the economic of Canadian health care
lizening
ECON317IndividualAssignment9.docxECON 317 SPRING 2019: INDIVIDUAL ASSIGNMENT 9 DUE March 28th, 2019 by 11:55 PM
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Honor Code: I guarantee that all the answers in this assignment, except those for the question specifically marked as a group discussion question, are entirely my own work. I have cited any outside sources in APA style.
Name or Signature for Honor Code: ______________________________________________
The table below is for TA use only.
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IF YOU HAVE ALREADY COMPLETED SIX ASSIGNMENTS, YOU DON’T HAVE TO WRITE THIS ONE! (BUT YOU MAY, IF YOU WISH). ONLY YOUR HIGHEST SIX ASSIGNMENT MARKS COUNT.
1. [Critique] Read the following paper:
Gaboury, I., Bujold, M., Boon, H. & Moher, D. (2009). Interprofessional collaboration within Canadian integrative healthcare clinics: Key components. Social Science & Medicine, 69, 707-715. Retrieved from https://doi.org/10.1016/j.socscimed.2009.05.048
Off-campus link:
https://www-sciencedirect-com.ezproxy.library.uvic.ca/science/article/pii/S0277953609003566
In class, we talked about Ontario’s health professional networks. This article investigates collaboration between biomedical (‘Western medicine’) health care practitioners and alternative/traditional medicine practitioners.
2. [Group Discussion Question][Analysis] In the early 2000s, British Columbia tried primary care reforms along the lines of those pursued by Ontario – using a mix of payment types to encourage physicians to provide the type of health care the province wanted. The results weren’t great. The following Globe and Mail article summarizes the findings of an investigation into BC’s primary care reforms:
Lavergne, R. & McGrail, K. (2017, March 24). British Columbia’s failed experiment in primary care. The Globe and Mail. Retrieved from https://www.theglobeandmail.com/opinion/british-columbias-failed-experiment-in-primary-care-reform/article31440332/
The following graphs are taken from a data appendix[footnoteRef:0] for the study[footnoteRef:1] the Globe and Mail article was based on. The situation is as follows: British Columbia wanted to improve health outcomes for people with chronic diseases. To do so, it paid physicians (provided monetary incentives) to treat patients with qualifying chronic diseases. [0: Laverne, M. R. et al. (2016). Appendix 2: Segmented Regression results for patients with qualifying disease prior to the study period, with and without incentives. [Web Page]. Retrieved from http://www.cmaj.ca/content/suppl/2016/08/15/cmaj.150858.DC1 ] [1: Laverne, M. R. et al. (2016). A population-based analysis of incentive payments to primary care physicians for the care of patients with complex diseases. CMAJ, 188(15), E375-E383. Retrieved from https://doi.org/10.1503/cmaj.150858 ]
The diseases in question were the following (as listed in Appendix 1).
· Congestive Heart Failure
· Chronic Obstructive Pulmonary Disease
· Chronic Kidney Disease (Renal Failure)
· Asthma
· Cerebrovascular Disease
· Ischemic Heart Disease
For the incentive program to be successful, we should at the very least see two things:
i. Health outcomes for patients with qualifying illnesses improving more with incentives than without incentives.
ii. Health outcomes for patients without incentives not negatively affected.
The graphs below divide the population of BC with qualifying diseases into two categories: those whose physicians received incentives (red) and those whose physicians did not receive incentives.
(Note: ‘Continuity of care’ means seeing the same physicians, who know the patient and her history, for all treatment. The opposite of continuous care is ‘Fragmented Care’, where a different physician who is unfamiliar with the patient is seen each visit.)
a. Based on these graphs, was the program successful according to criteria i and ii listed above? Briefly explain your reasoning.(4 marks)
Criterion i: Successful? Y/N
Reasoning:
Criterion ii: Successful? Y/N
Reasoning:
b. In some graphs, both the blue and red lines changed noticeably after the incentives were introduced. Using what you have learned in ECON 317, explain why the ‘No incentive’ group may have been affected by the incentives in the way seen in the graphs. (2 marks)
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