Quality of care Patient-centred primary and specialist care Medication reviews Chronic condition management and disease prevention 1

Quality of care

Patient-centred primary and specialist care

Medication reviews

Chronic condition management and disease prevention

1

When older Canadians needed care or treatment, their regular doctor always or often Canada CMWF average

Knew important information about their medical history

Spent enough time with them

Encouraged them to ask questions

Most older Canadians have a positive experience with their regular doctor

87% 87%

82% 86%

70% 66%

Compared with the CMWF average

Above average Same as average Below average

2

Patient-centred care from specialists is also relatively good in Canada

When specialists provided care or treatment, they always or often Canada CMWF average

Told patients about treatment choices

Involved patients as much as they wanted to be in decisions about treatment or care

72% 72%

79% 77%



3

In the past 2 years, was there a time when Canada CMWF average

A specialist did not have basic information or test results from the patient’s regular doctor about the reason for the visit

A patient’s regular doctor did not seem informed and up to date about the specialist care received

However, continuity of care between regular doctors and specialists can be improved

13% 9%

25% 18%



4

How do the provinces compare?

B.C. Alta. Sask. Man. Ont. Que. N.B. N.S. P.E.I. N.L. Can. CMWF Avg.

Regular doctor always or often

Knew important information about patients’ medical history 88% 86% 89% 84% 86% 89% 87% 85% 87% 84% 87% 87%

Spent enough time with patients 81% 80% 80% 79% 81% 87% 80% 85% 80% 78% 82% 86%

Encouraged patients to ask questions 72% 70% 64% 65% 68% 76% 68% 66% 72% 62% 70% 66%

Specialists always or often

Told patients about treatment choices 74% 74% 75% 78% 77% 58% 73% 76% 80% 77% 72% 72%

Involved patients as much as they wanted to be in decisions 81% 79% 83% 76% 80% 76% 81% 85% 88% 79% 79% 77%



5



Specialist did not have basic medical information from primary doctor

8% 8% 8% 11% 10% 26% 13% 6% 4% 9% 13% 9%

Primary doctor did not seem informed or up to date about care from specialist

16% 18% 18% 18% 18% 46% 22% 10% 13% 10% 25% 18%

Continuity of care between primary doctors and specialists was comparable to the international average in most Canadian provinces.



6

Medication reviews are common for older Canadians

How does Canada compare (2014)?

SourceCanadian Institute for Health Information. Drug Use Among Seniors on Public Drug Programs in Canada, 2012: Revised October 2014. Ottawa, ON: CIHI; 2014.

said a health care professional reviewed their medications in the past 12 months.

80%

Sweden

France

Norway

Netherlands

CMWF AVERAGE

Switzerland

United Kingdom

Australia

Germany

CANADA

New Zealand

United States

70%

80%*In Canada, seniors use an average of 7.2 prescription drugs in a year.

7

Canadians are more likely to have discussions about medication use

In the past 12 months, has a health care professional

Provided a written list of all medicationsExplained potential side effects

SwedenNorway

SwitzerlandNetherlands

FranceCMWF AVERAGE

GermanyAustralia

United StatesNew Zealand

United KingdomCANADA

59%

74%*

FranceSwitzerland

NorwayGermany

CMWF AVERAGEAustralia

United StatesNetherlands

New ZealandCANADA

United KingdomSweden

57%

67%*

8

Patient safety incidents related to medication use are common in Canada

SourceCanadian Institute for Health Information. Drug Use Among Seniors on Public Drug Programs in Canada, 2012: Revised October 2014. Ottawa, ON: CIHI; 2014.

Proportion of seniors on public drug programs taking a potentially

inappropriate (Beers list) drug, 2012

SourceCanadian Institute for Health Information. Adverse Drug Reaction–Related Hospitalizations Among Seniors, 2006 to 2011. Ottawa, ON: CIHI; 2013.

Almost 140,000 hospitalizations for adverse drug reactions among seniors between 2006–2007 and 2010–2011

39%

9


In the past 12 months, has a health care professional


Reviewed all medications 77% 78% 78% 75% 83% 83% 75% 66% 77% 65% 80% 70%

Explained potential side effects 72% 72% 72% 67% 76% 76% 67% 70% 68% 62% 74% 59%

Given a written list of all medications 59% 58% 58% 51% 67% 80% 66% 62% 57% 54% 67% 57%

Across provinces, medication management among older patients was equal to or better than that in other countries, on average.



10

Older people with chronic conditions who Canada CMWF average

Had discussions about main goals or priorities with their health providers

Received clear instructions about symptoms to watch for

Care to help manage chronic conditions is above average in Canada

* Chronic conditions include hypertension or high blood pressure; heart disease, including heart attack; diabetes; asthma or chronic lung disease such as chronic bronchitis, emphysema or chronic obstructive pulmonary disease; depression, anxiety or other mental health problems; cancer; and joint pain or arthritis.

of older Canadians had at least 1 chronic condition* (CMWF average 71%).78%

60% 55%

60% 56%



11

However, there is room to improve across countries

SourceThe Commonwealth Fund, 2012 Commonwealth Fund International Survey of Primary Care Doctors.

Canada CMWF average

People with chronic conditions who received a written plan for self-management from their health provider

37% 35%

21%Routinely

Occasionally

58%

21% of family physicians

routinely gave their patients with chronic conditions written instructions for self-management.

12



Hospitalizations for chronic conditions are declining in Canada but vary widely across the country

ACSC hospitalization rates (per 100,000)

SourceCanadian Institute for Health Information. Your Health System. http://yourhealthsystem.cihi.ca/. Accessed November 27, 2014.

Canadian rates

B.C. Alta. Sask. Man. Ont. Que. N.B. N.S. P.E.I. N.L. Can.

258

319

435

296267 275

425

319

428 419

289

Compared with the Canadian average


2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

417

289

13

Ambulatory care sensitive conditions (ACSCs) are chronic conditions that—when treated effectively in community settings—should not, in most cases, lead to hospitalization.

http://yourhealthsystem.cihi.ca/



Discussed with patients their main goals or priorities in caring for this condition

59% 59% 61% 57% 61% 61% 56% 60% 61% 58% 60% 55%

Given patients clear instructions about symptoms to watch for and when to seek further care or treatment

56% 57% 60% 60% 58% 68% 62% 58% 62% 58% 60% 56%

Given patients a written plan to help them manage their own care

42% 32% 36% 34% 35% 38% 35% 41% 42% 39% 37% 35%

In the past 12 months, has a health professional

In most provinces, management of chronic conditions was similar to the international average experience.



14

Discussions about healthy life habits are more frequent in Canada

During the past 2 years, has a health professional discussed

SourceThe Commonwealth Fund, 2010 Commonwealth Fund International Health Policy Survey.

But they happened less often in 2014 than they used to.

2010 2014 2010 2014 2010 2014A healthy diet and healthy eating Exercise or physical activity Things in life that worry patients

or cause stress

57%51%*

61%55%*

37%

25%

50%43%

54%48%

35%

23%

Canada CMWF Average

15

Canada leads in smoking cessation discussions

How does Canada compare (2014)?

SourceOECD Health Statistics 2014.

of older Canadians who smoked said a health professional talked to them about the health risks of smoking or using tobacco and ways to quit.

78%

AustraliaNetherlands

GermanyNorway

SwitzerlandSweden

CMWF AVERAGEUnited Kingdom

FranceNew Zealand

United StatesCANADA

63%

78%*

17% of older Canadians

smoked, higher than the CMWF average.

Lung cancer mortality rates were among the highest in the world for Canadian women at 46 deaths per 100,000 population.

16



A healthy diet and healthy eating 54% 52% 49% 47% 52% 48% 48% 52% 52% 47% 51% 43%

Exercise or physical activity 60% 55% 52% 51% 55% 55% 49% 54% 55% 51% 55% 48%

Things in life that worry patients or cause stress 27% 23% 25% 24% 26% 20% 22% 32% 22% 24% 25% 23%

Health risks of smoking or using tobacco and ways to quit 92% 75% 66% 84% 79% 71% 72% 72% 60% 59% 78% 63%

During the past 2 years, has a health professional discussed



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Documents

Quality of care Patient-centred primary and specialist care Medication reviews Chronic condition management and disease prevention 1