This study identifies challenges to and opportunities for improving vaccination rates among HCWs. A message that emphasizes the health benefits of vaccination to staff members, such as including vaccination as part of a staff "wellness" program, may improve the credibility of influenza immunization programs and coverage rates.

Canadians value ease of access to their health services. Although many studies have focused on accessibility to health services in Canada, few have examined rural-urban differences in this aspect, particularly from a national perspective. Yet disparities in access to health services exist between rural and urban populations, as do the challenges of delivering health care to more remote areas or to those with small populations. “Canada’s Rural Communities: Understanding Rural Health and Its Determinants” is a three-year research project co-funded by the Canadian Population Health Initiative (CPHI) of the Canadian Institute for Health Information (CIHI) and the Public Health Agency of Canada (PHAC). It involves investigators from the Public Health Agency of Canada, the Centre for Rural and Northern Health Research (CRaNHR) at Laurentian University, and other researchers. The first publication of the research project was How Healthy Are Rural Canadians? An Assessment of Their Health Status and Health Determinants;Footnote 1a1a this, the second publication, is a descriptive analysis of the utilization patterns of a broad range of health services by rural residents compared to their urban counterparts.

While immigrant subgroups may present vulnerabilities in terms of health status, health service use, and social determinants, comprehensive information on their health is lacking. To examine mortality (1980-1998) and health service utilization (1985-2002) patterns in Canadian immigrants, a record linkage pan-Canadian research initiative using immigration and health databases has been undertaken. Preliminary results indicate that overall mortality is low among Canadian immigrants as compared to the general population for most leading causes (thus supporting the notion of "healthy immigrant effect"), with causespecific exceptions. Moreover, results from British Columbia show that overall physician visits are low for immigrants, but not for all subgroups. Results from Ontario demonstrate a sharp increase in physician claims approximately three months following landing. Future analyses will address the short-and long-term health outcomes of immigrant subgroups, including less common diseases. Results are pertinent to practitioners working with immigrants and can inform immigrant health policy. La traduction du résumé se trouve à la fin de l'article.

SUMMARY BackgroundHelicobacter pylori infection is a major cause of peptic ulcer disease, but the prevalence of this infection has been decreasing steadily. Additionally, eradication of H. pylori decreases ulcer recurrence and prevents ulcer complications such as bleeding.

Purpose Patients want personalized information before surgery; most do not receive personalized risk estimates.Inadequate information contributes to poor experience and medicolegal complaints. We hypothesized that exposure to the Personalized Risk Evaluation and Decision Making in Preoperative Clinical Assessment (PREDICT) app, a personalized risk communication tool, would improve Electronic supplementary material The online version of this article (

Background: Little is known about inter-facility patient transfers in populations. In 2003, detailed information about inter-facility patient transfers began to be systematically collected in Ontario. Methodology: The authors undertook a descriptive examination of inter-facility patient transfers using a newly created population-based information system. Results: Approximately 1,000 inter-facility patient transfers occur in Ontario each day, and every day and a half, the total distance travelled for these transfers equals the distance around the earth' s circumference. The annual cost for patient transfers is approximately $283 million. Most common were routine and non-urgent inter-facility patient transfers. Eighty-five thousand patients (24.3% of transferred patients) were transported between healthcare facilities for dialysis appointments, appointments with physicians and return trips home. Patients with circulatory conditions were the most commonly transferred diagnostic group. Although 70% of all transfers were within 25 kilometres, some were for longer distances: for example, those involving pregnant women and newborn babies required travelling a median distance of 40.3 kilometres for continued care. Cardiac patients (54,000 patient transfers per year) travelled a median of 24.2 kilometres to reach a catheterization lab for treatment and further investigation. There was considerable lateral movement between academic health sciences centres (AHSCs). Over 16,000 patients per year (4.7% of all transfers) were transferred from one AHSC to another, predominantly for cardiac care. Discussion: Patients in Ontario are often transferred between healthcare facilities. Most transfers are for routine, non-life-threatening reasons, using the Emergency Medical Services (EMS) system. This practice diverts resources from more emergent requests. Although patient transportation is a necessary part of any healthcare system, the results of this study highlight the current demands on a system that was not intended for the volume of inter-facility patient transfers it is supporting. These results call into question the use of sophisticated, highly trained, expensive patient transfer resources to provide routine medical services in Ontario.

Governments in ontario have promised family physicians (fps) that participation in primary care reform would be financially as well as professionally rewarding. We compared work satisfaction, incomes and work patterns of fps practising in different models to determine whether the predicted benefits to physicians really materialized. study participants included 332 fps in ontario practising in five models of care. The study combined self-reported survey data with administrative data healThcare policy Vol.5 No.2, 2009 [e163]Financial and Work Satisfaction: Impacts of Participation in Primary Care Reform on Physicians in Ontario from ices and income data from the canada revenue agency. fps working in non-fee-for-service (ffs) models had higher levels of work satisfaction than those in ffs models. incomes were similar across groups prior to the advent of primary care reform. incomes of family health network fps rose by about 30%, while family health group fps saw increases of about 10% and those in ffs experienced minimal changes or decreases. self-reported change in income was not reliable, with only 47% of physicians correctly identifying whether their income remained stable, increased or decreased. The availability of a variety of ffs-and non-ffs-based payment options, each designed to accommodate physicians with different types or styles of practice, may be a useful tool for governments as they grapple with issues of physician recruitment and retention. RésuméEn Ontario, les gouvernements ont promis aux médecins de famille que leur participation à la réforme des soins de santé primaires comporterait des avantages à la fois financiers et professionnels. Nous avons comparé la satisfaction au travail, le revenu et les régimes de travail de médecins de famille oeuvrant dans divers modèles de pratique, afin de déterminer si les avantages prévus se sont effectivement matérialisés. Cette étude comptait sur la participation de 332 médecins de famille en Ontario oeuvrant selon cinq modèles de prestation de soins. Nous avons tenu compte de données de sondage déclarées volontairement par les médecins ainsi que de données administratives provenant de l'Institut de recherche en services de santé (IRSS) et de l' Agence du revenu du Canada. Les médecins de famille qui travaillent selon des modèles autres que la rémunération à l' acte (RAA) ont indiqué de meilleurs taux de satisfaction au travail que ceux qui fonctionnent selon la RAA. Avant l'instauration de la réforme des soins de santé primaires, les revenus entre les groupes étaient similaires. Le revenu des médecins qui travaillent dans les réseaux de santé familiale a augmenté de 30 pour cent et celui des médecins qui travaillent dans les groupes de santé familiale a augmenté de 10 pour cent, tandis que les médecins qui travaillent selon la RAA ont vu peu de changement ou une diminution de leur revenu. Les fluctuations de revenu déclarées volontairement ne sont pas fiables, car seulement 47 pour cent des médecins ont indiqué avec préci-sion si leur revenu s' étai...

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