Canada's Crumbling Medicare System

[styky]

Cancer screening info lost: Privacy commish

By Jonathan Jenkins ,Queen's Park Bureau

First posted: Tuesday, July 26, 2011
Nearly 6,500 colon cancer screening tests have gone missing and Privacy Commissioner Ann Cavoukian says another large batch of personal health information may also have been lost by Cancer Care Ontario.

“Medical test results rank among the most sensitive personal information about an individual,” Cavoukian said in a statement. “I am astounded that such a loss could take place."

Cavoukian said her office was told June 27 by CCO that the screening tests, sent out to doctors' offices across the province in February and March, were missing.

The search for them, including visits to physician clinics, has been going on ever since.

Patients whose information cannot be located will be notified by CCO, Cavoukian said, adding anyone who wished to make a complaint about the loss of privacy can do so by calling 416-326-3900 or 1-855-545-8989. Email complaints can be made to complaint@ipc.on.ca.

The loss involves the personal info of 6,490 Ontarians in the ColonCancerCheck program, whose results were in 15 screening activity reports delivery of which cannot be confirmed.

Another 11 reports with details on 5,440 other Ontarians is potentially missing.

The records include the name of each patient, date of birth, age, gender, health card number and colorectal cancer screening test information including test dates and results.

All the patients are between the ages of 50 and 74 and enrolled in ColonCancerCheck, Canada's first province-wide, population-based colorectal cancer screening program, CCO said in a release.

"At CCO, we take this matter very seriously and have conducted a thorough investigation to find out how many Screening Activity Reports cannot be confirmed as delivered," Dr. Linda Rabeneck, vice president of Prevention and Cancer Control for Cancer Care Ontario, said.

"Due to the personal health information contained in the Reports, we are informing the relevant primary care physicians and patients, and the public."

The records were sent to doctors through Canada Post's Xpresspost service, in which couriers are supposed to get a signature to confirm every delivery.

That was not done in all cases, Cancer Care said, and the agency is now calling and visiting the doctors for whom delivery of the reports can't be confirmed.
http://www.torontosun.com/2011/07/26/ca ... cy-commish

[Charles J. White]

The people are wrong, they have always been wrong, but that is the system we live in, people are allowed to be wrong, and because of that I and other individuals have to be punished for it through our earnings, and limiting our choices through coercion. Canadians love the idea of “free” healthcare. I guess democracy is great except for when someone less intelligent gets to counter-act my vote. Long Live Universal Canadian Healthcare!!

[RedDog]

Long Live Universal Canadian Healthcare!!

Except it's not really universal is it? Additional funds are extorted from others to pay for yours in your region. Why don't you pony up for theirs for a while if universal equality is the aim? It's like a Quebecer bragging about the fabulous child care programs available to them. There's nothing "universal" about it.

[Charles J. White]

Long Live Universal Canadian Healthcare!!

Except it's not really universal is it? Additional funds are extorted from others to pay for yours in your region. Why don't you pony up for theirs for a while if universal equality is the aim? It's like a Quebecer bragging about the fabulous child care programs available to them. There's nothing "universal" about it.

It was a joke, it wasn’t meant to be taken seriously, and does anyone have any sense of humor anymore?

[styky]

'Concierge medicine' a controversial trend in Canada
‎
CTV.ca -
While these clinics gets patients out of crowded emergency rooms and away from over-burdened family doctors, they may also run afoul of the Canada Health ...http://ottawa.ctv.ca/servlet/an/local/C ... OttawaHome

[styky]

Seniors and women less likely to be transported to trauma centres
Survival rates higher than in hospitals

TORONTO If you’re an older woman seriously injured in an accident, chances are you’ll be taken by ambulance to the nearest hospital rather than a trauma centre where survival rates are much higher, says the trauma director at St. Michael’s Hospital.

“We know that there are disparities based on age and we know that there are disparities based on gender. So if you are an older female, you are not going to have similar access to care as a younger male,” says Dr. Avery Nathens, who also serves as director of the American College of Surgeons’ Trauma Quality Improvement Program.

In Ontario, severely injured elderly patients are about 30 per cent less likely to get trauma centre care. Females, in general, are about 10 per cent less likely to receive trauma centre care. These differences in access to care persist even after taking into consideration differences in types of injury one might see in old versus young and male versus female, he said.

Nathens is doing further research and hopes to have data published soon. But he said he has seen it firsthand and had his observations confirmed by assessing Ontario hospital data collected by the Canadian Institute for Health Information.

“We don’t know why that is but we do know that a trauma centre reduces the risk of death considerably after injury,” Nathens says. The trauma surgeon has a big interest in access to care and has created special program at Toronto’s St. Mike’s to improve trauma care for the elderly.

Of more than 150 hospitals in Ontario, 11 have trauma centres, including St. Mike’s and Hamilton General Hospital. The centres operate 24 hours with highly specialized staff and sophisticated diagnostic equipment. Some have helipads.

Previous research by Nathens found that going directly to a trauma centre, even if it means bypassing a closer hospital, results in a nearly 25 per cent lower death rate, as well as savings and improved quality of life for survivors.

When someone is severely injured, in a car accident or shooting for example, paramedics assess a patient and use field triage criteria in deciding whether to transport a patient to the nearest hospital or one with a trauma unit that could be further away. They look at vital signs, level of consciousness, broken bones, skin penetration and signs of spinal injury.

Curiously, age is also among the criteria.

“Age should be a modifying factor, which means that you may have a lesser injury but if you are older you should err on the side of going to a trauma centre,” Nathens says. “For some reason, we haven’t gotten there yet.”

If a trauma centre is too far away, a patient will be taken to a local hospital where an emergency physician can decide to have the patient airlifted to one if the injury is serious enough.

“The biases occur at both the level of the paramedic making decisions and also the doc who decides whether the patient will be transferred to a trauma centre,” Nathens says.

A 2008 study in the Archives of Surgery also found elderly patients are less likely to end up in trauma centres. Possible reasons included inadequate training, unfamiliarity with protocol and unconscious age bias.

Nathens is concerned about inadequate access to trauma centres and has found 62 per cent of seriously injured adults in Ontario are taken to their nearest hospital first and 69 per cent are never transferred to a trauma centre. Those who live farthest away from the centres get short shrift.

On Friday, he released results of a poll showing more than eight in 10 Ontarians would want to be taken directly to a trauma centre if they were seriously injured, even if another hospital were closer.

Nathens says access to trauma centres should be given more attention.

“It does seem odd that we monitor access times for elective surgery, but there is no means of monitoring access to trauma centre care where lives are at stake.”

http://www.thespec.com/news/world/artic ... ma-centres

[styky]

C. difficile patient blasts St. Catharines Hospital hygiene
Claims room was filthy
CBC News
Posted: Aug 2, 2011
A St. Catharines woman recently discharged from hospital after contracting C. difficile has complained about "disgusting" conditions in her room at St. Catharines General Hospital, alleging her quarters were not cleaned for weeks at a time.

Adorelle Harrison-Royer, a cancer patient, contracted the C. difficile superbug during her stay. She says the room she stayed in was filthy, and claims that streaks of dried human excrement had crusted to the bottom of a commode next to her bed.

"It was hell. I felt so lonely," Royer said.

"The most disgusting of all this was that you had your toilet right there, your bed right here, and they would bring you your food," she said, her voice breaking with emotion. "Try and eat it now!"

Royer's sister snapped the photos of what she claimed to be dried feces left on a commode that was not cleaned for two weeks. She said that after getting no help from hospital staff, she decided to clean the room for herself....................http://www.cbc.ca/news/canada/toronto/s ... s-342.html

[styky]

For the time being, St. Catharines General has hired more housekeeping staff, and Matthews said the extra workers could be kept on full-time

Let me guess.....these new housekeeping staff will be trained by the ones that are already there?

[styky]

Ya right

Canadian health system more efficient than the one in the U.S.: study
Postmedia News Aug 4, 2011 – 6:31 PM ET

By Bradley Bouzane



The Canadian health-care system may be plagued by countless stories of lengthy wait times and crowded emergency rooms, but a new study shows the amount of time and money spent on administrative duties is a fraction of that required by the U.S. system.

The study from the University of Toronto and New York’s Cornell University says U.S. doctors pay an average of nearly $83,000 each for administrative costs associated with insurance documents. In Canada, for doctors based in Ontario that cost is significantly less at just over $22,200.

In addition, nurses, medical assistants and other hospital staff dedicate nearly 21 hours per week to filing insurance papers and other duties required to push insurance claims through. For the same duties in Ontario, just 2.5 hours are spent each week.

The findings of the study, published in the August edition of the journal Health Affairs, show that the “single payer” health-insurance system in Canada is largely responsible for the difference between countries.

It said the need for many U.S. patients to carry coverage from multiple insurance providers leads to the more demanding time commitments to file the appropriate documents................http://news.nationalpost.com/2011/08/04 ... u-s-study/

[styky]

Canada's health system failing elderly and others with long-term illnesses, says report
By Sharon Kirkey, Postmedia News August 10, 2011 11:26 AM

Read more: http://www.canada.com/health/Canada+hea ... z1UeGl0bFz

<snippet>
Canadians spoke about the need for more timely access to care, the high cost of prescription drugs, hospital inefficiencies and inappropriate use of emergency departments.

No one spoke about the need for more money, said CMA president and Ottawa Hospital chief of staff Dr. Jeff Turnbull.

"Normally people just automatically say: 'Just give us more money.' That didn't happen," he said. "They said we need value for money, we need management, we need better delivery systems so that we're accountable for health care."

Turnbull said he was struck by just how strong and consistent support was for a publicly funded health system. "They recognized it was failing them, but universally everyone we spoke to said this health care system is important to us, we believe in it and we think that it can be fixed," Turnbull told Postmedia News. "The huge support for a strong publicly funded health care system was very reassuring."

Still, across the country, people spoke about "inordinate" waits in emergency departments, cancelled surgeries and not being able to access a primary care doctor. "We heard about people surprised they had to pay for long-term care, or who couldn't get into long-term or home-based care," Turnbull said.


Link to the report.............http://www.cma.ca/advocacy/cma-media-centre

[styky]

Matt Gurney: The public is ready for health-care reform, why aren’t politicians?

Matt Gurney Aug 10, 2011 – 9:28 PM ET

The recent series of public consultations organized by the Canadian Medical Association (CMA) was a worthy exercise. Important issues were raised, stakeholders consulted and the public’s temperature taken … no medical pun intended. But let’s face it — Canadians have been jaw-jawing about health care continuously since health care consisted of a shot of penicillin and a recommendation to take up smoking as a way of combating anxiety.

So one can’t expect miracles in reports such as these. For all the talk of the need for innovation and original ideas, it’s hard to find either when discussing what is without a doubt the most thoroughly tilled soil in Canadian public policy..............http://fullcomment.nationalpost.com/201 ... liticians/

[styky]

Scott Stinson: Years of health-care warnings have had no effect on status quo

Scott Stinson Aug 11, 2011 – 9:22 PM ET

It might be simpler for all the various organizations and entities that have asked Canada’s governments to consider substantive reform to the country’s health-care system if they could just agree on a standard set of warnings and pleadings and then reissue the report periodically.

“[Insert Name of Group Here] Calls on Canada to Transform Health Care to Meet Challenges Ahead,” or something. Aging population this, demographic time bomb that, concerns about escalating costs yadda yadda and then sign your name and you’re done.

Sure, the government might notice eventually that the reports are all cribbed from one another, but so what? Everyone from the Auditor-General to the OECD to the Conference Board of Canada has been issuing these warnings about health-care spending for more than a decade now, and Ottawa and the provinces have utterly ignored them. At least the standardized form would save some time.

This week, it was the Canadian Medical Association’s turn to take another run this week at spearheading change, with a report that declares right off the top that “this once proud system is in distress.” Through a series of town halls and online exchanges, the CMA found that Canadians “reflected frustration with a system that doesn’t work as well as it should.”.................http://fullcomment.nationalpost.com/201 ... tatus-quo/

[styky]

They needed to fund a study to figure this out




After-hours clinics reduce emergency room use: study
CTV News.ca Staff

Date: Friday Aug. 12, 2011 12:18 PM ET

After-hours medical clinics can help reduce the demand on overcrowded hospital emergency wards, a new University of Alberta study finds.

Previous studies on how such clinics affect the number of patients who head to ERs have been inconclusive. But that may be because the clinics that were studied were too small to offset much of the demand on nearby hospital emergency rooms.

This study looked at the relatively small town of Leduc, Alta., a town of 20,000 near Edmonton with a single hospital.

Doctors at the Leduc Hospital had noted they were increasingly seeing patients in their ER who could have been better served in a doctor's office.

So with the town planning to open a new after-hours clinic that would be open in the evening from 6 p.m. to 10 p.m. four days a week, David Jones, a graduate student at the University of Alberta's School of Public Health, decided to see how the clinic would affect the hospital.

For 14 months prior to the opening of an after-hours clinic, he and a small team counted how many semi-urgent and non-urgent cases went to the emergency room and then how many went for the 14 months after the clinic opened.

Semi-urgent cases include such minor traumas as burns, or abdominal pain, while non-urgent patients have such things as nasal congestion or chronic low back pain.

Such cases can usually be treated in a doctor's office and have long been known to contribute to emergency department overcrowding.

The researchers found there was a 40 per cent reduction in such patients using the emergency department after the clinic opened.

The after-hours clinic saw an average of 261 patient visits per month after it opened. At the same time, there were 49 fewer semi-urgent patient visits per month to the Leduc ER during the clinic's operating hours. And overall, there were about 37 fewer total patient visits to the ER per month.

"This study provides further evidence that offering these services can positively impact emergency department use, and while we have to be careful about population size and intervention, we did see a definite reduction in emergency room visits," Jones said in a news release.

Jones's study is published in the Journal of Primary Care and Community Health.
http://www.ctv.ca/CTVNews/Health/201108 ... al-110812/

[styky]

Canadians in pain: Controls on drugs too tight, editorial says
‎
Montreal Gazette - Sharon Kirkey -
But pain is under treated in Canada, the journal says. ... Canada is one of the highest consumers in the world of opioid medications. ...http://www.montrealgazette.com/health/C ... story.html

[styky]

Blackwell on Health: Low grades for health system
Tom Blackwell Aug 16, 2011 – 7:00 AM ET | Last Updated: Aug 16, 2011 7:41 AM ET

A new survey on attitudes about the health-care system reveals some interesting responses, confirming that Canadians have widespread misgivings about the system, even while not fully understanding how it works. They also favour using tax incentives to encourage healthier living and eating.

The survey of 2,300 Canadians carried out in April by the consulting firm Deloitte was part of a larger poll covering 12 countries. It is considered accurate to within two percentage points, 95% of the time.

Some of the highlights include:

- Just 5% of respondents gave the system an A grade; 45% giving it a B, 36% a C, 10% a D, and 4% a failing F.

- 33% of Canadians said they understood how the system works, down from 39% in 2009 when Deloitte did a similar survey.

- 69% feel that the system has not improved in the last two years, while there were slightly more who thought it had deteriorated, as opposed to improved, in that period.

- 36% believe that half the money spent on health care is wasted; interestingly, half of those skeptics blame the waste on people failing to take responsibility for their own health.

- 13% reported that they are caring for another person, up from 10% in 2009, a possible sign of the increasing personal burden posed by the aging population. In a third of those cases, the individual is caring for a spouse.

- 55% rated their health as excellent or very good … even though 52% report having been diagnosed with one or more chronic diseases.

- 63% favour some kind of tax-based incentive to encourage more healthy diets and lifestyles.

- About 80% favour expanding medical-school enrollments to increase the supply of doctors.
http://news.nationalpost.com/2011/08/16 ... th-system/