Health and Health Care Delivery in Canada

Prepare for a career in Canadian health care with the only text of its kind! Written in a manageable, studentfriendly style, Health and Health Care Delivery in Canada, 3rd Edition makes it easy to understand the nation’s approach to health, wellness, and illness. Set entirely within a Canadian context, this text includes coverage of individual and population health, the role of federal agencies and provincial governments, health care funding, and current issues and future trends in health care. This new edition includes updated coverage on mental health care, Indigenous Peoples, palliative and endoflife care (including MAID), the legalization of marihuana, and the COVID19 pandemic (on Evolve). With enhanced online resources and updated review questions, it’s ideal for all Canadian students considering a career in health care! Front Cover Inside Front Cover Health and Health Care Delivery in Canada Copyright Dedication Preface Content Learning Features Acknowledgements Reviewers Contents Special Features Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Chapter 6 Chapter 7 Chapter 8 Chapter 9 Chapter 10 Chapter 1: The History of Health Care in Canada Evolution of health care: an overview Division of Responsibilities for Health The Origins of Medical Care in Canada The History of Healing Practices of Indigenous Canadians Contact With Outsiders The Development of Hospitals in Canada Segregated Hospitals for Indigenous People The Role of Volunteer Organizations in Early Health Care The Order of St. John The Canadian Red Cross Society Victorian Order of Nurses Childrens Aid Society The Concept of Public Health Is Introduced The Role of Nursing in Early Health Care The introduction of health insurance First Attempts to Introduce National Health Insurance Post-World War II: The Political Landscape Progress Toward Prepaid Hospital Care Progress Toward Prepaid Medical Care Significant events leading up to the canada health act Events Following the Introduction of the EPF Act The canada health act (1984) Criteria and Conditions of the Canada Health Act Public Administration Comprehensive Coverage Universality Portability Accessibility Interpreting the Canada Health Act Additional Components of the Act After the canada health act: commissioned reports and accords Social Union Commissioned Reports Impact of the Romanow Report Accords First Ministers Meeting, 2000 First Ministers Accord on Health Care Renewal, 2003 First Ministers Meeting on the Future of Health Care, 2004 Annual Conference of Ministers of Health, 2005 The Kelowna Accord, 2006 The Mental Health Commission of Canada (MHCC), 2007 The 2014 Health Accord The 2017 Health Accord Other Initiatives Summary Review questions References Chapter 2: The Role of the Federal Government in Health Care Health canada: objectives and responsibilities Health canada organization and structure Ministry Level Organizational structure of health canada Branches of Health Canada Office of Accountability and Evaluation Chief Financial Officer Branch Corporate Services Branch Departmental Secretariat First Nations and Inuit Health Branch Health Environments and Consumer Safety Branch Healthy Products and Food Branch Biologic and Genetic Therapies Directorate The Office of Nutrition Policy and Promotion The Therapeutic Products Directorate Natural and Nonprescription Health Products Directorate Communications and Public Affairs Branch Strategic Policy Branch Health Care Policy Directorate Office of Nursing Policy Marketed Health Products Directorate Regions and Programs Branch New Additions to Health Canadas Organizational Structure The Opioid Response branch The Cannabis Legalization and Regulation branch Agencies of health canada The Canadian Institute for Health Information Canadian Institutes of Health Research The Canada Food Inspection Agency Patented Medicine Prices Review Board Public Health Agency of Canada Global organizations collaborating with health canada Public Health Threats: National and International Response Public Safety Canada North American Collaboration World Health Organization (WHO) World Health Assembly Pan-American Health Organization Organisation for Economic Co-Operation and Development Ebola, Zika, Influenza: A Closer Look The Ebola virus The Zika virus Influenza Summary Review questions References Chapter 3: The Role of Provincial and Territorial Governments in Health Care Provincial and territorial health care plans Division of Powers Structure of the Health Plans: An Overview Regionalization initiatives across canada British Columbia Alberta Saskatchewan Manitoba Ontario Previous Framework Quebec New Brunswick Nova Scotia Prince Edward Island Newfoundland and Labrador Northern Regions Northwest Territories Yukon Nunavut Who pays for health care? Provincial/territorial roles Health Care Premiums Payroll Tax Other Sources of Funds Distribution of Funds Private and public health insurance Provincial Insurance Plans Eligibility Application for Coverage Health Cards Using a health card Health card fraud Insured and Uninsured Services Private Health Care Hospital Services Medical Services Ambulance Services Insured Health Care Providers Other Than Physicians Extended Health Care Services Assistive Devices and Medical Products Drug Plans Summary Review questions References Chapter 4: The Dollars and ``Sense ́ ́ of Health Care Funding Funding versus the delivery of health care Levels of health care funding Federal Health Transfer Payments Negotiating Funds: Health Accords Federal Government Costs for Direct Health Care Provincial and Territorial Costs for Direct Health Care Trends in Health Care Spending The Cost of Poor Health Expenditures for hospitals Hospital Funding Mechanisms Requirements for Funding The Cost of Hospital Care Factors That Affect Hospital Costs Costing Details Cost-Reduction Strategies Length of Stay Same-Day Admissions Day Surgery Deliveries Bed Management Timely Discharge Out-patient and Community Support Tax Credits for Caregivers Palliative Care Mergers, Rationalization, and Integration of Services Continuing care in canada Demographics and Challenges Alternative Level of Care Continuing care: options Home Care Residential Care Private Residences Long-Term Care Facilities (Nursing Homes) The rising cost of drugs Major Cost Drivers for Drug Expenditures Drug Insurance Brand-Name and Generic Drugs Controlling the Cost of Patented Drugs Health human resources Physicians How Physicians Are Paid: Billing Options Fee-for-Service Capitation- or Population-Based Funding Indirect Capitation Global Budget Salary and Contract Blended Funding Specialists Compensation Nurses Midwives Other health care cost drivers Technology CT, Positron Emission Tomography Scanners, and MRIs Outsourcing Electronic Health Records Conclusion Summary Review questions References Chapter 5: Practitioners and Workplace Settings Categories of health care providers Conventional Medicine Complementary and Alternative Medicine Chiropractic: Conventional, Complementary, or Alternative? Regulation of health care professions Title Protection Performing Controlled Acts Exceptions Delegated Acts Complaint Process Educational Standards Licence to Practise Nonregulated Professions and Occupations Mainstream health care providers Physicians Family Physicians Emergentologists Geriatricians Cardiologists Gynecologists and Obstetricians Internists and Hospitalists Neurologists Ophthalmologists Oncologists Psychiatrists Physiatrists Radiologists Respirologists Surgeons Nurses Registered Nurses Advance Practice Nurses Nurse Practitioners Clinical Nurse Specialists Registered Psychiatric Nurses Licensed Practical Nurses Physician Assistants Pharmacists Midwives Optometrists and Opticians Osteopathic Physicians Podiatrists (Chiropodists) Personal Support Workers Psychologists Speech-Language Pathologists and Audiologists Communications Disorders Assistant Respiratory Therapists Physiotherapists Occupational Therapists Physiotherapy Assistants and Occupational Therapy Assistants Administrative Roles Health Information Management Health Office Administration Laboratory and Diagnostic Services Alternative Practitioners Volunteer Caregivers Practice settings Care in the Home and the Community Home Care Management in Saskatchewan Clinics Urgent Care and Walk-In Clinics Ambulatory Care Clinics Outpatient Clinics Mental Health Clinics Harm Reduction Sites or Clinics Methadone Clinics Nurse Practitioner-Led Clinics Why Clinics Make Sense Primary health care: issues and trends The Ongoing Shortage Strategies for Improvement Primary Health Care Groups Forming a Group Basic Structure and Function Primary Care Models: Regional Variations Primary Care Groups: Payment Mechanisms Patient Enrollment and Primary Care Models (Rostering) Telephone Helplines Community Health Centres Primary Care in Northern Regions Summary Review questions References Chapter 6: Essentials of Population Health in Canada Population health Introduction of population health to canada The Lalonde Report, 1974 Alma-Ata Conference, 1978 Ottawa Charter for Health Promotion, 1986 The Epp Report, 1986 The Public Health Program Initiative Toward a Healthy Future: The First Report on the Health of Canadians, 1996 National Forum on Health, 1994-1997 Determinants of health 1. Income and Social Status 2. Social Support Networks 3. Education and Literacy 4. Employment and Working Conditions 5. Social Environment 6. Physical Environment 7. Personal Health Practices and Coping Skills 8. Healthy Child Development 9. Biology and Genetic Endowment 10. Health Services 11. Gender 12. Culture The population health approach: the key elements The Public Health Agency of Canada Template Key Element 1. Focus on the Health of a Target Population Key Element 2. Address the Determinants of Health and Their Interactions Key Element 3. Use Evidence-Informed Decision Making Key Element 4. Increase Upstream Investments Key Element 5. Apply Multiple Strategies Key Element 6. Collaborate Actions Sectors and Levels Key Element 7. Engage the Public Key Element 8. Demonstrate Accountability for Health Outcomes Population health promotion model Population health in canada and abroad Summary Review questions References Chapter 7: Health and the Individual Health, wellness, and illness: key concepts Health Wellness Dimensions of Wellness Physical wellness Mental wellness Emotional wellness Intellectual wellness Social wellness Spiritual wellness Environmental wellness Occupational wellness Meditation and wellness Illness Disease Disability Health models Medical Model Holistic Model Indigenous Wholistic Theory for Health Wellness Model International Classification of Functioning Disability and Health Changing perceptions of health and wellness Past Approaches The psychology of health behaviour Health Belief Model Transtheoretical Model Social-Ecological Model Protection Motivation Theory The health-illness continuum Sick Role Behaviour Stages of Illness: Influence on Patient Behaviour Self-Imposed Risk Behaviours The health of canadians today Leading Causes of Death in Canada Cancer Cardiovascular Diseases Cerebrovascular Disease Summary Review questions References Chapter 8: The Law and Health Care Laws used in health care legislation Constitutional Law Statutory Law Regulatory Law Common (Case) Law and Civil Law in Canada Classifications of Law: Public and Private Law Tort Law Intentional tort Unintentional tort Negligence Litigation and the duty of care Contract Law Criminal Law The law, the division of power, and the jurisdictional framework Workplace Safety Occupational Health and Safety Occupational Health and Safety Legislation: Objectives Occupational Health and Safety and Workers Compensation Boards Workplace Hazardous Materials Information System Drugs and the Law Controlled Drugs and Prescriptions Dispensing controlled drugs in facilities Prescribing controlled drugs The Opioid Crisis Are Prescription Drugs Safe? Cannabis (Marijuana) Legalization of Recreational Cannabis The Role of the Federal Government The Role of the Provincial and Territorial Governments Cannabis sales Prescribing medical cannabis Advertising prescription drugs Health Canadas Emergency Powers The Quarantine Act International Health Regulations Health care as a right Medically Necessary: What Does It Mean? The Canadian Charter of Rights and Freedoms The Law, the Constitution, and End-of-Life Issues Advanced Care Directives Types of advanced care directives Medical Assistance in Dying Types of Medically Assisted Death Eligibility Health Professionals Involved in MAID Consent Additional Safeguards The legality of private services in canada Independent Health Care Facilities Informed consent to treatment Types of Consent Express Consent Written Consent Oral Consent Implied Consent Consent in an Emergency Situation Who Can Give Consent Age of Consent for Minors Consent for Deceased Organ Donation The health record The Importance of Accurate Recording Ownership of Health Information Storage and Disposal of Health Information Federal Legislation and Privacy Laws Privacy Act Personal Information Protection and Electronic Documents Act Confidentiality Security Electronic Health Information Requirements Health care professions and the law Regulated Health Care Providers Unions, Health Care, and Legal Implications ``Sorry, I Made a Mistake ́ ́ Ending a Physician-Patient Relationship Physician Authority: Involuntary Confinement Nonregulated Health Care Providers Other legal issues in health care The Use of Restraints Patient Self-Discharge From a Hospital Good Samaritan Laws Whistleblowing Summary Review questions References Chapter 9: Ethics and Health Care What Is Ethics? Morality and Morals Values Sense of Duty Ethical Theories: The Basics Teleological Theory Deontological Theory Virtue Ethics Divine Command Ethical Principles and the Health Care Profession Beneficence and Nonmaleficence Respect Autonomy Truthfulness Fidelity Justice Patients Rights in Health Care Rights in Health Care Duties and Rights Autonomy and the Patient Truthfulness Parental Rights, Ethics, and the Law Rights and Mental Competence Ethics at work The Code of Ethics Special Boundaries and Relationships With patients With colleagues In the hospital setting Rationale for Boundaries Trust Vulnerability Balance of power and transference Accepting gifts The Ethics Committee End-of-life issues Euthanasia Ethical Principles and Medical Assistance in Dying Rights Autonomy Values Trust Preparation for End-of-Life Decisions Do Not Resuscitate Requests Palliative Care Care in a Hospice Allocation of resources Organ Transplantation Finances and Resources Other Ethical Issues in Health Care Abortion Premature Deliveries Genetic Testing Summary Review questions References Chapter 10: Current Issues and Future Trends in Health Care in Canada Mental health and addiction Structure and Implementation of Services Services for Armed Forces Community-Based Services Mental Health Practitioners Registered Psychiatric Nurses Family Physicians Mental Health Commission of Canada The Stigma of Mental Illness Mental Health and Addiction Disorders Drug Misuse Actions Taken Against Drug Misuse Mental Illness and Homelessness Reducing Homelessness Mental Illness and the Justice System Transition Into the Community Mental Illness and Employment The Future of Mental Health Care E-Mental Health Caring for an aging population Providers Time Residential and Long-Term Care Accommodation Whats Next? Home and continuing care The Problems Recipients of Home Care Accessing Home Care Services The Future Drug coverage Funding The Future Cannabis Indigenous health care Demographics Health Determinants and Challenges Addressing Some Specific Issues Systems of Health Care Delivery for Indigenous People Care partners Access to Services and any Provisions Health Care Providers Practitioner Retention Related Organizations Culturally Safe Health Care The Way Forward Information technology and electronic health records Canada Health Infoway Hospitals Advantages of computerization Security of hospital information systems Security protocols Doctors A National EHR System: Is it Achievable? The financial sustainability of health care in canada Social Media and Health Care What is Considered to be Social Media Provider/Patient Relationships Support Groups Risks Summary Review questions References Appendix: Declaration of Alma-Ata Declaration I II III IV V VI VII Primary Health Care VIII IX X Glossary Index