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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.

Canada has been among the world leaders in recognizing the multiple factors that impact health. Focusing on Canada's health care system, Raisa B. Deber provides brief descriptions of some key facts and concepts necessary to understand health care policy in Canada and place it in an international context. An accessible guide, Treating Health Care unpacks key concepts to provide informed discussions that help us understand and diagnose Canada's health care system and to clarify which proposed changes are likely to improve it - and which are not. This book provides background information to clarify such concepts as: determinants of health; how health systems are organized and financed (including international comparisons); health economics; health ethics; and roles and responsibilities of different stakeholders, including government, providers, and patients. It then addresses some key issues, including equity, efficiency, access and wait times, quality improvement and patient safety, and coverage and payment models. Using analysis rather than advocacy, Deber provides a toolkit to help understand health care and health policy

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.

Ontario has an immediate need for 70,000 long-term-care (LTC) beds—38,000 to address current waitlists and a further 32,000 in need of replacement, which together will cost more than $20 billion. This study examines funding sources and requirements and ownership structures in the LTC homes sector in Ontario. Semi-structured interviews were used to understand the ability, challenges, and willingness of LTC home owners to undertake the needed construction. Respondents identified poor access to capital funding, inadequate returns on private capital, differences in funding by ownership model, differing costs by region, and regulatory obstacles. Policy options are identified to overcome constraints and spur construction and redevelopment of LTC homes.

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).