Canada - World Health Organization Regional Office for Europe

More documents

Recommendations

Info

44 Health systems in transition Canada 2.7.2 Health research There are a handful of university-based research centres focused on health services and policy research including the MCHP, the Centre for Health Economics and Policy Analysis (CHEPA) at McMaster University, the Centre for Health Services and Policy Research (CHSPR) at the University of British Columbia, and IRSPUM (Institut de recherche en santé publique) at the University of Montreal. Researchers are funded through national and provincial health funding organizations. The CIHR Institute of Health Services and Policy Research is the single largest health services and policy research institute in Canada, although other CIHR institutes, including those for Aboriginal People’s Health, Gender and Health and Population and Public Health, also invest in health services and policy research. An alliance of provincial health research funding agencies, the National Alliance of Provincial Health Research Organizations (NAPHRO), was created in 2003 to promote collaboration on common issues. Its members include: • Michael Smith Foundation for Health Research (BC) • Alberta Innovates – Health Solutions • Saskatchewan Health Research Foundation • Manitoba Health Research Council • Ontario Ministry of Health and Long-Term Care • Ontario Ministry of Research and Innovation • Fonds de la recherche en santé du Québec • New Brunswick Health Research Foundation • Nova Scotia Health Research Foundation • Newfoundland and Labrador Centre for Applied Health Research. 2.7.3 Health technology assessment Objective and reliable HTA is essential for effective planning as well as for evidence-based decision-making by health managers and providers. Most technological progress is incremental, and new advances tend to build directly on existing ideas, products and techniques, but some technological change involves major breakthroughs in terms of new products (e.g. new cancer drugs) or new techniques (e.g. bariatric surgery). An often used example of the latter involves genetic testing and gene technologies and HTA agencies must deal
Health systems in transition Canada 45 with both types of technological change (Giacomini, Miller & Browman, 2003; Morgan & Hurley, 2004; Rogowski, 2007). While HTA reports that include an economic evaluation are useful to health system decision-makers operating under a budget constraint, they involve more time and expense to complete than HTAs, which only address clinical effectiveness. Tarride et al. (2008) found that less than 25% of HTAs in Canada included an economic evaluation although it is unclear how this compares with HTA agencies outside Canada. HTA organizations operate at provincial and at the pan-Canadian levels. Currently, there are three provincial HTA agencies. The first fully fledged HTA agency, the Agence d’évaluation de technologies et des modes d’intervention en santé (AETMIS) 4 , was established in Quebec in 1988. In 2011, AETMIS was renamed INESSS – l’Institut national d’excellence en santé et en services sociaux. The second is the Ontario Health Technology Advisory Committee and the Medical Advisory Secretariat, once part of the Ministry of Health and Long-Term Care, but now part of Health Quality Ontario, an arm’s length public agency. The third provincially based organization is in Alberta, where the HTA unit at the Institute of Health Economics (IHE) 5 makes recommendations to Alberta Health Services and the provincial ministry of health (Hailey, 2007; Menon & Stafinski, 2009). In addition, there are numerous academic and hospital-based organizations that conduct HTAs (Battista et al., 2009). The CADTH is the sole pan-Canadian HTA agency and it is also the largest producer of HTAs in the country. Established and funded by F/P/T governments, CADTH’s mandate is to provide evidence-based evaluations of new health technologies including prescription drugs and medical devices, procedures and systems (see section 2.3.3) to all participating governments. 6 These recommendations are advisory in nature and it is up to the governments to decide whether or not to introduce medical technologies or add prescription drugs to their respective health systems and public drug plans (Hailey, 2007). Established in 2003, CADTH’s CDR streamlines the process for reviewing new pharmaceuticals and providing recommendations to all provinces and territories except Quebec. The CDR process has three stages: (1) CADTH does a systematic review of the clinical evidence and pharmaco-economic data; (2) the Canadian Expert Drug Advisory Committee (CEDAC) under 4 AETMIS was originally incorporated as the Conseil d’évaluation des technologies de la santé, the name which it retained until renamed in 2000. 5 Until 2006, the HTA unit at IHE was housed at the Alberta Heritage Foundation for Medical Research. 6 All participating member governments have a seat on CADTH’s board of directors. Quebec is not a founding member of CADTH and has no seat on the CADTH board (CADTH, 2011).
Page 1 and 2:
Health Systems in Transition Vol. 1
Page 3 and 4:
Health Systems in Transition Gregor
Page 5 and 6:
Contents Preface . . . . . . . . .
Page 7 and 8:
Preface The Health Systems in Trans
Page 9 and 10:
Acknowledgements The HiT on Canada
Page 11 and 12:
List of abbreviations Abbreviations
Page 13 and 14:
List of tables and figures Tables p
Page 15:
Abstract Canada is a high-income co
Page 18 and 19: xvi Health systems in transition Ca
Page 20 and 21: xviii Health systems in transition
Page 22 and 23: xx Health systems in transition Can
Page 24 and 25: xxii Health systems in transition C
Page 26 and 27: 2 Health systems in transition Cana
Page 34 and 35: 10 Health systems in transition Can
Page 43 and 44: 2. Organization and governance Cana
Page 45 and 46: Health systems in transition Canada
Page 67: Health systems in transition Canada
Page 83: Health systems in transition Canada
Page 88 and 89: 64 8000 7000 6000 5000 4000 3000 20
Page 90 and 91: 66 6.0 5.0 4.0 3.0 2.0 1.0 Health s
Page 105 and 106: 4. Physical and human resources The
Page 107 and 108: 5 4 3 2 1 Health systems in transit
Page 115 and 116: 4.0 3.5 3.0 2.5 2.0 1.5 Health syst
Page 117 and 118: 1.0 0.9 0.8 0.7 0.6 0.5 0.4 1.2 1.1
Page 119 and 120:
Health systems in transition Canada
Page 121 and 122:
Page 123 and 124:
5. Provision of services Although i
Page 125 and 126:
Page 127 and 128:
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
Page 143:
Page 146 and 147:
122 Health systems in transition Ca
Page 148 and 149:
Page 150 and 151:
Page 153 and 154:
7. Assessment of the health system
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
Page 169:
Page 172 and 173:
Page 174 and 175:
Page 176 and 177:
Page 178 and 179:
Page 180 and 181:
Page 182 and 183:
Page 184 and 185:
Page 186 and 187:
Page 188 and 189:
Page 190 and 191:
Page 192 and 193:
Page 194 and 195:
Page 196 and 197:
Page 198 and 199:
Page 200 and 201:
Page 202 and 203:
Page 209 and 210:
The Health Systems in Transition pr
Page 211:
The European Observatory on Health
show all

Canada - World Health Organization Regional Office for Europe

Create successful ePaper yourself

Delete template?

Save as template?