Health care system in canada


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How Healthcare Sector works in Canada according to WHO

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Health care system in canada

  2. 2. Canada is the second largest country in the world, with a land area of about 10 million km2. <br />It is a confederation of 10 provinces and 2 territories.<br />The estimated total population of the country is about 29.6 million people<br />OVERVIEW<br />
  3. 3. Publicly funded, privately delivered health care system <br />Best described as an interlocking set of ten provincial and three territorial health insurance plans.<br />Known to Canadians as “Medicare,” the system provides access to universal, comprehensive coverage for medically necessary hospital and physician services.<br />The services are administered and delivered by the provincial and territorial (i.e., state or regional) governments, and are provided free of charge<br />HEALTHCARE SYSTEM<br />
  4. 4. Also assistance from the federal (i.e., national) government in funding <br />To receive their full allocation of federal funding for health care, the provincial and territorial health insurance plans must meet five criteria:<br />Comprehensiveness, <br />Universality, <br />Portability, <br />Accessibility <br />Public Administration<br />
  5. 5. The provincial and territorial plans must insure all medically necessary services provided by hospitals, medical practitioners and dentists working within a hospital setting.<br />All insured health services provided by hospitals and medical practitioners be covered by the plan<br />COMPREHENSIVENESS <br />
  6. 6. The provincial and territorial plans must entitle all insured persons to health insurance coverage on uniform terms and conditions <br />It should cover 100% of the total insured population<br />UNIVERSALITY <br />
  7. 7. The provincial and territorial plans must cover all insured persons when they move to another province or territory within Canada and when they travel abroad.<br />The provinces and territories have some limits on coverage for services provided outside Canada, and may require prior approval for non-emergency services delivered outside their jurisdiction.<br />PORTIBILITY <br />
  8. 8. The provincial and territorial plans must provide all insured persons reasonable access to medically necessary hospital and physician services without financial or other barriers.<br />ACESSIBILITY <br />
  9. 9. The provincial and territorial plans must be administered and operated on a non profit basis by a public authority accountable to the provincial or territorial government.<br />PUBLIC ADMINISTRATION<br />
  11. 11. Municipal Governments<br />Providers:<br />Hospitals<br />Other Institutions<br />Physicians<br />Other health professionals<br />Individuals<br />Taxes<br />Provincial Governments<br />Taxes<br />Transfers<br />Premiums<br />Health Services<br />Federal Government<br />Insured Health Services<br />Transfers<br />Taxes<br />Federal Direct Health Expenditures<br />Workers’Compensation Board<br />Health Services<br />Taxes<br />Premiums<br />Employers<br />Private Insurers<br />Premiums<br />Premiums<br />Non Insured Health Services<br />Premiums<br />Non Insured Health Services<br />
  12. 12. Financed primarily through taxation, both provincial and federal, personal and corporate income taxes<br />Federal funding is transferred to the provinces as a combination of cash contributions and tax points (taxing power).<br />Public sector funding represents about 72% of total health expenditure. The remaining 28% is financed privately through supplementary insurance, employer-sponsored benefits or directly out-of-pocket.<br />HEALTH CARE FINANCE AND EXPENDITURE<br />
  13. 13. Most public sector funding comes from central revenue streams. <br />Some provinces use ancillary funding methods which are nominally targeted for health care, such as sales taxes, payroll levies and lottery proceeds.<br />BENEFITS:<br /><ul><li>Aminimum, medically necessary hospital
  14. 14. Medicare care as provided for under the Canada Health Act</li></li></ul><li>Approximately 1.6 million people work in health care and social services in Canada, and include a mix of professionals in addition to nurses and physicians.<br />The health industry is the 3rd largest employer after manufacturing and the retail trade.<br />HEALTH HUMAN RESOURCE<br />
  16. 16. By general practitioners (GPs) and family physicians<br />Usually the initial contact with the formal health care system <br />Control access to most specialists, many allied providers, admissions to hospitals at which they have admitting privileges, diagnostic testing and prescription drug therapy.<br />Most GPs are private practitioners who work in independent or group practices and enjoy a high degree of autonomy.<br />PRIMARY HEALTH CARE<br />
  17. 17. Private practitioners are generally paid on a fee-for-service basis and submit their service claims directly to the provincial insurance plan for payment.<br />Patients are free to choose their own physicians<br />Use of the emergency room is also their primary access point for health care. This practice is generally discouraged by provincial governments due to the cost of emergency care.<br />Other healthcare personnel includes:<br /><ul><li>Dentists
  18. 18. Nurses
  19. 19. Pharmacists</li></li></ul><li>Primary health care services often includes:<br /><ul><li> Prevention and treatment of common diseases and injuries; basic emergency services;
  20. 20. Referrals to and coordination with other levels of care , such as hospital and specialist care;
  21. 21. Primary mental health care; palliative and end-of-life care;
  22. 22. Health promotion;
  23. 23. Healthy child development;
  24. 24. Primary maternity care;
  25. 25. Rehabilitation services.</li></li></ul><li>Funded and provided separately from the main components of health care<br />Administered through local or regional health units<br />Services range from broad immunization programmes, such as the current programme of providing second-dose measles immunizations, to health programmes that educate identified at risk groups<br />Perform a role of coordinating or directly providing personal and home care services such as meals-on-wheels programmes, homemaker services, or home nursing care<br />They are an integral part of community health care.<br />PUBLIC HEALTH SERVICES<br />
  26. 26. Specialized ambulatory physician care is provided<br />Specialists control access to other specialists and allied providers, and admissions to hospitals, and prescribe necessary diagnostic testing, treatment and prescription drug therapy.<br />Specialists are trained and must be certified too<br />Many specialists maintain private practices and are more likely to have a staff appointment in a hospital or an affiliation with a hospital out-patient clinic.<br />SECONDARY AND TERTIARY CARE<br />
  27. 27. Institution-based Care<br />Largely focused on the provision of long-term care and chronic care<br />Range from residential care facilities to intensive chronic care facilities<br />Majority of patients are elderly<br />Services provided outside institutions<br />Ranges from physician visits, specialized nursing care and homemaker services to meals-on wheels programmes and adult day care.<br />SOCIAL CARE<br />Home-based care<br />
  28. 28. Evolutionary change in the health care system during the 1980s and 1990s<br />Focuses on quality assurance and the role of provinces in reviewing their lists of services provided, ensuring that they are financing high quality services directed towards health gain<br />There is freedom of choice of primary care providers, while on the level of secondary care there are some limitations as access to specialists and hospitals requires a referral by the primary care provider.<br />CONCLUSION<br />
  29. 29. Canadian health care system will continue its development through an evolutionary process and that it will be renewed to reflect the new vision of health care<br />It is increasingly being recognized as one of a broader range of services, providers and delivery sites<br />