Canada - World Health Organization Regional Office for Europe

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Health systems in transition Canada
1. The man goes directly to the ED (the vast majority of ED patients come
without a GP’s referral). He is taken to hospital by a household member
or by an ambulance.
2. Once at the ED, he provides his provincial health card and briefly
describes the problem. He is then referred to a triage nurse who estimates
the urgency of the complaint after further inquiry. The waiting time for
admission into an ED room for further tests and examination depends on
the level of urgency.
3. The man is then examined by an emergency physician and told about the
diagnosis and the recommended surgical procedure.
4. A medical team performs the required surgery or procedure.
5.6 Pharmaceutical care
Inpatient drugs are dispensed by hospitals without charge to patients as part
of medicare. Outpatient pharmaceuticals, the cost of which may be covered in
whole or part through public or private drug plans, are prescribed by physicians
and in rare cases by other health providers who have the right to prescribe
certain classes of drugs. Individuals obtain their prescription drugs at retail
pharmacies. Almost all pharmacies, whether they are independent or part of a
chain, sell a host of products beyond prescription and over-the-counter drugs.
Pharmacies in large chain grocery stores now compete directly with traditional
stand-alone pharmacies by selling prescription and over-the-counter drugs.
Provincial and territorial drug plans vary in terms of the extent and depth
of coverage, and these variations are most pronounced for expensive drugs
(Menon, Stafinski & Stuart, 2005; Grootendorst & Hollis, 2011; McLeod
et al., 2011). Unlike all other provincial plans, the Quebec drug programme is
a mandated social insurance plan in which the private sector plays a key role
(Pomey et al., 2007). To add further complexity to these provincial and territorial
differences, eligible First Nations and Inuit patients are covered through the
federal non-insured health benefits programme. The one exception is inpatient
drug therapy: since prescription drugs provided in hospitals are considered
part of universal coverage, they are provided to all provincial and territorial
residents, including First Nations and Inuit, free of charge, by P/T governments.
In terms of public and private insurance coverage for prescription drugs,
there is an east–west gradient in Canada, with residents living in the four
Western Canadian provinces as well as Ontario and Quebec having noticeably