Canadian Health Care Delivery System

Level 4

Rehabilitation - when client enters treatment - required after illness, injury, or addiction - eg. physiotherapy, occupational speech therapy, social services

Urbanization and health

This did not help because the crowdedness led to bad living situations, creating diseases. As a result, the government helped in health improvement and helped pay for such services

Canadian Health care delivery system PRE 1970s

Tommy Douglas made public insurance plan Hospital Insurance and Diagnostic Act (HIDSA) ensured that 1/2 of the hospital and diagnosis services costs will be paid by federal gov. All provinces and territories got federal funded care Medical Care Act paid insurance for hospital services for ALL

Healthcare promotion

a process for enabling people to take control over and improve their health

Prepathogenesis

before agent reacts with host Susceptibility ,(exposure), adaptation, (latency), early pathogenesis *early detection possible is adaptation to early clinical stage

Pathogenesis

development of disease clinical disease= (symptom onset), early clinical stage (diagnosis occurs), late clinical stage

Primary Prevention

happens when exposed to agent - prevents onset of illeness before disease - health promotion and specific protection like: vaccines, masks, isolation, etc.

Levels of healthcare (5)

health promotion disease and injury prevention diagnosis and treatment rehabilitation supportive care

Population health

looks at collective health. an approach that addresses the entire range of factors that determine health, thus affecting the entire population's health

Upstream thinking

making smarter decisions that solve a problem more efficiently. eg. instead of constantly saving people that are downing, prevent them from drowning in the first place.

2 Periods of illness

Prepathogenesis and Pathogenesis * the iceberg metaphor states that if you only look at the apparent (clinical) disease, it is not representative of the whole picture AKA the inapparent subclinical disease)

Ottawa Charter for Health Promotion

Created by Jake Epp= Behavioural and socioeconomic approach. This is the first UPSTREAM approach to healthcare. 3 challenges included: decrease inequities, increase prevention, enhance coping. 5 Strategies to achieve health for all: 1. health public policy 2. supportive environments 3. encourage public participation/ strengthen community action 4. develop personal skills 5. reorient health services

Level 1

Health Promotion - wellness services - eg. yoga, antismoking, promoting self-esteem in children and adolescents, advocacy for health public policy

Approaches to Health in Canada

1970s -> end of 1980s Lalonde and Epp helped create the first upstream approach. WHO changed their definition of health: - when a person/group is able to realize aspirations/satisty needs and is able to change/cope with the environment, then health can be seen as a resource for everyday life, and not as a objective for living. - It is a positive concept that emphasizes on social/personal resources as well as physical capabilities Canada Healthcare Act - public administration comprehensiveness, universality, portability, and accessibility Ottawa Charter for Health Promotion initiated the PHC= Primary Health Care= to achieve health for all.

welfare state

A government that undertakes responsibility for the welfare of its citizens through programs in public health and public housing and pensions and unemployment compensation etc.

Canadian Health care delivery system 1980s

Behavioral/Lifestyle approach to health care lost popularity because of victim blaming. victim blaming= "if you're poor, you can't buy health enhancements" Canadian Constitution Act made a Social Safety net to protect such vulnerable Canadians. The Canadian Charter of Rights and Freedoms was made to have a right to have the service costs covered, but not the right to care. - this means that "yes, services must be free, but they can refuse care if stated so" Canada Health Care Act has criteria that needs to be met in order to get money back. The 5 principles are: public administration, portability, and accessibility.

Provincial Jurisdiction/Responsibility

Develops own health care insurance plan manages, finances, and plans the insurable health care services and delivery determined the needs for healthcare professionals reimburses physicians and hospitals eg. MedsCheack, ODB, Health Promotion Programs

Level 3

Diagnosis and Treatment Primary Care - to prevent... leads to decision - first contact with health care system - eg. early detection, routine care Secondary Care - diagnostic - comes from referral of first care - provisions of specialized medical service Tertiary Care - specialized and highly technical care - complicated health issues have sophisticated diagnosis treatment - HIGH LEVEL!

Level 2

Disease and injury prevention to reduce risk factors strategies include: - clinical (screening/immunizing) - behavioural (lifestyle change, support groups) - environmental (societal pressure for healthy environment) e. climate change strike

population health promotional model

Focuses on population. Developed by Hamilton and Bhantti

Health for Canadian settlers

Health used to really poor with the influx of European settlers. People were expected to be self reliant. This changed when the first hospitals opened up, funded by Catholic missionaries. - the first hospital was Hotel-Dieu in Montreal

Settings for Health Care Delivery

Institutional Sector: hospitals, long-term care, psychiatric facilities, rehab community sector: public health, physician offices, community health centers and clinics, assisted living, home care, adult support programs, community and voluntary agencies, occupational health, hospital and palliative care, parish nursing

Canadian Health Care Trends

Shift acute care & institutions to the community 2 influential reports: 1. Romanow said medicare must be monitored 2. Kirby was for private sectors instead Health Accord was a 10 yr plan that focused on stable funding and assured healthcare services Common Statements on shared health were that we must have frequent access to healthcare.

Level 5

Supportive care - for clients with chronic illeness, procressive illeness, or diability - eg. long-term care, home care - also includes respite care and palliative care

Pillars of Primary Health Care

Teams - needs multi-sectoral team members working together - part of the team and empowered to make own decisions Access - ensures that Canadians have access when and where they need it Information - more sharing and more access to information for professionals and all canadians Healthy living - wellness focused

Medical Approach

The old-school way of thinking they used to think that only science fixes all = downstream thinking

Constitution Act

There used to only be 4 provinces (Ontario, Quebec, new Brunswick, and nova scotia) Each province was responsible for health, education and social services whereas the Federal government was responsible for aboriginal health, military personnel and veterans, and policy development in other words, the federal gov can write laws, provinces cannot.

Canadian Health care delivery system 1970s

They allowed out-hospital care but still strongly believed in the medical approach Mark Lalonde made the Lalonde report. This focused of BEHAVIOURAL approach to health. Influenced by fields that include: lifestyle, environment, human biology and healthcare organizations. The key was to self-modify. Alma Ata Declaration realized the realities of global poor healthcare and that the world needs to step up their game! They realized that health is a socio-economic issue and is a human RIGHT

Federal Jurisdiction/Responsibility

uses the Canada Health Act to adminiter national principles helps give money to health care services to provinces (gives 1/2 of the money back) covers the costs for specific groups: indigenous, veterans, inmates, RCMP promotes and gives money for studies about health promotion and prevention of diseases