Research Paper on "Evaluation of Home Care and Community Care in Canada"

Research Paper 15 pages (4724 words) Sources: 8 Style: APA

[EXCERPT] . . . .

70% of the deaths in Canada are caused by chronic illnesses

60% of the health costs in Canada arise from chronic illnesses

A third of yearly mortalities in Canada arise from chronic illnesses (Rachlis, 2004).

Primary care sector

Primary health care is the attention and care accorded to a patient immediately when an incidence occurs right from first aid to hospital care. Primary health care in any country defines the country's ability to manage and maintain good and quality healthcare system that focuses on fairness and fair cost care to all. A case example, Canada has, over the past period of between 10 to 20 years focused on creating good infrastructure and strengthening the already existing health infrastructure that support primary care. Primary care affects each and everybody in need of health care primarily. Every growing economy needs a good health care systems and a community needs a robust and accommodative primary care that is reachable at any time of need (Aggarwal, & Hutchison, 2012).

Initiatives by the Government

Governments agreed to first-dollar insurance coverage extension for targeted facilities in homecare in three fields: (1) a fortnight of acute homecare following discharge from infirmaries; (2) end-of-life homecare; and (3) a fortnight of acute homecare for mental health patients. Apparently, nearly all provinces now cover these limited areas, though there is considerable territorial and provincial variability with regard to other homecare facilities (Marchildon, 2005).

The process of healthcare restructuring now in progress in every territory and province has started heading in the direction of integrated systems. Territorial/Provincial administrations are instituting regional systems of healthcare, which integrate community health, hospitals, and homecare services. Nevertheless, it typically appears that the voice of health promotion and community health is weak; biomedical and hospital perspectives still dominate. Some marked improvements have been made with regard to preventive practice enhancement among professionals in the health sector, led by professional institutions (Bell, & Joly, 1998).

Though a majority of health reform plans by territorial/provincial governments includes statements supporting health promotion, cost cutting remains the overriding concern. The net impact has been major employee layoffs and closures of hospital beds. Whether this has been accompanied by redirection of savings of institutions to community-centered initiatives is unclear (Bell, & Joly, 1998).

Healthcare Professionals

Healthcare has a number of stakeholders that are directly involved with the system. Of importance are the health care professionals that work in the various departments of the healthcare system. They range from administration, patient care providers, equipment operators, equipment suppliers who altogether form the health care system and make it successful (Boychuk, 2009).

The Labor Statistics Bureau (BLS) estimated, in 2006, that homecare services and medical facilities employ 1.85 million workers; this figure does not include directly-appointed caregivers (i.e., hired by patients and their family members) and informal caregivers (Bureau of Labor Statistics, 2006). In this paper, the following categories will be addressed:

Licensed professionals: These include nurse practitioners, doctors, assisted living and nursing home administrators, registered nurses, other community service and home health agency CEOs and executives, and licensed vocational and practical nurses;

The rapidly growing number of nursing assistants in these years was both a response to the inadequate supply of registered nurses and the expansion of hospitals that characterized these years. Nursing assistants were a heterogeneous category of labor that had a long history within hospitals; however, it is readily acknowledged that nursing assistants have been important to nursing practice (Twohig, 2014).

Public financing of individual doctors, usually family physicians has developed Primary health care in Canada. However, there have been other models in the development of primary health care like the public health nurses, community health centers, well-baby clinics as well as the incorporation of non-medical health care providers whose focus is promotion of health have been included. The development of the system witnessed the rise of several concerns:

The absence of providers of primary health care;

the incoherent manner in which several sections of the health care system engaged with each other, usually leaving patients to seek medications from different institutions and providers;

problems in assimilating primary health care providers like nurse practitioners, social workers, pharmacists, or community health workers;

more evidence that practices in Canadian primary health care focus on acute or episodic conditions, while chronic conditions like diabetes, heart disease or even hypertension require more comprehensive care;

Recognition that more utilization of multidisciplinary teams of providers can decrease clinical errors, increase satisfaction in the provider, and improve patient outcomes within chronic and acute care settings (Health Council of Canada, 2005).

The Canadian health committee came up with three major new perspectives to deal with the health care systems. The perspectives agreed upon were:

The creation of the Federal Health Promotion Directorate housed within the Department of National Health and Welfare in 1978

Rapid growth in programs aimed at lifestyle featuring social marketing and health education campaigns

A refinement of health promotion practice in communities and grassroots efforts across the country (Evidence-informed change management in Canadian healthcare organizations. Ottawa, ON: Canadian Health Services Research Foundation, 2012)

The way forward for community health and homecare in Canada

Canada has a policy that no one should be denied medical attention in whatever situation or case he/she has found himself in. This policy helps greatly in achieving a healthy health care system to take care of her citizens (MacKinnon, 2013).

Reorientation

For effective positive change to occur in the healthcare system, there needs to be a mindset change in the key players. Their needs to be a re-organization of the key factors affecting the lives, principles and rules and the way certain regulations work. The factor that needs a lot to be done on is the way money and resources are used in the health care systems. For acceptability and uniformity, there is the need to come up with common definitions and standard measures. This will enable easy evaluation process and measurement of progress and effect of healthcare to communities (Starfield, Shi, & Macinko, 2005).

Community Participation

There is the need to come up with and build community-sharing forums that enable people to share and build on experiences. This plays a greater part in building and coming up with lasting solutions to support healthcare in the community. It is further reasonable and advisable that the governance systems facilitate efficient delivery models to the community. This is important in providing real time information and response to the community. With good systems, it means that there is easy information transfer, quick feedback and help reaches the victim in time. This will also foster the acceptance of the system by the community and the practitioners in general. Attention needs to be given to known impediments and barriers.

Remuneration Issues

Previously, there existed barriers to effective coordination between the stakeholders and that slowed down the pace and effectiveness of service delivery. These issues are the different interests of different key players. The different interests play out on different levels of the system. Many logistical issues are involved right from planning through training and implementation. The biggest difference creator is the remuneration issue that affects everyone across board. Different key players across board always seem to agitate for higher pay on different levels. This is a big concern.

Information and Communication

The need also to have better information system is another issue that all the stakeholders hold at high esteem. If unchecked, it may lead to failure in the service delivery. The training models needs to reflect future of collaborative practice between all disciplines of humanity. To achieve this, there is the need to have a continuous professional training program to the staff. Information technology is important today and so it has become another basic necessity to every aspect of life and it needs to be incorporated in the healthcare system as a management and reference tool. This facilitates the availability of information and patient's history whenever needed. To achieve the desired goals by the health system there needs to be a decision making support system that outline the steps and the accepted measures to the needs and evaluation of the people when needed (Nolte, & Tremblay, 2005).

Access to healthcare

Infrastructure shortage

Recent studies show that Canadians suffer in waiting for medical attention as compared to other countries. It is in this realization, that there is a need to come up with more swift and fluent course of actions to iron out these hitches in the medical healthcare systems. To realize these, goals have to be set and actualized (Health Care in Canada, 2012; Samson, 2003). Akin to other western democratic countries, Canada faces significant changes within its health care system. Undeniably, many writers as well as decision makers illustrate the extent of change the Canadian health care system needs as a large-scale transformation. The notion of the desire for noteworthy change in the Canadian system is extensive. In addition, the backdrop of change confronting the health care systems is wide. It entails issues that tend to challenge health care systems for a number… READ MORE

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