Health care in the North: what Canada can learn from its circumpolar neighbours

Young, T. Kue; Chatwood, Susan

doi:10.1503/cmaj.100948

Cited by 47 publications

(55 citation statements)

References 7 publications

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“…The health care system faces challenges in the geographical distances, infrastructural barriers that complicate travels between towns and settlements, high turnover of health care professionals and high financial expenditures on acute evacuations of patients (13,14). A way of ensuring coherent patient pathways might be telemedicine, which has already been used in specific specialties such as telepsychiatry, teleophthalmology, teleradiology and teledermatology (15,16).…”

mentioning

confidence: 99%

Spirometry in Greenland: a cross-sectional study on patients treated with medication targeting obstructive pulmonary disease

Nielsen

Olsen

Jarbøl

et al. 2016

International Journal of Circumpolar Health

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BackgroundChronic obstructive pulmonary disease (COPD) is globally increasing in frequency and is expected to be the third largest cause of death by 2020. Smoking is the main risk factor of developing COPD. In Greenland, more than half of the adult population are daily smokers, and COPD may be common. International guidelines recommend the usage of spirometry as a golden standard for diagnosing COPD. The current number of spirometries performed among patients treated with medication targeting obstructive pulmonary disease in Greenland remains unexplored.ObjectiveTo estimate the prevalence of patients aged 50 years or above treated with medication targeting obstructive pulmonary disease and the extent to which spirometry was performed among them within 2 years.DesignAn observational, cross-sectional study based on the review of data obtained from electronic medical records in Greenland was performed. The inclusion criterion was that patients must have been permanent residents aged 50 years or above who had medication targeting obstructive pulmonary disease prescribed within a period of 15 months prior to data extraction. A full review of electronic patient records was done on each of the identified users of medication targeting obstructive pulmonary disease. Information on age, gender, town and spirometry was registered for each patient within the period from October 2013 to October 2015.ResultsThe prevalence of patients treated with medication targeting obstructive pulmonary disease aged 50 years or above was 7.9%. Of those, 34.8% had spirometry performed within 2 years and 50% had a forced expiratory volume (1 sec)/ forced vital capacity (FEV1/FVC) under 70% indicating obstructive pulmonary disease.ConclusionThe use of medication targeting obstructive pulmonary disease among patients over 50 years old is common in Greenland. About one third of the patients had a spirometry performed within 2 years. To further increase spirometry performance, it is recommended to explore possible barriers in health care professionals’ usage of spirometry in different health care settings in Greenland.

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mentioning

confidence: 99%

Spirometry in Greenland: a cross-sectional study on patients treated with medication targeting obstructive pulmonary disease

Nielsen

Olsen

Jarbøl

et al. 2016

International Journal of Circumpolar Health

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“…These are among the world’s economically most advanced countries, where substantial financial resources are available to improve health care. The major rationale for making circumpolar comparisons is that collaboration across northern regions and the sharing of best practices offer an effective approach to health system improvement [37,38]. For this to be realised, significant evidence gaps such as those relating to the health workforce need to be closed.…”

Section: Discussionmentioning

confidence: 99%

Comparing health care workforce in circumpolar regions: patterns, trends and challenges

Young

Fedkina

Chatwood

et al. 2018

International Journal of Circumpolar Health

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Background: The eight Arctic States exhibit substantial health disparities between their remote northernmost regions and the rest of the country. This study reports on the trends and patterns in the supply and distribution of physicians, dentists and nurses in these 8 countries and 25 regions and addresses issues of comparability, data gaps and policy implicationsMethods: We accessed publicly available databases and performed three types of comparisons: (1) among the 8 Arctic States; (2) within each Arctic State, between the northern regions and the rest of the country; (3) among the 25 northern regions. The unit of comparison was density of health workers per 100,000 inhabitants, and the means of three 5-year periods from 2000 to 2014 were computed.Results: The Nordic countries consistently exceed North America in the density of all three categories of health professionals, whereas Russia reports the highest density of physicians but among the lowest in terms of dentists and nurses.The largest disparities between “north” and “south” are observed in the Northwest Territories and Nunavut of Canada for physicians, and in Greenland for all three categories. The disparity is much less pronounced in the northern regions of Nordic countries, while Arctic Russia tends to be oversupplied in all categories.Conclusions: Despite efforts and standardisation of definitions by international organisations such as OECD, it is difficult to obtain an accurate and comparable estimate of the health workforce even in the basic categories of physicians, dentists and nurses . The use of head counts is particularly problematic in jurisdictions that rely on short-term visiting staff. Comparing statistics also needs to take into account the health care system, especially where primary health care is nurse-based.List of Abbreviations ADA: American Dental Association; AHRF: Area Health Resource File; AMA: American Medical Association; AO: Autonomous Okrug; AVI: Aluehallintovirasto; CHA: Community Health Aide; CHR: Community Health Representative; CHW: Community Health Worker; CIHI: Canadian Institute for Health Information; DO: Doctor of Osteopathic Medicine; FTE: Full Time Equivalent; HPDB: Health Personnel Database; MD: Doctor of Medicine; NOMESCO: Nordic Medico-Statistical Committee; NOSOSCO: Nordic Social Statistical Committee; NOWBASE: Nordic Welfare Database; NWT: Northwest Territories; OECD: Organization for Economic Co-operation and Development; RN: Registered Nurse; SMDB: Scott’s Medical Database; WHO: World Health Organization

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“…Understanding the transitions by key IUCH mandate activities, specifically scientific networking, international relations, Indigenous affairs, international congress and journal publications, allows one to follow the historical trajectory and may help us to identify areas where collaboration could be enhanced. (8) to present-day collaborations, which encompass broader areas of study that include health service delivery, monitoring of population health, community-based methods and the socio-economic determinants of health (9). To support scientific networking, the IUCH provided funding to Working Groups in the early 1990s (10).…”

Section: Introductionmentioning

confidence: 99%

Circumpolar health collaborations: a description of players and a call for further dialogue

Chatwood

Parkinson

Johnson

2011

International Journal of Circumpolar Health

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Health care in the North: what Canada can learn from its circumpolar neighbours

Cited by 47 publications

References 7 publications

Spirometry in Greenland: a cross-sectional study on patients treated with medication targeting obstructive pulmonary disease

Spirometry in Greenland: a cross-sectional study on patients treated with medication targeting obstructive pulmonary disease

Comparing health care workforce in circumpolar regions: patterns, trends and challenges

Circumpolar health collaborations: a description of players and a call for further dialogue

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