Measuring Outcomes in the Canadian Health Sector: Driving Better Value from Healthcare

Veillard, Jérémy; Dhalla, Irfan A.; Fekri, Omid; Klazinga, Niek

doi:10.2139/ssrn.2689797

Cited by 14 publications

(9 citation statements)

References 18 publications

(6 reference statements)

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“…Entretanto, a atualização das listas de coberturas provinciais são pouco transparentes. 35,36 Por fim, algumas peculiaridades são observadas na participação da iniciativa privada no sistema de saúde.…”

Section: Françaunclassified

Listas de cobertura mínimas no setor privado: revisão de benchmarks internacionais

Lemmer¹,

Pires²,

Yoshida³

et al. 2022

JAFF

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Resumo: Objetivo: Análise das práticas regulatórias e funcionamento dos sistemas de saúde em diferentes países, com foco principal na regulação de planos de saúde vinculados ao setor privado. Método: Revisão da literatura, acrescida por informações coletadas por um desk research. A busca foi realizada na base de publicações MEDLINE, considerando publicações datadas em 2018 e 2019. Os 23 países avaliados foram organizados em cinco grupos. Resultados: Os dados apontam similitudes entre os países agrupados no que se refere às características dos sistemas de saúde e da participação do setor de saúde suplementar. Prevalecem, em âmbito global, sistemas de saúde de cobertura universal e financiados por contribuições da seguridade social e por impostos gerais. Numa parcela dos países, a participação da iniciativa privada tem caráter complementar, ofertando serviços não cobertos pelo setor público. Em outros, suplementar, ofertando serviços similares ao setor público, porém com maior oferta de prestadores. Estratégias de copagamento e utilização de listas mínimas de cobertura se mostram prevalentes. Entretanto, os mecanismos e frequências de suas atualizações são variáveis. Conclusão: A maior parte dos países analisados adota sistemas públicos e universais, que são suplementados ou complementados, de forma variável, por serviços do setor privado empresarial. Listas mínimas de cobertura e copagamento são adotadas por diversos países, de diferentes regiões. A frequência de atualização das listas é variável, sendo mais comum a atualização anual, utilizando estratégias diversas para a avaliação de tecnologias em saúde. Palavras-chave/descritores: Sistema de saúde; saúde suplementar; planos de saúde; lista de cobertura; rol de procedimentos; desk research Abstract: Objective: Analysis of regulatory practices and functioning of health systems in different countries, with a primary focus on the regulation of health plans linked to the private sector. Method: A literature review was conducted and complemented with information collected by a desk search. The search was carried out on MEDLINE, considering publications dated in 2018 and 2019. The 23 countries evaluated were organized into five groups. Results: The data pointed to similarities between the grouped countries, regarding their health systems' main characteristics and the participation of the supplementary health sector. Globally prevailing health systems with universal coverage and financed by social security contributions and general taxes. In some countries, the participation of the private sector is complementary, and offers services not covered by the public sector. In others, it is supplementary, offering similar services to the public sector with a wider range of providers. Co-payment strategies and the use of minimum coverage lists are prevalent. However, the mechanisms and frequencies of their updates are variable. Conclusion: Most of the countries analyzed adopt public and universal systems, which are supplemented, in a variable way, by the liberal practice of t...

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Section: Françaunclassified

Listas de cobertura mínimas no setor privado: revisão de benchmarks internacionais

Lemmer¹,

Pires²,

Yoshida³

et al. 2022

JAFF

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“…To make health-related decisions, patients first need to identify what is most important to them, then, they need to be supported in their decision-making [2]. Patients involved in decisions about their health, report better experiences of care and obtain better health outcomes [3]. However, achieving the full potential of SDM, including greater patient involvement, requires that healthcare professionals have the attitudes and skills necessary to predispose them to SDM [4].…”

Section: Introductionmentioning

confidence: 99%

Continuing professional education of Iranian healthcare professionals in shared decision-making: lessons learned

Rahimi

Rodríguez

Croteau

et al. 2021

BMC Health Serv Res

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Background In this study, we sought to assess healthcare professionals’ acceptance of and satisfaction with a shared decision making (SDM) educational workshop, its impact on their intention to use SDM, and their perceived facilitators and barriers to the implementation of SDM in clinical settings in Iran. Methods We conducted an observational quantitative study that involved measurements before, during, and immediately after the educational intervention at stake. We invited healthcare professionals affiliated with Tabriz University of Medical Sciences, East Azerbaijan, Iran, to attend a half-day workshop on SDM in December 2016. Decisions about prenatal screening and knee replacement surgery was used as clinical vignettes. We provided a patient decision aid on prenatal screening that complied with the International Patient Decision Aids Standards and used illustrate videos. Participants completed a sociodemographic questionnaire and a questionnaire to assess their familiarity with SDM, a questionnaire based on theoretical domains framework to assess their intention to implement SDM, a questionnaire about their perceived facilitators and barriers of implementing SDM in their clinical practice, continuous professional development reaction questionnaire, and workshop evaluation. Quantitative data was analyzed descriptively and with multiple linear regression. Results Among the 60 healthcare professionals invited, 41 participated (68%). Twenty-three were female (57%), 18 were specialized in family and emergency medicine, or community and preventive medicine (43%), nine were surgeons (22%), and 14 (35%) were other types of specialists. Participants’ mean age was 37.51 ± 8.64 years with 8.09 ± 7.8 years of clinical experience. Prior to the workshop, their familiarity with SDM was 3.10 ± 2.82 out of 9. After the workshop, their belief that practicing SDM would be beneficial and useful (beliefs about consequences) (beta = 0.67, 95% CI 0.27, 1.06) and beliefs about capability of using SDM (beta = 0.32, 95% CI -0.08, 0.72) had the strongest influence on their intention of practicing SDM. Participants perceived the main facilitator and barrier to perform SDM were training and high patient load, respectively. Conclusions Participants thought the workshop was a good way to learn SDM and that they would be able to use what they had learned in their clinical practice. Future studies need to study the level of intention of participants in longer term and evaluate the impact of cultural differences on practicing SDM and its implementation in both western and non-western countries.

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“…The use of outcome measures in the health sector promotes the achievement of care goals, facilitates patient–healthcare professional communication, matches the delivery of health care to the patient’s needs, and supports the decision-making for the allocation of healthcare resources [ 9 ]. A well-developed outcome measure should consist of three primary psychometric properties: reliability, validity, and responsiveness to change [ 10 , 11 ] (Table 1 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical measurement properties of malnutrition assessment tools for use with patients in hospitals: a systematic review

Vincent

2020

Nutr J

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Background The use of malnutrition outcome measures (OM) by registered dietitians (RD) with inpatients in hospitals has increased promoting the achievement of nutritional care goals and supporting decision-making for the allocation of nutritional care resources in hospitals. There are 3 commonly used OMs: Subjective Global Assessment (SGA), Patient Generated-Subjective Global Assessment (PG-SGA) and Mini Nutritional Assessment (MNA). The purpose of this current study was to systematically review the evidence of the clinical measurement properties of malnutrition assessment tools for use with patients admitted in hospitals. Methods MEDLINE, Cinahl, EMBASE, and PubMed were searched for articles published between 2000 and 2019. Research articles were selected if they established reliability, validity, and responsiveness to change properties of the SGA, PG-SGA and MNA tools, were written in English, and used any of these OMs as an outcome measure. Abstracts were not considered. The risk of bias within studies was assessed using the Quality Appraisal for Clinical Measurement Study (QA-CMS). Results Five hundred five studies were identified, of which 34 articles were included in the final review: SGA (n = 8), PG-SGA (n = 13), and MNA (n = 13). Of the 34 studies, 8 had a quality score greater than 75%; 23 had a quality score of 40–75% and 3 studies had a quality score of less than 40%. PG-SGA was found to have excellentdiagnostic accuracy (ROC: 0.92–0.975; Sensitivity: 88.6–98%; Specificity: 82–100%), sufficient internal consistency (Cronbach’s alpha: 0.722–0.73), and strong test-retest reliability (r = 0.866). There was insufficient evidence to suggest adequate diagnostic accuracy and good inter-rater reliability for SGA. Only one study examined the minimum detectable change of MNA (MDC = 2.1). Conclusions The evidence of validity for the existing malnutrition assessment tools supports the use of these tools, but more studies with sound methodological quality are needed to assess the responsiveness of these OMs to detect the change in nutritional status.

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Measuring Outcomes in the Canadian Health Sector: Driving Better Value from Healthcare

Cited by 14 publications

References 18 publications

Listas de cobertura mínimas no setor privado: revisão de benchmarks internacionais

Listas de cobertura mínimas no setor privado: revisão de benchmarks internacionais

Continuing professional education of Iranian healthcare professionals in shared decision-making: lessons learned

Clinical measurement properties of malnutrition assessment tools for use with patients in hospitals: a systematic review

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