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Sociology
Introduction to healthcare
The term health refers to the physical, mental and social wellbeing of a person. To be healthy, one must be physically, mentally, emotionally and socially secure and active.
The topic under discussion that is healthcare is the preservation/ betterment of physical and mental wellbeing of people through the care, identification, and examination and care for any sickness, ill health, damage, and other physical and mental malfunctioning in human beings.
Healthcare systems
In many countries of the world, especially in the developed countries, there are health care systems that enable their citizens to access to quality health facilities and take care of any health issues that are faced by them. Countries like Germany, France, UK, Canada and Singapore etc. have elaborate and well-functioning healthcare systems.
When it comes to gauge the functioning and goals of a health care system there are three basic things that come into play namely access, quality of care and cost. A good healthcare system should be accessible to the public, should provide quality care to the diseases and the costs should be in a range that is affordable for the middle and lower middle class income groups.
Canadian healthcare system
Now let’s look at the Canadanian healthcare system
The Canadian system started off with a health insurance program at provincial level which bore the costs of universal hospital (1947) and cost of doctors (1962). The expenditures were taken care of on a 50/50 % basis with the federal government for health institutions (1957) and for physicians or practitioners (1968) ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"HjlkHcZz","properties":{"formattedCitation":"(Clements et al.)","plainCitation":"(Clements et al.)","noteIndex":0},"citationItems":[{"id":14,"uris":["http://zotero.org/users/local/orkqtrjP/items/8F7AC5D7"],"uri":["http://zotero.org/users/local/orkqtrjP/items/8F7AC5D7"],"itemData":{"id":14,"type":"article-journal","title":"Effective Teamwork in Healthcare: Research and Reality","container-title":"HealthcarePapers","page":"26-34","volume":"7","issue":"sp","source":"Crossref","abstract":"Issues affecting health workplaces range from serious concerns that could affect the immediate physical safety of workers to those that would improve productivity and efficiency, or make an organization a preferred employer. Employers and workers might consider effective teamwork an asset, but for patients it is a prerequisite. This paper reviews the evidence for effective teamwork, primarily that gathered by a research team funded by the Canadian Health Services Research Foundation (CHSRF). We also review the expert opinion provided by a group of 25 researchers and decision makers convened by CHSRF in late 2005 at a forum for discussion about issues related to effective teamwork. Included in the retreat were representatives from professional organizations and occupations as well as areas such as legal liability.","DOI":"10.12927/hcpap.2013.18669","ISSN":"19296339","shortTitle":"Effective Teamwork in Healthcare","language":"en","author":[{"family":"Clements","given":"Dave"},{"family":"Dault","given":"Mylène"},{"family":"Priest","given":"Alicia"}],"issued":{"date-parts":[["2007",1,15]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Clements et al.). During 1960s, other governments at provincial and territorial levels followed this system and till 1972 it was prevalent all over Canada. Then came the “National Medical Care Insurance Act” (1968) that made the federal government to bear 50% of the cost of the insurances at provincial levels.
The main features of Canada’s system are: easy access to public, compendious, flexibility, good administration of public insurances and universality. However, the system faces problems also. Canada’s system is believed to be “mediocre at best”. But U.S healthcare system is more costly and less efficient as compared to the Canadian system ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"HtYLz1wB","properties":{"formattedCitation":"(Ginter et al.)","plainCitation":"(Ginter et al.)","noteIndex":0},"citationItems":[{"id":31,"uris":["http://zotero.org/users/local/orkqtrjP/items/VNYDFCCU"],"uri":["http://zotero.org/users/local/orkqtrjP/items/VNYDFCCU"],"itemData":{"id":31,"type":"book","title":"The strategic management of health care organizations","publisher":"John Wiley & Sons","ISBN":"1-119-34970-2","author":[{"family":"Ginter","given":"Peter M."},{"family":"Duncan","given":"W. Jack"},{"family":"Swayne","given":"Linda E."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Ginter et al.).
The effective team work in healthcare in Canada results in the identification of weak areas that need improvement and consequently result in better outcomes for the patients and better team coordination. This also decreases the errors made during work ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"3ijd7q7S","properties":{"formattedCitation":"(Clements et al.)","plainCitation":"(Clements et al.)","noteIndex":0},"citationItems":[{"id":14,"uris":["http://zotero.org/users/local/orkqtrjP/items/8F7AC5D7"],"uri":["http://zotero.org/users/local/orkqtrjP/items/8F7AC5D7"],"itemData":{"id":14,"type":"article-journal","title":"Effective Teamwork in Healthcare: Research and Reality","container-title":"HealthcarePapers","page":"26-34","volume":"7","issue":"sp","source":"Crossref","abstract":"Issues affecting health workplaces range from serious concerns that could affect the immediate physical safety of workers to those that would improve productivity and efficiency, or make an organization a preferred employer. Employers and workers might consider effective teamwork an asset, but for patients it is a prerequisite. This paper reviews the evidence for effective teamwork, primarily that gathered by a research team funded by the Canadian Health Services Research Foundation (CHSRF). We also review the expert opinion provided by a group of 25 researchers and decision makers convened by CHSRF in late 2005 at a forum for discussion about issues related to effective teamwork. Included in the retreat were representatives from professional organizations and occupations as well as areas such as legal liability.","DOI":"10.12927/hcpap.2013.18669","ISSN":"19296339","shortTitle":"Effective Teamwork in Healthcare","language":"en","author":[{"family":"Clements","given":"Dave"},{"family":"Dault","given":"Mylène"},{"family":"Priest","given":"Alicia"}],"issued":{"date-parts":[["2007",1,15]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Clements et al.)
Also there are rules and regulations that apply to the big pharmaceuticals and are checked for the economic activities or situations which is an important factor that contributes to the quality of Canadian healthcare.
My research shows that Canada spends approximately about 228 billion dollars (2016) on healthcare and corresponding to 6,299 dollars per person. Whereas U.S spends 3.5 trillion (2017) which makes for eighteen percent of U.S total income which is more than any other developed country’s spending but still almost half (46.1%) deaths owing to diseases were due to either cancer, heart diseases or respiratory diseases. Also the quality of the medical service is also compromised in U.S as medical errors are also a leading cause of deaths and thousands of people die every year due to such errors ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"knqLpl1f","properties":{"formattedCitation":"(Freemantle et al.)","plainCitation":"(Freemantle et al.)","noteIndex":0},"citationItems":[{"id":26,"uris":["http://zotero.org/users/local/orkqtrjP/items/Y8L9V4N3"],"uri":["http://zotero.org/users/local/orkqtrjP/items/Y8L9V4N3"],"itemData":{"id":26,"type":"article-journal","title":"Promoting cost effective prescribing","container-title":"BMJ","page":"955-956","volume":"310","issue":"6985","source":"www.bmj.com","abstract":"In many countries the cost effectiveness of drugs is receiving increasing attention. Rising budgets have heightened concerns about containing costs and whether resources are used efficiently.1 The need for rigorous examination of cost effectiveness as well as clinical effectiveness has been argued for.2 3 4 The message is clear: doctors may prescribe an effective drug to patients who will benefit, but if the drug is not cost effective they may be using resources that would produce greater benefit for other patients for the same cost.\n\nExpensive drugs require the use of limited resources, which, once deployed are not available for other activities that may bring greater benefits for patients. When an expensive drug is shown to be cost effective, however, its use is justified by the additional benefits it brings. To use scarce resources efficiently the careful and explicit measurement of the value of what is given up (the opportunity cost) and the value of what is gained (for example, improvements in the length and quality of life) is essential. The measurement of cost alone or effectiveness alone will produce inefficiency as a rational health care system finances expensive alternatives to existing treatments only if these bring additional benefits commensurate with the cost.\n\nThe pharmaceutical industry has been quick to realise the potential of economic analyses in promoting new and expensive products.5 Governments have also recognised the importance of economic …","DOI":"10.1136/bmj.310.6985.955","ISSN":"0959-8138, 1468-5833","note":"PMID: 7728021","journalAbbreviation":"BMJ","language":"en","author":[{"family":"Freemantle","given":"Nick"},{"family":"Henry","given":"David"},{"family":"Maynard","given":"Alan"},{"family":"Torrance","given":"George"}],"issued":{"date-parts":[["1995",4,15]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Freemantle et al.).
It is researched upon that if the amount spent on home care is increased to two hundred dollars to allocate for the costs of self-care and for professionals’ services will lead to a saving of two hundred and fifty dollars every day for the patients or put in other words seven hundred and fifty thousand dollars each day for some three thousand patients in Ontario. It will lead to a whole of 273,750,000 dollars every year in amount spent in hospitals. But such investments will count if we see that:
Estimates as that of the Public Health Agency of Canada highlighted the Canadians spend a hundred and ninety billion dollars every year on the “Chronic diseases” in direct and indirect costs
According to the World Economic Forum, due to the chronic diseases the Canadians suffer from, lead to loss in productivity about four hundred percent more than the money spend directly on the treatment of the diseases.
The study of the “Ontario Chronic Disease Prevention and Management” in 2007 revealed that only in Ontario if then expenses on the chronic diseases were reduced by a mere ten percent, there could be a 1.2 billion dollar worth of savings ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"X6jX43R9","properties":{"formattedCitation":"(Manns et al.)","plainCitation":"(Manns et al.)","noteIndex":0},"citationItems":[{"id":21,"uris":["http://zotero.org/users/local/orkqtrjP/items/E8ZAKJJX"],"uri":["http://zotero.org/users/local/orkqtrjP/items/E8ZAKJJX"],"itemData":{"id":21,"type":"article-journal","title":"Population based screening for chronic kidney disease: cost effectiveness study","container-title":"BMJ","page":"c5869","volume":"341","source":"www.bmj.com","abstract":"Objective To determine the cost effectiveness of one-off population based screening for chronic kidney disease based on estimated glomerular filtration rate.\nDesign Cost utility analysis of screening with estimated glomerular filtration rate alone compared with no screening (with allowance for incidental finding of cases of chronic kidney disease). Analyses were stratified by age, diabetes, and the presence or absence of proteinuria. Scenario and sensitivity analyses, including probabilistic sensitivity analysis, were performed. Costs were estimated in all adults and in subgroups defined by age, diabetes, and hypertension.\nSetting Publicly funded Canadian healthcare system.\nParticipants Large population based laboratory cohort used to estimate mortality rates and incidence of end stage renal disease for patients with chronic kidney disease over a five year follow-up period. Patients had not previously undergone assessment of glomerular filtration rate.\nMain outcome measures Lifetime costs, end stage renal disease, quality adjusted life years (QALYs) gained, and incremental cost per QALY gained.\nResults Compared with no screening, population based screening for chronic kidney disease was associated with an incremental cost of $C463 (Canadian dollars in 2009; equivalent to about £275, €308, US $382) and a gain of 0.0044 QALYs per patient overall, representing a cost per QALY gained of $C104 900. In a cohort of 100 000 people, screening for chronic kidney disease would be expected to reduce the number of people who develop end stage renal disease over their lifetime from 675 to 657. In subgroups of people with and without diabetes, the cost per QALY gained was $C22 600 and $C572 000, respectively. In a cohort of 100 000 people with diabetes, screening would be expected to reduce the number of people who develop end stage renal disease over their lifetime from 1796 to 1741. In people without diabetes with and without hypertension, the cost per QALY gained was $C334 000 and $C1 411 100, respectively.\nConclusions Population based screening for chronic kidney disease with assessment of estimated glomerular filtration rate is not cost effective overall or in subgroups of people with hypertension or older people. Targeted screening of people with diabetes is associated with a cost per QALY that is similar to that accepted in other interventions funded by public healthcare systems.","DOI":"10.1136/bmj.c5869","ISSN":"0959-8138, 1468-5833","note":"PMID: 21059726","shortTitle":"Population based screening for chronic kidney disease","journalAbbreviation":"BMJ","language":"en","author":[{"family":"Manns","given":"Braden"},{"family":"Hemmelgarn","given":"Brenda"},{"family":"Tonelli","given":"Marcello"},{"family":"Au","given":"Flora"},{"family":"Chiasson","given":"T. Carter"},{"family":"Dong","given":"James"},{"family":"Klarenbach","given":"Scott"}],"issued":{"date-parts":[["2010",11,8]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Manns et al.). The government of Canada is actively working on these and other related aspects of the healthcare system.
Challenges
Canada’s health-care system faces some issues as well. Firstly, post late 1970s, the federal governments have lessened the money allocations towards the system. Secondly, the costs of the hospital insurance have been ever increasing. Canada spent about 11.1% of her total income on healthcare which was approximately 7% back in 1975. The money spent per head in Canada costs for around 6000 Canadian dollars which makes the Canadian healthcare more costly as compared to other developed nations. Moreover, the Canadian healthcare system is practically more responsive and accessible to the main chronic illness issues like heart diseases and cancer than it is for other non-chronic issues. It seems like the patients of chronic diseases are prioritized over other patients.
Also there is some need of repairing and redesigning of the system in the areas in which it is weak and not so efficient. Research and analysis still needs to be carried out in light of which there would be initiated any essential reforms in the Canadian healthcare system.
Work Cited
ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Clements, Dave, et al. “Effective Teamwork in Healthcare: Research and Reality.” HealthcarePapers, vol. 7, no. sp, Jan. 2007, pp. 26–34. Crossref, doi:10.12927/hcpap.2013.18669.
Freemantle, Nick, et al. “Promoting Cost Effective Prescribing.” BMJ, vol. 310, no. 6985, Apr. 1995, pp. 955–56. www.bmj.com, doi:10.1136/bmj.310.6985.955.
Ginter, Peter M., et al. The Strategic Management of Health Care Organizations. John Wiley & Sons, 2018.
Manns, Braden, et al. “Population Based Screening for Chronic Kidney Disease: Cost Effectiveness Study.” BMJ, vol. 341, Nov. 2010, p. c5869. www.bmj.com, doi:10.1136/bmj.c5869.
“Top 3 Leading Causes of Death in the US.” Pharmacy Times, https://www.pharmacytimes.com/news/top-3-leading-causes-of-death-in-the-us. Accessed 14 Mar. 2019.
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