses had graduate education, were employed in larger communities and had experienced higher job resources and lower job demands. Proportionally fewer PC-Only than PC-Plus nurses followed protocols/decision support tools, dispensed medications and provided emergency services. Proportionally more PC-Only than PC-Plus nurses ordered advanced diagnostic tests/imaging, and fewer PC-Only than PC-Plus nurses performed and interpreted laboratory tests and diagnostic imaging on site. Conclusion: Contributions of the rural and remote nursing workforce to PC are rendered invisible by contemporary characterizations of the PC workplace, limiting evaluation and improvement efforts. Résumé Contexte et objectif : Les infirmières fournissent des soins de santé primaires (SSP) essentiels dans les régions rurales et éloignées du Canada. Nous avons examiné le contexte et les responsabilités de la pratique de cette main-d' oeuvre peu connue et mal étudiée. Méthode : Nous avons analysé des données provenant d' une enquête pancanadienne sur la pratique infirmière dans les régions canadiennes rurales et éloignées, de 2014 à 2015 (Nursing Practice in Rural and Remote Canada II). Résultats : Parmi 3 822 répondants, 192 ont indiqué que les SSP formaient l' essentiel de leur pratique (SSP-seul) et 111 ont indiqué que ces soins formaient une partie de leur pratique (SSP-plus). Toute proportion gardée, plus d'infirmières SSP-seul que SSP-plus ont reçu leur diplôme, ont été employées dans des grandes communautés, ont bénéficié de plus de ressources au travail et ont connu moins d' exigences au travail. Toute proportion gardée, moins d'infirmières SSP-seul que SSP-plus ont utilisé les outils d' aide aux protocoles ou à la décision, ont délivré des médicaments et ont fourni des services d' urgence. Toute proportion gardée, plus d'infirmières SSP-seul que SSP-plus ont prescrit une imagerie ou un test diagnostic poussé et moins d'infirmières SSP-seul que SSP-plus ont effectué et interprété des tests en laboratoire et des imageries diagnostiques sur les lieux. Conclusion : La contribution de la main-d' oeuvre infirmière dans les régions canadiennes rurales et éloignées demeure invisible en raison des caractérisations contemporaines du lieu de travail des SSP, ce qui limite les efforts d'évaluation et d' amélioration.