The effect of the Ontario Bariatric Network on health services utilization after bariatric surgery: a retrospective cohort study

Elnahas, Ahmad; Jackson, Timothy; Okrainec, Allan; Austin, Peter C.; Bell, Chaim M.; Urbach, David R.

doi:10.9778/cmajo.20160042

Cited by 10 publications

(8 citation statements)

References 18 publications

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“…However, the average wait period for bariatric surgery at the time was approximately 5 years. [79] , [80] As a result, patients lobbied the Ontario government to include bariatric surgery as an insured out-of-country procedure. Much like the experience in Europe, postoperative care and treatment were complicated by a lack of follow-up when the procedure was completed out-of-country.…”

Section: North American Experiencementioning

confidence: 99%

“…Due to the continued and increased demand for bariatric surgery in Ontario, the provincial government funded The Ontario Bariatric Network through OHIP, which places a significant emphasis on the importance of patient follow-up and increased funding for these procedures to be completed in Canada. [79] Other health services in Ontario have been outsourced in the past mainly because of poor domestic accessibility as opposed to achieving higher quality care. Addictions medicine, and fertility services were other treatments that at one point were approved as out-of-country health services due to their demand and limited access.…”

Section: North American Experiencementioning

confidence: 99%

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Cross-border healthcare: A review and applicability to North America during COVID-19

et al. 2022

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Cross-border healthcare is an international agreement for the provision of out of country healthcare for citizens of partnered countries. The European Union (EU) has established itself as a world leader in cross-border healthcare. During the Coronavirus disease of 2019 (COVID-19) pandemic, the EU used this system to maximize utilization of resources. Countries with capacity accepted critically ill patients from overwhelmed nations, borders remained open to healthcare workers and those seeking medical care in an effort to share the burden of this pandemic. Significant research into the challenges and successes of cross-border healthcare was completed prior to COVID-19, which demonstrated significant benefit for patients. In North America, the response to the COVID-19 crisis has been more isolationist. The Canada-United States border has been closed and bans placed on healthcare workers crossing the border for work. Prior to COVID-19, cross-border healthcare was rare in North America despite its need. We reviewed the literature surrounding cross-border healthcare in the EU, as well as the need for a similar system in North America. We found the EU cross-border healthcare agreements are generally mutually beneficial for participating countries. The North American literature suggested a cross-border healthcare system is feasible. A number of challenges could be identified based on the EU experience. A prior agreement may have been beneficial during the COVID-19 crisis as many Canadian healthcare institutions-maintained capacity to accept critically ill patients.

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Section: North American Experiencementioning

confidence: 99%

Section: North American Experiencementioning

confidence: 99%

Cross-border healthcare: A review and applicability to North America during COVID-19

et al. 2022

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“…16 For example, some Centres of Excellence in the Ontario Bariatric Network have successfully implemented team-based models of care. 17 Operations research-the application of quantitative methods to the analysis of complex organizational problems-has great potential to understand and address inefficient processes in surgical care. 18 For example, operations research methods identified ways to reduce elective surgical cancellation 19 and demonstrated that downstream availability of resources such as inpatient surgical beds has an outsized influence on the utilization of operating rooms.…”

Section: Efficiencymentioning

confidence: 99%

“…16 For example, some Centres of Excellence in the Ontario Bariatric Network have successfully implemented team-based models of care. 17…”

Section: How Can Access Be Improved?mentioning

confidence: 99%

Improving access to health services in Canada

Urbach

2018

Healthc Manage Forum

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The Commonwealth Fund 2017 report ranked Canada's healthcare system low in access to care and last among all 11 counties studied in terms of timeliness of care. While long wait times for certain elective surgical procedures appear to be emblematic of Canadian Medicare, they are not inevitable. Wait times could be improved by focusing on public awareness and measurement of wait times and improving the appropriateness, efficiency (eg, with implementation of single-entry models for surgical referrals and greater use of ambulatory surgery), and productivity of surgical care (eg, by activity-based funding for surgical procedures and by reducing the cost of perioperative care). Ideas on how physician leaders can build on recent accomplishments are provided.

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“…A surgeon can be in only one place at a time. However, emerging team-based models of surgical care, such as acute-care surgery services and some specialized clinical programs (bariatric surgery, 4 for example), have shown that this traditional model of surgery is not necessary for the provision of high-quality and patient-centred care. Groups of surgeons pooled into teams, with provisions for cross-coverage and escalation, are better equipped to deal with the unpredictable nature of emergency surgery than a specific solo practitioner who may be occupied elsewhere at the moment a patient needs to be in the operating room.…”

mentioning

confidence: 99%