Financial and work satisfaction: impacts of participation in primary care reform on physicians in ontario.

Governments in Ontario have promised family physicians (FPs) that participation in primary care reform would be financially as well as professionally rewarding. We compared work satisfaction, incomes and work patterns of FPs practising in different models to determine whether the predicted benefits to physicians really materialized. Study participants included 332 FPs in Ontario practising in five models of care.

Factors affecting long-term-care residents' decision-making processes as they formulate advance directives.

Purpose: The purpose of this study was to describe factors contributing to the decision-making processes of elderly persons as they formulate advance directives in long-term care.

Design And Methods: This study was qualitative, based on grounded theory. Recruitment was purposive and continued until saturation was reached.

Coming of age and taking stock: the state of academic health policy research centres in Canada.

This descriptive study takes stock of the nation's health services and health policy research capacity by profiling the organizational models, operational challenges and success strategies utilized by Canadian academic health policy research centres. While each such centre is unique, the results point to some common themes, including symbiotic relationships between centres and their ministries of health, pervasive infrastructure funding challenges and the importance of having a supportive academic home.

Simulation modeling of change to breast cancer detection age eligibility recommendations in Ontario, 2002-2021.

Purpose: The purpose of this project was to demonstrate the development and use of a decision support tool based on simulation modeling of breast cancer screening to evaluate the implications for the provision of health services and the economic impact of extending routine radiographic screening for breast cancer to women in the 40-49 age group between 2002 and 2021.

Methods: The main method was computer simulation with a Markov model that used published estimates of population size by age group, breast cancer prevalence and incidence, screening program participation rate, sensitivity and specificity of the screening test and diagnostic test, stage transition probabilities, directed diagnosis rates and costs.

Findings: The model predicted that changes to age eligibility requirements would result in the detection of an additional 6610 women with breast cancer in Ontario requiring treatment, at an additional cost of 795 Canadian per case.

Monitoring trends in waiting periods in Canada for elective surgery: validation of a method using administrative data.

Background: Provincial governments require timely, economical methods to monitor surgical waiting periods. Although use of prospective procedure-specific registers would be the ideal method, a less elaborate system has been proposed that is based on physician billing data. This study assessed the validity of using the date of the last service billed prior to surgery as a proxy for the beginning of the post-referral, pre-surgical waiting period.

Family physician views about primary care reform in Ontario: a postal questionnaire.

Background: Primary care reform initiatives in Ontario are proceeding with little information about the views of practicing family physicians.

Methods: A postal questionnaire was sent to 1200 randomly selected family physicians in Ontario five months after the initial invitation to join the Ontario Family Health Network. It sought information about their practice characteristics, their intention to participate in the Network and their views about the organization and financing of primary care.

Accountability in public health units: using a modified nominal group technique to develop a balanced scorecard for performance measurement.

Background: Little attention has been paid to the need for accountability instruments applicable across all health units in the public health system. One tool, the balanced scorecard was created for industry and has been successfully adapted for use in Ontario hospitals. It consists of 4 quadrants: financial performance, outcomes, customer satisfaction and organizational development.

Equity in Canadian health care: does socioeconomic status affect waiting times for elective surgery?

Background: Waiting times for surgical and other procedures are an important measure of how well the health care system responds to patient needs. In a universal health care system such as Canada's, it is important to determine if waiting times vary by socioeconomic status (SES). We compared waiting times for elective surgery of patients living in low and high socioeconomic areas.

Medical Savings Accounts in publicly funded health care systems: enthusiasm versus evidence.

Medical Savings Accounts (MSAs) have been suggested as a possible solution to Canada's health care funding woes. This approach is intended to reduce demand for health services by making individuals financially responsible for their pattern of consumption. MSAs may have appeal in the private insurance industry.