On Line Survey Results
Canadian Health Care Primer
US Health Care Primer
Comparison Statistics
Implications for EAP Professionals
Future Steps towards Wellness Culture
Sat 0810-smith-case-for-legalizing-medically-assisted-dying-in-canada- -parkIhsaan Peer
This document summarizes a presentation by Dr. Derryck H. Smith arguing for the legalization of medically-assisted dying in Canada. Dr. Smith outlines the common arguments for and against assisted dying, noting evidence does not support claims it would undermine palliative care or lead to abuse. Data from jurisdictions where assisted dying is legal show it is infrequently used and mostly by well-educated, terminally ill patients wishing to control their death. Dr. Smith argues individual autonomy should drive policy over religious beliefs alone, and that legalization need not compromise palliative care access or oversight.
Agent Michele Thompkins presented information on supplemental Aflac insurance policies for individuals and groups. Aflac policies provide benefits to help cover expenses major medical may not, such as copays, deductibles, and lost wages. They offer policies for accident, cancer, hospital confinement indemnity, life, short term disability, and more. Enrollment for groups can be done through presentations and individual appointments.
This document discusses decisional capacity and assessing capacity in older adults. It covers:
- Determining capacity can be difficult when individuals have complex impairments, and requires balancing ethics, law, and protecting individuals.
- Capacity is a medical determination of whether someone can make their own decisions, while competency is a legal status determined by a judge.
- Tools for assessing cognition like the MMSE can provide likelihood ratios for capacity, but capacity evaluations consider multiple factors.
- The Aid to Capacity Evaluation (ACE) is a validated instrument that assesses understanding, appreciation of risks/benefits, and reasoning to make a medical decision. Scores help determine capacity.
The document makes the case for peer support services and a certified peer workforce in the United States. It discusses how peer roles are evolving within recovery-oriented health systems. Currently, 46 states and Washington D.C. have established programs to train and certify peer specialists. The implementation of peer supports and services aims to improve quality of life and physical health for those with mental illnesses, while lowering inpatient rates and increasing outpatient services to promote longevity, wellness, and sustainability.
A Change in Behavior: A Pragmatic Clinical Guide to Delirium, Terminal Restle...VITAS Healthcare
The goal of this webinar was to help physicians and healthcare professionals differentiate delirium, terminal restlessness, and dementia-related agitation and aggression in patients near the end of life.
This document provides information on continuing education credit for completing an advanced cardiac disease training. It states that learners must complete an evaluation to receive a certificate of completion and participate in the entire activity, as partial credit is not available. It then lists the accredited organizations that provide credit for various specialties, such as physicians, nurses, social workers, and nursing home administrators. Exceptions to credit eligibility for certain specialties are also noted for some states.
This document discusses a study examining the relationship between family caregivers of dementia patients and healthcare providers. The study aimed to identify how diagnosis is provided, understand caregiver needs, and determine how providers can better support caregivers. Key findings include that specialists rather than primary care physicians usually provide the diagnosis, and caregivers desire more information from doctors on disease progression, services, and financing care. Healthcare providers reported needing more time with patients and families and could better utilize tools to assist caregivers. There is a shortage of geriatricians available to support this vulnerable population.
How useful are advance directives in directing end of life care and do people really understand or want to know the true status of their health as the end nears?
Sat 0810-smith-case-for-legalizing-medically-assisted-dying-in-canada- -parkIhsaan Peer
This document summarizes a presentation by Dr. Derryck H. Smith arguing for the legalization of medically-assisted dying in Canada. Dr. Smith outlines the common arguments for and against assisted dying, noting evidence does not support claims it would undermine palliative care or lead to abuse. Data from jurisdictions where assisted dying is legal show it is infrequently used and mostly by well-educated, terminally ill patients wishing to control their death. Dr. Smith argues individual autonomy should drive policy over religious beliefs alone, and that legalization need not compromise palliative care access or oversight.
Agent Michele Thompkins presented information on supplemental Aflac insurance policies for individuals and groups. Aflac policies provide benefits to help cover expenses major medical may not, such as copays, deductibles, and lost wages. They offer policies for accident, cancer, hospital confinement indemnity, life, short term disability, and more. Enrollment for groups can be done through presentations and individual appointments.
This document discusses decisional capacity and assessing capacity in older adults. It covers:
- Determining capacity can be difficult when individuals have complex impairments, and requires balancing ethics, law, and protecting individuals.
- Capacity is a medical determination of whether someone can make their own decisions, while competency is a legal status determined by a judge.
- Tools for assessing cognition like the MMSE can provide likelihood ratios for capacity, but capacity evaluations consider multiple factors.
- The Aid to Capacity Evaluation (ACE) is a validated instrument that assesses understanding, appreciation of risks/benefits, and reasoning to make a medical decision. Scores help determine capacity.
The document makes the case for peer support services and a certified peer workforce in the United States. It discusses how peer roles are evolving within recovery-oriented health systems. Currently, 46 states and Washington D.C. have established programs to train and certify peer specialists. The implementation of peer supports and services aims to improve quality of life and physical health for those with mental illnesses, while lowering inpatient rates and increasing outpatient services to promote longevity, wellness, and sustainability.
A Change in Behavior: A Pragmatic Clinical Guide to Delirium, Terminal Restle...VITAS Healthcare
The goal of this webinar was to help physicians and healthcare professionals differentiate delirium, terminal restlessness, and dementia-related agitation and aggression in patients near the end of life.
This document provides information on continuing education credit for completing an advanced cardiac disease training. It states that learners must complete an evaluation to receive a certificate of completion and participate in the entire activity, as partial credit is not available. It then lists the accredited organizations that provide credit for various specialties, such as physicians, nurses, social workers, and nursing home administrators. Exceptions to credit eligibility for certain specialties are also noted for some states.
This document discusses a study examining the relationship between family caregivers of dementia patients and healthcare providers. The study aimed to identify how diagnosis is provided, understand caregiver needs, and determine how providers can better support caregivers. Key findings include that specialists rather than primary care physicians usually provide the diagnosis, and caregivers desire more information from doctors on disease progression, services, and financing care. Healthcare providers reported needing more time with patients and families and could better utilize tools to assist caregivers. There is a shortage of geriatricians available to support this vulnerable population.
How useful are advance directives in directing end of life care and do people really understand or want to know the true status of their health as the end nears?
Dr. William Duncan speaks from a background as a legislator in Washington DC working to write and promote legislation regarding HBOT into the medical system in America.
Advanced Lung Disease: Prognostication and Role of HospiceVITAS Healthcare
The goal of this webinar was to educate physicians and healthcare professionals about the medical management of advanced lung disease (ALD) and the value of advance care planning (ACP) for end-of-life patients.
Transition from allopathic to integrated medical practiceLouis Cady, MD
This is the keynote lecture of the series of three lectures that Dr. Cady presented to the World Link Medical seminar in Salt Lake City, Utah on June 1, 2012.
The 10th Annual Utah Health Services Research Conference: Assessment of Actual Pediatric Organ Donation Potential: Neurological and Circulatory Determination of Death. By: Erin E. Bennett, M.D., MPH; Jill Sweney, M.D.; Cecile Aguayo, R.N.; Craig Myrick, R.N.; Armand H. Matheny Antommaria, M.D., Ph.D.; Susan L. Bratton, M.D., MPH.
Patient Centered Research Methods Core, University of Utah, CCTS
The document discusses a program called HealthPerx that addresses rising healthcare costs. It provides (1) telemedicine access to board certified physicians 24/7, reducing office and ER visits; (2) discounts on pharmacy, dental, vision, and hearing care through provider networks; and (3) lifestyle savings on fitness clubs, identity theft protection, and other services. Studies show the program reduces costs through lower utilization and discounts, saving families thousands per year in both healthcare and lifestyle expenses.
A Patient's request to exchange medical costs in last year of life for Hep C Tx.Jeffrey Harris
This document proposes an economic exchange between a patient, healthcare providers, and payers. The patient, a 58-year-old man with diabetes, hepatitis C, and other conditions, argues that covering new treatments for his conditions will save costs in the long run. He offers to forgo expensive end-of-life care past age 75 in exchange for coverage of continuous glucose monitors and hepatitis C treatment now. Data on the high costs of diabetes and end-stage liver disease support that this exchange could save at least $250,000 total in future healthcare expenses.
This document summarizes and promotes critical illness insurance. It describes how such insurance provides financial protection for people diagnosed with serious illnesses by paying lump sums that can be used flexibly. The summary highlights that critical illness rates are increasing in the US, that most health insurance does not cover all costs of treatment and recovery, and that critical illness insurance helps allow patients to focus on recovery rather than financial stresses. It also shares one example of a policyholder who received benefits to pay medical bills following a brain tumor diagnosis.
This document summarizes a presentation about dealing with complexity at Bridgepoint Health Hospital. It discusses (1) the increasing burden of complex chronic diseases, (2) Bridgepoint Health's focus on improving care for patients with multiple chronic conditions, and (3) the Bridgepoint Collaboratory for Research and Innovation, which conducts leading edge research to advance understanding and care of complex chronic diseases.
Presentation by Lenny Recupero, M.Ed.
Community Injury Prevention Coordinator
Division of Injury and Violence Prevention
Virginia Department of Health
A Snapshot of Fall-Related
Injuries Among Older Adults
Online Conference Takes “Deep Dive” into Affordable Care ActPYA, P.C.
PYA’s Martie Ross, Principal, joined three other panelists in a full-day, online conference sponsored by the American Institute of Certified Public Accountants to offer an in-depth look at healthcare reform under the Affordable Care Act (ACA).
The document provides an overview of key provisions and implementation timeline of the Patient Protection and Affordable Care Act (ACA). It establishes health insurance exchanges by 2014 to facilitate the purchase of qualified health plans. The ACA also defines essential health benefits that must be covered and establishes different coverage levels (bronze, silver, gold, platinum). Health insurers must offer at least one silver and one gold plan on the exchanges.
The history of healthcare in the US shows rising costs over time and various attempts at reform. Early 1900s saw the rise of paid hospital care and surgery becoming common. The 1910s saw the beginnings of the health insurance movement despite opposition. In the 1930s, the Depression halted healthcare reforms despite Roosevelt's calls for reform. The 1940s saw the rise of employer provided health benefits and antibiotics. The 1960s saw Medicare and Medicaid passed under Johnson. Attempts at national healthcare failed under Nixon in the 1970s. By the 1990s, over 44 million Americans lacked health insurance, leading to the passage of Obamacare in 2010 in an effort to address rising costs and the uninsured.
Healthcare History Timeline from Annenberg ClassroomHeather Zink
This timeline summarizes the major developments in the history of health care and health insurance in the United States from 1900 to 2010. It shows that organized medicine began taking shape in the early 1900s while the concept of health insurance was first promoted in 1912. The first modern health insurance plan was created in 1929 in Dallas, Texas. Major developments include the establishment of Medicare and Medicaid in 1965, the passage of the Affordable Care Act in 2010, and various attempts at health care reform throughout the 20th century.
The document provides an overview of the complex U.S. healthcare system, including its decentralized market-based structure compared to other countries' centralized systems. It discusses key players like doctors, hospitals, insurers, and governments. It also covers major public programs like Medicare and Medicaid, as well as private insurance concepts like health plans, coding, and reimbursement structures including capitation and fee-for-service.
The Value Proposition of Hospice | VITASVITASAuthor
The goal of this webinar was to help hospice and healthcare professionals discover the evidence-based benefits of hospice care, while gaining key insights on hospice eligibility guidelines, how hospice differs from other types of care, and how the Medicare Hospice Benefit helps patients facing advanced illness.
Health Care: Understanding the Future, a Canadian Perspective by Carolyn Benn...neelumaggarwal
In April of 2010, the Canada US Business Council (formerly the Canadian Club of Chicago), hosted Dr. Carolyn Bennett, Liberal Critic for Health, Parliament of Canada. This talk gave the Canadian perspective on health care in addition to showing the similarities and differences between the two health care systems.
The document discusses informed medical decision making and shared decision making. It notes that many patients have misconceptions about medical procedures and their benefits. Decision aids can help by providing information to patients and clarifying their values and preferences. When used, decision aids increase patient knowledge and accuracy, reduce decision conflict, and result in less invasive treatment choices. The document advocates for implementing practical protocols to routinely use decision aids during medical decision making.
International Health Policy and Practice: Comparing the U.S. and Canada on Ac...The Commonwealth Fund
Dr. Eric Schneider's presentation on international health policy and practice. This presentation was delivered at the 2015 AcademyHealth Annual Research Meeting on June 14, 2015.
The document summarizes issues with the current US healthcare system including high costs, large number of uninsured, restricted access to care, and high administrative costs. It presents single-payer healthcare as an alternative that could provide universal comprehensive coverage for all Americans through tax funding, reduce costs, improve access and choice, while maintaining physician autonomy and quality of care. Medical students would have lower debt under such a system.
The goal of this webinar is to help hospice and healthcare professionals understand the history, philosophy and practice of hospice care and palliative care, including common myths and misconceptions, common diagnoses for hospice referrals, identification of hospice-eligible patients, reimbursement for hospice services, and the benefits of advance care planning and early referrals.
Dr. William Duncan speaks from a background as a legislator in Washington DC working to write and promote legislation regarding HBOT into the medical system in America.
Advanced Lung Disease: Prognostication and Role of HospiceVITAS Healthcare
The goal of this webinar was to educate physicians and healthcare professionals about the medical management of advanced lung disease (ALD) and the value of advance care planning (ACP) for end-of-life patients.
Transition from allopathic to integrated medical practiceLouis Cady, MD
This is the keynote lecture of the series of three lectures that Dr. Cady presented to the World Link Medical seminar in Salt Lake City, Utah on June 1, 2012.
The 10th Annual Utah Health Services Research Conference: Assessment of Actual Pediatric Organ Donation Potential: Neurological and Circulatory Determination of Death. By: Erin E. Bennett, M.D., MPH; Jill Sweney, M.D.; Cecile Aguayo, R.N.; Craig Myrick, R.N.; Armand H. Matheny Antommaria, M.D., Ph.D.; Susan L. Bratton, M.D., MPH.
Patient Centered Research Methods Core, University of Utah, CCTS
The document discusses a program called HealthPerx that addresses rising healthcare costs. It provides (1) telemedicine access to board certified physicians 24/7, reducing office and ER visits; (2) discounts on pharmacy, dental, vision, and hearing care through provider networks; and (3) lifestyle savings on fitness clubs, identity theft protection, and other services. Studies show the program reduces costs through lower utilization and discounts, saving families thousands per year in both healthcare and lifestyle expenses.
A Patient's request to exchange medical costs in last year of life for Hep C Tx.Jeffrey Harris
This document proposes an economic exchange between a patient, healthcare providers, and payers. The patient, a 58-year-old man with diabetes, hepatitis C, and other conditions, argues that covering new treatments for his conditions will save costs in the long run. He offers to forgo expensive end-of-life care past age 75 in exchange for coverage of continuous glucose monitors and hepatitis C treatment now. Data on the high costs of diabetes and end-stage liver disease support that this exchange could save at least $250,000 total in future healthcare expenses.
This document summarizes and promotes critical illness insurance. It describes how such insurance provides financial protection for people diagnosed with serious illnesses by paying lump sums that can be used flexibly. The summary highlights that critical illness rates are increasing in the US, that most health insurance does not cover all costs of treatment and recovery, and that critical illness insurance helps allow patients to focus on recovery rather than financial stresses. It also shares one example of a policyholder who received benefits to pay medical bills following a brain tumor diagnosis.
This document summarizes a presentation about dealing with complexity at Bridgepoint Health Hospital. It discusses (1) the increasing burden of complex chronic diseases, (2) Bridgepoint Health's focus on improving care for patients with multiple chronic conditions, and (3) the Bridgepoint Collaboratory for Research and Innovation, which conducts leading edge research to advance understanding and care of complex chronic diseases.
Presentation by Lenny Recupero, M.Ed.
Community Injury Prevention Coordinator
Division of Injury and Violence Prevention
Virginia Department of Health
A Snapshot of Fall-Related
Injuries Among Older Adults
Online Conference Takes “Deep Dive” into Affordable Care ActPYA, P.C.
PYA’s Martie Ross, Principal, joined three other panelists in a full-day, online conference sponsored by the American Institute of Certified Public Accountants to offer an in-depth look at healthcare reform under the Affordable Care Act (ACA).
The document provides an overview of key provisions and implementation timeline of the Patient Protection and Affordable Care Act (ACA). It establishes health insurance exchanges by 2014 to facilitate the purchase of qualified health plans. The ACA also defines essential health benefits that must be covered and establishes different coverage levels (bronze, silver, gold, platinum). Health insurers must offer at least one silver and one gold plan on the exchanges.
The history of healthcare in the US shows rising costs over time and various attempts at reform. Early 1900s saw the rise of paid hospital care and surgery becoming common. The 1910s saw the beginnings of the health insurance movement despite opposition. In the 1930s, the Depression halted healthcare reforms despite Roosevelt's calls for reform. The 1940s saw the rise of employer provided health benefits and antibiotics. The 1960s saw Medicare and Medicaid passed under Johnson. Attempts at national healthcare failed under Nixon in the 1970s. By the 1990s, over 44 million Americans lacked health insurance, leading to the passage of Obamacare in 2010 in an effort to address rising costs and the uninsured.
Healthcare History Timeline from Annenberg ClassroomHeather Zink
This timeline summarizes the major developments in the history of health care and health insurance in the United States from 1900 to 2010. It shows that organized medicine began taking shape in the early 1900s while the concept of health insurance was first promoted in 1912. The first modern health insurance plan was created in 1929 in Dallas, Texas. Major developments include the establishment of Medicare and Medicaid in 1965, the passage of the Affordable Care Act in 2010, and various attempts at health care reform throughout the 20th century.
The document provides an overview of the complex U.S. healthcare system, including its decentralized market-based structure compared to other countries' centralized systems. It discusses key players like doctors, hospitals, insurers, and governments. It also covers major public programs like Medicare and Medicaid, as well as private insurance concepts like health plans, coding, and reimbursement structures including capitation and fee-for-service.
The Value Proposition of Hospice | VITASVITASAuthor
The goal of this webinar was to help hospice and healthcare professionals discover the evidence-based benefits of hospice care, while gaining key insights on hospice eligibility guidelines, how hospice differs from other types of care, and how the Medicare Hospice Benefit helps patients facing advanced illness.
Health Care: Understanding the Future, a Canadian Perspective by Carolyn Benn...neelumaggarwal
In April of 2010, the Canada US Business Council (formerly the Canadian Club of Chicago), hosted Dr. Carolyn Bennett, Liberal Critic for Health, Parliament of Canada. This talk gave the Canadian perspective on health care in addition to showing the similarities and differences between the two health care systems.
The document discusses informed medical decision making and shared decision making. It notes that many patients have misconceptions about medical procedures and their benefits. Decision aids can help by providing information to patients and clarifying their values and preferences. When used, decision aids increase patient knowledge and accuracy, reduce decision conflict, and result in less invasive treatment choices. The document advocates for implementing practical protocols to routinely use decision aids during medical decision making.
International Health Policy and Practice: Comparing the U.S. and Canada on Ac...The Commonwealth Fund
Dr. Eric Schneider's presentation on international health policy and practice. This presentation was delivered at the 2015 AcademyHealth Annual Research Meeting on June 14, 2015.
The document summarizes issues with the current US healthcare system including high costs, large number of uninsured, restricted access to care, and high administrative costs. It presents single-payer healthcare as an alternative that could provide universal comprehensive coverage for all Americans through tax funding, reduce costs, improve access and choice, while maintaining physician autonomy and quality of care. Medical students would have lower debt under such a system.
The goal of this webinar is to help hospice and healthcare professionals understand the history, philosophy and practice of hospice care and palliative care, including common myths and misconceptions, common diagnoses for hospice referrals, identification of hospice-eligible patients, reimbursement for hospice services, and the benefits of advance care planning and early referrals.
Slides from a talk at Ryerson University Health Service Management program's 1st Annual Symposium by Dr. Michael Rachlis.
Reproduced here with permission
Enhancing Access, Quality, and Equity for Persons With Advanced IllnessVITASAuthor
This diverse panel examined various facets of healthcare access, equity, and inclusion as it
relates to individuals in underserved communities who are coping with advanced illness. Based on their
decades of experience in end-of-life care, as well as evidence-based data and a compelling case study
of a Filipino-American US Navy Veteran, panel members shared strategies on how to mitigate
current barriers, including ensuring patients are granted timely access to hospice and palliative
services and that appropriate levels of care are provided.
Canadian Expert Patients in Health Technology Conference
Nov 7 – 8, 2016: Day 2 Appropriate Place in Therapy Allan Miranda (Janssen), John Snowden (Amgen), Dawn Richards (Canadian Arthritis Patient Alliance), Seema Nagpal (Canadian Diabetes Association),
The goal of this webinar was to educate healthcare professionals about advance directives and advance care planning,
including the types and purposes of legal documents that govern patients’ decisions and
preferences.
The document discusses the value of hospice care within the Medicare system. It notes that recent statistical analyses found hospice generated cost savings in a patient's last six months of life and up to a year of hospice enrollment. The document then proposes examining these results from different perspectives within the serious illness care continuum, including from primary care physicians and considering diversity, equity and inclusion. Expert hospice and palliative care clinicians would discuss the importance of earlier access to such care in a patient's disease trajectory, as well as the
HIV and Primary Care Transformation baltimore 5 21sbromer
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This webinar provides resources and guidance on effective conversations with patients and families about their goals, wishes, and values for end-of-life care.
When facing critical illness, ethical considerations loom large, guiding decisions that profoundly affect individuals and their loved ones. In such scenarios, principles like autonomy, beneficence, non-maleficence, and justice become paramount.
Autonomy, the right to self-determination, acknowledges the patient's ability to make decisions regarding their care. However, in cases like the 84-year-old who underwent aneurysm surgery, cognitive impairment or advanced age may compromise autonomy, necessitating surrogate decision-making.
Beneficence and non-maleficence dictate the obligation to act in the patient's best interest while avoiding harm. The story of the 84-year-old illustrates this balance. While surgery aimed to prolong life, it inadvertently led to limitations, such as the inability to engage fully in activities like playing with grandchildren.
Justice concerns the fair distribution of resources and burdens. In the context of critical illness, it prompts questions about equitable access to care and allocation of medical resources. For instance, the emotional toll on the family of the baby who didn't survive may raise questions about the allocation of resources for neonatal care.
These ethical principles intersect with personal narratives, such as the 84-year-old's desire to participate in family activities or the grief of losing a baby. They guide clinicians, families, and policymakers in navigating complex decisions, seeking to uphold dignity, respect, and the best possible outcomes amidst challenging circumstances.
PELATIHAN PERAWATAN PALIATIF PADA STROKE - 16 maret 2020papahku123
This document discusses palliative care and end-of-life care for stroke patients. It outlines the seven principles of palliative care programs which focus on informed patient and family involvement, support for caregivers, a palliative approach to care, access to specialist palliative care, coordinated and integrated treatment, quality care from skilled staff, and community support. It also discusses assessing patient needs, managing symptoms, communication with patients and families, and the goals of palliative care for stroke which are to manage symptoms, provide counseling and support, and improve quality of life.
HOW TO SAVE MONEY ON YOUR HEALTHCARE: An Integrative Medicine ApproachLouis Cady, MD
In this webinar, the fourth in a series of five from Dr. Louis Cady and the Cady Wellness Institute, we focus on the actual dollars and cents of health care expenditures, and the societal and PERSONAL costs of poor health maintenance behavior. We examine the essentially passive US medical system, that would rather drug a symptom than fix the underlying problem.
Great attention is paid on not shaming the patient or the doctors as they exist in the current system. Both groups "do not know what they do not know." Confirmation bias is rampant.
This webinar points the way to living a more vital, energetic life, with a minimum of cost, grief, and misery.
High-powered webcast to NNLM Feb 21, 2019. Introduces the Superpatient concept, contrasts it with generic "citizen scientists," gives several examples, addresses the cultural obstacles that hold back progress, and asks how medical libraries might encourage and support superpatients in their efforts.
The goal of this webinar was to educate healthcare professionals about the differences between palliative and curative care while exploring the history and philosophy of the hospice movement.
International Health Policy and Practice: Comparing the U.S. and Canada on Ef...The Commonwealth Fund
The document compares the healthcare systems of the US and Canada based on data from the Commonwealth Fund's International Health Policy Survey. It finds that Canada outranks the US in several areas of healthcare system effectiveness, including quality of care, effective care, safe care, and coordinated care. Specifically, Canadians are more likely than Americans to report high quality experiences such as having their healthcare providers discuss treatment plans and contact them between visits. The US outperforms Canada in measures of timely access but lags in efficiency, equity, and healthy lives. Overall, the survey ranks Canada's healthcare system as 10th best globally and the US system as 11th.
Similar to Challenge of Delivering Healthcare & EAP: US / Canada Perspective (20)
The line between EAP and staff is often very distinct, for reasons of confidentiality. This presentation provides options for staff, supervisors and management to greater strengthen EAP usage, while maintaining confidentiality.
Overcoming mental health and addictions within community and the workplace is not easy. Learn simple tools that community and workplace leaders can use to combat common mental health and addiction issues.
The Aboriginal Friendship Centre of Calgary in partnership with Alberta Health Services, and the Tsuut'ina Nation, provided an exceptional program to offset the high risk of suicide among at-risk indigenous youth. This program provided new healthy, self-esteem building options, for at-risk youth from Calgary group homes and the community at large.
Patients facing chronic illness re-frame their definition of wellness and manage to cope in spite of adversity. This patient led research project delves into the myriad ways that those suffering from chronic illness chart a new path for themselves.
Peformance Management and EAP Best PracticesCG Hylton Inc.
This webinar will examine how EAP services can help organizations to enhance their performance management programs. The webinar will provide practitioners with a greater understanding of effective performance management and the common barriers that can affect a wide variety of organizations. The webinar will pay special attention to how EAP services can broaden their scope and value by helping organizations to implement and sustain performance management programs that work.
Learning objectives:
1. Understanding effective performance management and identifying potential barriers.
2. Providing services designed specifically to help organizations enhance their performance management programs.
3. Adding value to current EAP services through performance management support.
For additional handouts please email chris at hylton dot ca
This webinar will review documentation best practices for EAP providers. The webinar will pay special attention to EAPA Standards and Guidelines for program records. We will also review protocols for preserving confidentiality and discuss processes for releasing information with and without consent. The webinar will present the challenges of documenting electronic communications in EAP services and provide strategies to overcome these challenges.
Learning objectives:
1. Understanding documentation and records management, including electronic documents.
2. Understanding EAPA Standards and Guidelines for program records.
3. Understanding and communicating protocols for confidentiality and release of information.
For additional handouts please email the author chris at hylton dot ca
Understanding general rules around corporate governance
Understanding the duties of directors
Understanding the impact of strong electoral policies and guidelines for elected officials
Identifying the 12 things that EVERYONE gets wrong about financial planning, Understanding insurance, Demystifying savings and investments, Wading through the banking and lending challenges, Effective tax and estate planning
This document summarizes Chris Hylton's experience in an active living program. Some of the benefits he experienced include improved fitness levels, making new friends in running groups, and building a running shoe collection. However, he also faced skepticism from neighbors and developed a mysterious illness. After ruling out other causes, his doctor diagnosed him with arrow phobia based on his exposure to arrows in the program's fitness tests and materials. Chris eventually concluded that exercise is unnecessary and people can celebrate health indoors without it.
Mindful employer program 2015 easna institute clearwaterCG Hylton Inc.
This document summarizes a presentation about supporting workplace mental health. The presentation discusses the different perspectives of managers and employees, with managers focused on tasks and customers while employees are more concerned with mental health, emotions, and personal goals. It suggests that managers could better support mental health by being more sensitive to employee needs, like a dog's sensitive sense of smell. The presentation promotes becoming a "mindful employer" through developing mindful managers, promoting mental health awareness, and eliminating stigma around seeking help. It provides resources for workshops, training champions within organizations, and supporting employees with mental illness concerns.
The C Suite, EAP and Organizational Mental HealthCG Hylton Inc.
How Managers Make a Difference in Organizational Health
EAP in the C Suite: Influencing Organizational Health.
The productivity of any organization is dependent on a number of factors: leadership, teamwork, engagement, morale, as well as employee well-being. The EAP, while concentrating on employee mental health and wellness, has the opportunity to link directly into adjacent areas. Why is it problematic? Not only do most organizations fear scrutiny, and change, but employees are mindful that the confidential EAP is there for the employees and their dependents, not so much the employer. They know the EAP is not a vehicle for rants or critiques of the organization, and above all else they are keen not to breach EAP confidentiality. So how does one square this circle?
Reaching beyond the traditional bounds of EAP requires imagination, courage, and a desire for change in organizational culture. Working closely with the Executive team or the Human Resource department, which is always committed to better engage staff and management, the EAP can provide certain baseline information to guide the engagement process. Without compromising confidentiality, the keystone of any EAP, the EAP can at intake or follow up, add in generic quality of workplace, engagement, and job satisfaction questions, where aggregated data to ensure confidentiality, would complement other data gathering processes.
In this way the EAP could serve as a thermometer of corporate health and wellness. Problematic areas could be defined in more detail with a larger employee sample, and further engagement processes with staff developed.
Through staff focus groups, interviews or other engagement sessions, the EAP could lead the charge about broadening the EAP from simply being a mental health and wellness program for employees to a broader mandate.
Traditional EAP clinical usage data, when married to organizational mental health data manifested in a myriad of files relating to critical incidents, lost time accidents, disability claims, prescription drug usage, employee satisfaction survey data, and other employer files, can yield a wealth of knowledge about how to improved employee and corporate health and wellness, along with the bottom line.
File management is key to managing the ever increasing forms, letters, documents, agreements, that flow within the organization. Learn how to do this effectively.
This document provides an overview of a conference on conflict resolution presented by Chris Hylton. Some key points discussed include understanding perceptions and root causes of conflict, learning from how animals avoid conflict through senses like smell, exploring Maslow's hierarchy of needs in relation to conflict, and introducing the "win-win" approach to conflict resolution through cooperative problem solving. Communication techniques for active listening and dealing with difficult emotions were also covered. The presentation addressed various types of conflicts such as those between employees and managers, with elected officials, youth, and between different cultures.
Chris Hylton, a benefits and HR consultant, gave a presentation on wellness and benefit planning. He discussed types of benefit plans like fully insured, ASO, and flex plans. Joint purchasing allows for more flexibility and customization of benefits. Benefit trends include rising drug costs, especially for biologics, and a focus on health and wellness programs to address chronic diseases and improve employee productivity. Carrier programs use electronic claims submission and audits to reduce costs. Flexible spending accounts and wellness initiatives were recommended.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms for those who already suffer from conditions like anxiety and depression.
Hidden Pathways Thru Chronic Illness - PROMS Forum Nov 28 2014CG Hylton Inc.
See how a team of patient researchers (PaCERS) helped those with chronic illness find new meaning and strength thru and in spite of their illness. Audio recording of the session is available here https://connectmeeting.ucalgary.ca/p5dw8dib86t/
Occupational health and safety has to be adapted for the aging workplace in order to be effective. By integrating best practices for the aging worker, OH&S may successfully be integrated into an organization's culture and safety is assured, every step of the way.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
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1. Describe the organisation of respiratory center
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3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
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7. Explain the role of peripheral chemoreceptors in regulation of respiration
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3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
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Challenge of Delivering Healthcare & EAP: US / Canada Perspective
1. The Challenge of Delivering
Health Care and EAPs:
US/Canadian Perspective
22 Annual EASNA Institute
Montreal, Canada
May 7, 2010
Max Heirich Ph.D.
Patricia A. Herlihy Ph.D., RN
Chris Hylton MA
Francois Legault MSW RSW
Michael Mulvihill MSW
Ben Murray Research Assistant
1
2. Presentation Goals
The significant problems we face cannot
be solved at the same level of thinking we were at
when we created them.
Albert Einstein
♦ TODAY - Health in modern society has been defined
at the individual level of treatment. As a result, our
focus is on containing costs—almost entirely—for
individuals
♦ TOMORROW - The Culture of Wellness can support
prevention and treatment side by side for the good of
the whole while preventing risks and containing costs.
3. Overview of Presentation
♦ On Line Survey Results
♦ Canadian Health Care Primer
♦ US Health Care Primer
♦ Comparison Stats
♦ Implications for EAP Professionals
♦ Future Steps towards Wellness Culture
4. US vs Canadian Health Care Survey
Sample - N=60 (EASNA = 51%)
US = 71%
Canada =22%
Both 7%
Position
Clinicians = 15%
Vendors = 23%
Internal EAP Dir = 22%
Consultants = 16%
Important On-going Legislation
HIPPA
Mental Health Parity
US Health Care Reform
BC - Consolidation & Cutbacks
Interested Policy Issues
Single Payor System
Impact of US HC Bill on EAP &
Wellness Programs
Bullying Legislation
5. All you need to know
about Canada
We mostly speak English
We use a Dollar (Canadian dollar)
We have Provinces instead of States
We have a Prime Minister instead of a
President
We have a big country with few people
We have Medicare
5
6. Canada Trivia
What is our favorite
syrup? What do Mike Myers,
What is our favorite Leslie Nielson, Michael
sport? J Fox, Celine Dion,
What is our favorite have in common?
saying? What’s a kilometre?
What is on the Cdn What’s Ottawa?
Flag? What is $1 US worth in
What is our national Canada?
animal
6
7. More Trivia…..
Canada spends more of its gross domestic
product (GDP) on education and less on health
care than the United States
Canada has more donut shops per capita than the
United States does
Canada's two official sports are lacrosse and
hockey
Canada's national colors are red and white
Canadians consume more Kraft Dinner (aka Kraft
Macaroni & Cheese) per capita than any other
nationality on earth
7
8. Canada’s Medicare System
Administration of the health care insurance plan
of a province must be carried out on a non-profit
basis by a public authority
Comprehensive: all medically necessary services
provided by hospitals and doctors must be
covered
Universal: all insured persons in the province or
territory must be entitled to public health
insurance coverage on uniform terms and
conditions
8
9. Canadian Medicare
Portable: coverage for insured services must be
maintained when an insured person moves or
travels within Canada or travels outside the
country
Accessible: reasonable access by insured persons
to medically necessary hospital and physician
services must be unimpeded by financial or
other barriers
9
10. Canadian Medicare
Medicare looks after physical and psychiatric
health at no cost, covers cost of all hospital stays
Cdn employers, like US, provide insured
supplementary healthcare for employees
Covers Rx drugs outside of hospital
Mental health counseling up to $350 to $1000 a year
Psychiatric referrals are free thru Medicare
Psych referrals via family physician or
Emergency Dept of hospital
EAP counselor cannot refer
10
11. No Average Patient, No Average Wait…
Care Area 10%— 50% 10%—
Shortest Longest Waits
Waits
Emergency department wait to 10 minutes 51 minutes 165 minutes
physician initial assessment
Hip fracture same day next day 3 days
Non-emergency 1 day 3 weeks 4 months
MRI/CT/angiography
Specialists a few days 1 month 4 months
Non-emergency surgery a few days 1 month 6 months
Hip replacement <1 month 4.5 months 14 months
(specialist to surgery)
Knee replacement 1–2 months 7 months 21 months
(specialist to surgery)
Sources: National Ambulatory Care Reporting System, Statistics Canada, Canadian Joint 11
Replacement Registry and Hospital Morbidity Database, CIHI.
12. Access to Doctor When Sick or Need Medical Attention
Same Day Appointment Wait of 6 Days or More
Source: Primary Care and Health System Performance: Adults’ Experiences in
Five Countries, Commonwealth Fund, 2004. CIHI
12
13. Emergency Room Use and Waits in 2004
Patient Activity Canada US
% %
Went to the emergency department
in the last 2 years 38 34
Went to the emergency department,
but felt they could have been treated
by regular doctor if available 18 16
Reported waiting >2 hours
before being treated 48 34
Source: Primary Care and Health System Performance: Adults’ Experiences in
Five Countries, Commonwealth Fund, 2004. CIHI
13
14. Comparisons of Patients Who Waited More Than Four Weeks
to See a Specialist
75
50
57
25
23
0
United States Canada
Note: Patients are adults with health problems.
Source: 2005 International Health Policy Survey, Commonwealth Fund. CIHI 14
15. Canada/U.S. Comparison of Unmet Needs 2002– 2003
♦ Same % of Canadians (11%) and Americans
(13%) report unmet health care needs
♦ Of those reporting unmet needs, the primary
barrier sited was:
♦ “Waiting for care” for 32% of Canadians
♦ “Cost” for 53% of Americans
Source: Joint Canada-US Health Survey, Statistics Canada/NCHS. CIHI
15
16. Life Expectancy
Male Female All
76.02 83 79.43
Canada
69.6 73.33 71.38
China
74.85 82.89 78.76
France
64.65 70.46 67.48
Phillipines
66.11 69.51 67.77
Saudi Arabia
76.95 82.37 79.58
Sweden
74.24 79.9 77.12
US
Source: U.S. Bureau of the Census, International Data Base (2000 midyear estimates) 16
17. Mental Health Indicators Average Rankings for Suicide
Female Male
Lowest Rate of Suicide
Belgium, France, 7.3 8.3
Germany, US
Middle Rate of Suicide
Australia,
Canada, Japan, 7.0 7.3
Sweden
Highest Rate of Suicide
Finland, Denmark, 6.8 5.8
Nether, Spain, UK
Source: Dr. B. Starfield 2002 , OECD Tapes, 1998
17
18. Canada & Mental Health?
Incidence of Mental Illness is generally similar to
other industrial countries
Mental health is provided like all other health
services but is on average less available (Kirby
report, 2006)
Canada has no current national strategy for mental
health
Mental Health Commission of Canada has a 10 year
mandate to address gaps and develop and drive
implementation of a national strategy (for more
details: www.mentalhealthcommission.ca)
18
19. Health Care Industry vs health care system
♦ Developed piece by piece - Decade by Decade
♦ Designed by Private Innovations (solved problems
for innovators)
♦ Each addition built on old foundation (only
occasional Government interventions)
20. US Health Care Timeline: 1930 - 1990
SS Leg - Unions -
BC negotiate HMO vs Fee National
Hospital Health for Service - Insurance
Insurance Coverage multinational Attempt-
1940s 1960 companies 1980 failed
1930 Insurance 1950 Civil Rights 1970 Reagonomics: 1990
for War Deregulation
Voting Act & For Profit
Plant
Factories Medicare/ Services
Medicaid
21. 2000 - 2008: US Health Care Disintegrates
Health Care major economic growth area
Consolidation leads to rapid cost increases
Higher Health Insurance Premiums
Increased Monies going to Administrative Services
Insurance begins to refuse coverage for pre-existing
conditions
Coverage dropped if medical bills too high
Efforts to control Health Care Costs increases
Major Tax cuts for wealthy
22. US Mounting Health Care Crisis
* 48 million Americans - no
insurance
* Costs for Medicare and
Medicaid Skyrocket
* Global economic downturn
23. Reforming US Health Care
♦ Creating a New Social Contract - Historical
(Social Security: 1936 & Medicare/Medicaid: 1966)
♦ Addressing Four Key Problems:
¨Increasing Access to care
¨Controlling Health care costs
¨Maintaining economic vitality of Health Care Industry
¨Dealing with Federal Deficit
♦ Solution had to be a Political One
Seeking a Win-Win for Government, health care industry,
employers and citizens
24. US -Why Not Medicare for All?
♦ Would require major tax increases…
♦ No political will for any further tax increases
♦ Health Care Industry is too Strong…
♦ Health Care industry major donors to Congress
♦ Lobbyists for all aspects of Health Care have great
influence in Congress
25. US Reforms - Improving Access
♦ No one can be denied coverage
♦ All insurance must offer Mental Health Parity
♦ Expanding Medicaid access:
♦ Free Care for all persons below 133% poverty
♦ Physician Incentives to treat Medicaid enrollees
♦ Partial premiums subsidies (via tax credits)
♦ Young adults can remain on parents insurance
policies
26. US Reforms - Improving Access
♦ Making Health Care available in underserved areas:
- Funding more School & Community Clinics
- Recruiting a National Health Service Corps -
via Medical student scholarships and loan repayment credits
to provide primary care and other services where most
needed
♦ Offering Federal long-term care insurance for at-home
Elderly Care
27. US - Controlling Costs
♦ 80% - 85% of Private Insurance Company premiums
must be spent on actual health care services
♦ Co-Op Exchanges help people buy insurance:
♦ Monitor & Insure Quality
♦ Some States will include public insurance plans
♦ Feds move to Value Based Purchasing
vs Fee for Service
28. US - Controlling Costs (cont)
♦ Prevention Services for Medicaid & Medicare
♦ Chronis Disease Management for Medicaid & Medicare
♦ Help Evaluating Business Wellness Programs
♦ Demonstration Projects to try out cost effective reforms
(ie. Does Malpractice Insurance Reform decrease
use of unnecessary or “defensive medicine”?)
29. Maintaining US Health Care Industry Vitality
♦Adds 32 million additional paying health care services
consumers (trading increased volume for reduced price)
♦ Federal subsidies to lower income population
♦ Demonstration Projects
¨Develop Cost Effective Best Practices
♦ Changes to Medicare and Medicaid Programs
- Test Cost-Effectiveness of alternative Remuneration Strategies
for Health Services
30. Cost….
Additional Federal Costs: 935 billion over 10 years
♦ How will funds be found ?
♦ Higher Medicare monthly taxes for the wealthy
♦ Programs to monitor & eliminate fraud and abuse in
Medicare and Medicaid Billing Services
♦ Annual Fees assessed on the Health Care Industry
♦ Taxing Private Health Insurance companies on excess costs
of “Cadillac plan” policies
31. Effects on Federal Deficit
The 2010 Health Care
Reform Bill will
provide health insurance
to 32 million more
Americans WHILE also
reducing the federal
2020 - $138 Billion
Deficit
Reduction
2030 - additional $1.2
Trillion Reduction
32. US- Limitations of New Health Care Bill
♦ Cost Control - Needs reimbursement authority to
incentivize use of Demonstrated Best Practices
♦ Needs Stronger Competition to force lower Private
Insurance Prices
♦ Still Need More Access
♦Bill includes 32 million Americans
♦Another 16 million will remain outside of system
♦ Need a larger cultural change toward a “Wellness
Culture”
33. Current health expenditure per capita by category
of care, 2007
In-patient Out-patient (incl. same day) Long-term care/homecare
Pharmaceuticals Prevention Administration
Investment
$516
$200
$200
$959
$793
$631
$562
$3,188
$1,325
$1,413 $604
US Canada
Source: OECD Health Data 2009 and McKinsey Global Institute.
34. Average Annual Real Growth in Health Spending
2003-2006 by Category of Care
In-patient Out-patient (incl. same day) Long-term care/homecare
Pharmaceuticals Administration/Public Health Administration
Other
100%
5% 6%
8% 2%
7%
2%
80% 13%
22%
8%
60%
16%
40% 45%
37%
20%
19%
10%
0%
United States Canada
Source: OECD Health Data 2009 and McKinsey Global Institute.
35. Health Expenditure: per capita US$ 2007
Public expenditure on health Private expenditure on health
8000
7000
6000
5000 3983
4000
3000 1169
2000 3307 2726
1000
0
United States Canada
36. Mental Health Resources
Canada vs US (per 100,000 population)
13.7
Psychiatrists 12.0
31.1
Psychologists 35.0
US
Psychiatric 6.5 Canada
Nurses 44.0
35.3
Social Workers 100.3
0 50 100 150 200
37. Health Care Capacity and Utilization, 2007
Diagnostic procedures Surgical procedures
MRI units MRI exams CT CT exams Revascularisatio Knee Caesarean
per million per 1 000 scanners per 1 000 n (CABG+PTCA) replacement section
population population per million population per 100 000 per 100 000 per 100
population population population births
Canada 6.7 31.2 12.7 103.5 208.6 139.5 26.3
US 25.9 91.2 34.3 227.8 521.3 183.1 31.1
OECD 11.0 41.3 22.8 110.7 266.7 117.9 25.7
Average
Source: OECD Health Data 2009
38. Strategic Decision to Adopt the“Wellness Mission”
Become part of the Business Strategy
Holistic view of mental and physical health
Paradigm Shift to Prevention of Mental Stress
Lay the foundation for “wellness culture”
Secure genuine top leadership support
38
39. Practical Implications
Understand global differences
Screen health risks & refer to wellness
Screen depression/stress & refer to EAP
Improve joint utilization and engagement
Integrated data to produce outcomes
Training programs for “effective referrals”
39
40. Innovative Implications
Prevention of depression & happiness science
Workplace stress programs – “wellness approach”
New Technologies: Online, Digital, MM
Health Coaching & Telehealth
Growing practice of Positive Psychology
Sustainability of programs & behavior change
40
42. Resources - Helpful Websites
Health and Wellness
America’s Health Insurance Plans - www.ahiphiwire.org/wellbeing
Centers for Disease Control - www.cdc.gov/nchs/fastats/hinsure.htm
Canadian Institutes for Health Information - www.cihi.ca
Gallup-Healthways Well-Being Index™ - www.well-beingindex.com
Health Canada – Healthy Living - www.hc-sc.gc.ca/hl-vs/index-eng.php
Health Promotion Advocates http://healthpromotionadvocates.org/sources_detail_documents.htm
IHPM - Institute for Health and Productivity Management - www.ihpm.org/
Mental Health Commission of Canada - www.mentalhealthcommission.ca
National Wellness Institute - www.nationalwellness.org
WorldatWork: global human resources association focused on compensation, benefits, work-life and
integrated total rewards - www.worldatwork.org
43. Resources - Topic Based
Behavioral Health
OPEN MINDS - www.openminds.com
On-Line Therapy
Online Therapy Institute - www.onlinetherapyinstitute.com
Therapy Online - www.therapyonline.ca
International Organizations
Organisation for Economic Cooperation and Development Health - ww.oecd.org
World Health Organization - www.who.int
Wellness Culture
Judd Allen - www.healthyculture.com
Joel Bennett - Wellness Organization - www.intellpre.com
Martin Shain - http//healintheworkplace.wordpress.com
Michael O’Donell - http://healthpromotionadvocates.org
44. Resources - Publications
Heirich, Max. (1998). Rethinking Health Care: Innovation & Change In
America
Disparities in health expenditure across OECD countries: Why does the United
States spend so much more than other countries?
www.oecdwash.org/PDFILES/Pearson_Testimony_30Sept2009.pdf
Health Data 2009, Organisation for Economic Cooperation and Development
www.oecd.org/document/16/0,3343,en_2649_34631_2085200_1_1_1_1,00.html
Mental Health Atlas 2005, World Health Organization
www.who.int/mental_health/evidence/en/
The World Factbook www.cia.gov/library/publications/the-world-
factbook/fields/2102.html
Organisation for Economic Cooperation and Development Health
www.oecd.org
Statistics Canada Health Reports – Waiting time for medical specialist
consultations in Canada, 2007 www.statcan.gc.ca/pub/82-003-x/82-003-
x2010002-eng.htm
45. Presenters - Contact Information
Max Heirich - mheirich@umich.edu
Patricia Herlihy - p_herlihy@brownbear.us
Chris Hylton - chris@hylton.ca
Francois Legault - Francois.Legault@hc-sc.gc.ca
Michael Mulvihill -michael.d.mulvihill@gmail.com
Benjamin Murray - ben.murray@hc-sc.gc.ca
Editor's Notes
Emergency department wait to physician initial assessment – 10 minutes; Source: National ambulatory Care Reporting System; page 16 of Waiting for Health care in Canada. Self reported wait for specialist care – Health Services Access Survey, first 6 months of 2005, page 18 paragraph 1 of report. Self reported wait for non-emergency MRI / CT / Angiography - Health Services Access Survey, first 6 months of 2005, page 21, paragraph 3 of report. Self reported wait for non-emergency surgery - Health Services Access Survey, 2002, 2003, first 6 months of 2005, page 29, graph 16. Hip replacement – Canadian Joint Replacement Registry 2005, page 40 paragraph 1 of the report. Knee replacement - Canadian Joint Replacement Registry 2005, page 40 paragraph 1 of the report. Hip fracture - Hospital Morbidity Database, page 40, graph 22 of report.
Respondents in Canada and the U.S. were significantly less likely than those in other countries to report same-day access and more likely to wait six days or longer for an appointment. This variation was even more pronounced in a 2005 Commonwealth Fund survey of adults with health problems. Page 15 of report.