HLTA03 Week 2: Introduction to Health Systems and the Canada Health Act
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67 Terms
What is health care?
A relationship where providers offer personal services to patients, based on trust.
What are health-care “silos”?
Separate areas of health-care with limited coordination or integration
What are the 3 main levels of care?
Primary
Secondary
Tertiary
What is primary care?
The first point of contact w/ health-care system; provides general, ongoing care
What is secondary care?
Specialized care, usually accessed through a referral
What is tertiary care?
Highly specialized care for complex conditions
Give an example of primary care
A family doctor managing a patient’s diabetes
Give an example of secondary care
A cardiologist treating a patient after referral
Give an example of tertiary care
A specialized cancer centre providing complex treatment
What are the main functions of primary care?
First point of entry
Coordinates care
Diagnoses, treats, & prevents common illness
Manages chronic disease
Provides check-ups & immunization
Why is good primary care important?
It improves cost-effectiveness, equity, quality, and health-system sustainability
What is generalism?
Treating a wide range of health problems rather than specializing in one disease or body system
Why is generalism important?
it helps providers manage unclear diagnoses, uncertainty, and multiple health problems
Why is primary care often less expensive than hospital care?
It relies more on one-on-one care and less on expensive technology
What relationships does primary care maintain?
Patients: ongoing, long-term relationships
Health systems: coordination w/ specialists
Community: consideration of population health need
Who can provide primary care, besides family doctors?
Nurses, nurse practitioners, physicians assistants, midwives, pharmacists, social workers, & dietitians
Why is primary care ideal for chronic disease management?
It provides continuous, coordinated care as people age & develop multiple chronic conditions
What is specialized care?
Care provided by specialists or highly trained providers for specific conditions
Can patients usually refer themselves to specialists in Canada?
No. Specialized care is generally accessed through referrals
What is emergency care?
Urgent care for potentially life-threatening illness or injury
Who provides emergency medical services?
Paramedics & emergency medical technicians (EMTs)
What can emergency services do?
Provide treatment at the scene, during transport, and transfer patients between facilities
What is long-term care (LTC)?
Ongoing health, personal, and social care for people who need continued assistance
Give an example of LTC institutions
Nursing homes and homes for the aged
What is home and community care?
Care provided at home or in the community to support health & independence
What are the 3 purposes of home & community care?
Acute-care substitution: allows patients to leave hospital while still receiving care
LTC substitution: helps people remain home instead of entering LTC
Prevention/maintenance: helps people stay healthy enough to remain home
What makes an occupation a profession?
Specialized body of knowledge
Recognized education & training
Methods to test competence
Potential for harm if care is improper
What is information asymmetry in health care?
Patients often cannot independently judge the quality of care they receive
What is a regulated health profession?
A profession licensed and overseen by a regulatory body under government legislation
What is the main purpose of professional regulation?
To protect the public
What is the difference between a regulatory body & a professional association?
Regulatory bodies protect the public; associations advocate for their members
How many regulated health professions does Ontario have?
28!
What do personal support workers (PSWs) do?
Help people with activities of daily living
Are PSWs generally regulated?
No, they are generally unregulated
What are informal caregivers?
People, often family members, who provide unpaid care
What are the benefits and challenges of informal caregiving?
It can help people remain home and reduce health-system costs, but may create financial and personal burdens for families
Why can professional regulation create challenges?
Licensing requirements differ across provinces & countries, complicating mobility & recognition of foreign-trained workers
What does HHR stand for?
Health Human Resources: the health-care workforce
What are the 3 key HHR questions?
How many providers are needed?
Where will providers come from?
How can providers be retained?
What is recruitment?
Getting people to work in a particular job or location
What is retention?
Keeping people in a particular job or location
What is stickiness?
The probability that a worker will remain in the same job the following year
Which setting is generally more sticky: hospitals or home care?
Hospitals, partly because of better pay
What happens when there are too few health-care providers?
Staff shortages and reduced access to care
Why must workforce planning consider training time?
Training new health-care providers takes time, so shortages cannot be fixed immediately
How can licensing and regulation affect HHR?
They influence where and how providers can work, affecting workforce distribution
What are the two main levels of government involved in Canadian health care?
Federal & provincial/territorial governments
What are examples of federal health responsibilities?
Pharmaceutical regulation
Public health
Indigenous health services
Armed forces
Veterans
Inmates
Refugees
What are examples of provincial health responsibilities?
Health-service delivery & financing
Hospitals
Provincial professional licensing
What is the key difference between federal & provincial responsibilities?
The federal government handles national responsibilities; provinces & territories largely deliver and finance health services
Who was Tommy Douglas?
Saskatchewan premier associated w/ pioneering publicly funded healthcare in Canada
Why was Saskatchewan important to Medicare?
It pioneered publicly funded hospital care & universal medical insurance
What was the significance of the Saskatchewan Hospital Plan?
It expanded publicly funded hospital care
What did the federal Hospital Insurance & Diagnostic Services Act do?
It helped provinces fund hospital & diagnostic services.
Why was there a doctors’ strike in Saskatchewan in 1962?
Some doctors opposed the introduction of publicly funded medical insurance
What was the significance of Saskatchewan’s medical insurance plan?
It introduced universal, publicly funded medical insurance in Saskatchewan
What did the federal Medical Care Act achieve?
It provided federal support for provincial medical insurance plans
What happened by 1971?
All provinces had medical insurance plans meeting federal criteria
What changed with Established Programs Financing?
Federal health funding shifted toward block funding
What is the Canada Health Act?
Federal legislation establishing principles provinces must follow to receive full federal healthcare funding
When was the Canada Health Act passed?
1984
What are the five Canada Health Act principles?
public administration
comprehensiveness
universality
portability
accessibility
P-C-U-P-A
What is one major strength of Canadian Medicare?
It reduces financial barriers to medically necessary hospital & physician services
What is one major weakness of Canadian Medicare?
Many services, such as outpatient prescriptions, dental care and vision care, aren’t universally covered
Does Canadian Medicare cover every healthcare service?
No. Universal coverage mainly applies to insured medically necessary hospital and physician services.
Why does the Canada Health Act matter?
It establishes national standard while provinces and territories administer their own health plans.
What are the key milestones in the development of Medicare in Canada?
1947: Saskatchewan Hospital Plan
1957: Federal hospital insurance legislation
1962: Saskatchewan medical insurance and doctors’ strike
1984: Canada Health Act