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EVALUATION OF THE SUCCESS OF A PLAN REQUIRES COLLECTION OF STATISTICS AND INDICATORS FOR MONITORING PURPOSES. IN THE HEALTH CARE FIELD, OUTCOMES ARE DIFFICULT TO MEASURE. RELIANCE ON HEALTH PLANNING MAY PARADOXICALLY MAKE HEALTH CARE SERVICES LESS EFFICIENT IF A CONCENTRATION ON SHORT-TERM OUTCOMES LEADS TO ABANDONMENT OF PROGRAMS WITH LONG RANGE IMPACT BUT DIFFICULT TO MEASURE IN SHORT TERM.

"Health policy is inherently interdisciplinary. While working with colleagues and students, Raisa B. Deber, has conducted research on a variety of issues that have a direct influence on Canadian health policy. Treating Health Care is intended for both the informed and non-expert reader wishing to understand the Canadian health care system. Building on key issues surrounding heath care, Deber fills the gap in the existing literature by providing accurate information regarding relevant topics, key concepts, and international comparisons. An experienced teacher of health policy and expert with the Health Evidence Network of Canada, Deber favours analysis over advocacy to unpack Canada's health care system. Instead of stressing politics, and the history of the health care system in Canada, Deber provides a comprehensive overview that is useful in not only understanding the state of the current system, but inunderstanding and evaluating future reforms."--

ABSTRACTEvaluation of the success of a plan requires the collection of statistics and indicators for monitoring purposes. In the health care field, outcomes are notoriously difficult to measure.To the extent that a successful program of prevention should result in providing less of a service, a conflict exists between planning and prevention: in the absence of outcome measures, success will be indistinguishable from failure, as in both cases, planned targets would not be met. To avoid this dilemma, an indicator‐oriented planning system would be predicted to operationalize prevention in countable terms requiring increased inputs, or increased numbers of processes, regardless of the payoffs in health benefits. Screening, check‐ups, and one‐on‐one contacts with health professionals would be emphasized at the expense of group‐oriented activities or societal changes. Planning can thus have counter‐productive policy implications.This theory is illustrated by reference to the current health care system in the U.S.S.R., including their anti‐smoking and anti‐alcoholism programmes.

Conflicts between the planning & prevention phases of health services policy are examined, focusing on the limits of indicator approaches & on models for preventive public health in the USSR. An overview of the centrally planned health system in the USSR is presented, noting the dominance of goal projection in antialcoholism & antismoking programs (coupled with production demands in the alcohol & tobacco industries); overplanning is seen as inhibiting creative & adaptive responses in care provision, with screening, check-ups & one-on-one contacts taking priority over group activities or societal changes. General limits of such rationality in dealing with actual morbidity are examined. Modified HA.

This second edition features all new cases, as well as adding an introductory chapter that provides a framework and tools for health policy analysis in Canada.

Although the use of performance indicators for the analytical (and highly measurable) phase of the medical laboratory process has had a long and successful history, it is now recognized that the value of a laboratory test is embedded in a system of care. This case study, using both documents and interview data, examines the approaches to accountability in the Ontario Medical Laboratory Sector, noting both the challenges and benefits. This sector relies heavily on the regulation instrument, including a requirement that all medical laboratories licensed by the provincial government must follow the guidelines set out by the Quality Management Program – Laboratory Services. We found the greatest challenges exist in the pre-analytical phase (where a large portion of total laboratory errors occur), particularly the interface between the laboratory and other providers.

Long-term care (LTC) residential homes provide a supportive environment for residents requiring nursing care and assistance with daily living activities. The LTC sector is highly regulated. We examine the approaches taken to ensure the delivery of quality and safe care in 10 LTC homes owned and operated by the City of Toronto, Ontario, focusing on mandatory accountability agreements with the Local Health Integration Networks (LHINs). Results are based on document review and seven interviews with LTC managers responsible for the management and operation of the 10 LTC homes. One issue identified was the challenges associated with implementing new legislative and regulatory requirements to multiple bodies with differing requirements, particularly when boundaries do not coincide (e.g., the City of Toronto's Long-Term Care Homes and Services Division must establish 10 different accountability agreements with the five LHINs that span into the City of Toronto's geographic area).