Health systems and Economics
Cardiac disease, particularly heart failure is a major cause of death, disability and making use of health care in Canada (Tran, et al., 2016). The cardiac disease not only leads to impaired functional capacity but also diminishes the quality of life of people and their caregivers (Alpert, et al., 2017). Even though people of Canada are experiencing the substantial adverse impact of the disease, awareness among health care professionals, governments, and the Canadian population is limited. The stakeholder involved is the Canadian Government, public and private organizations working for heart disease, healthcare system and people of Canada. A WHO framework which is based on six building blocks of health systems will be used in the assignment to identify the effectiveness of different aspect of Canada’s healthcare system concerning cardiac disease management.
The first building block is effective health services which impart that Canadian healthcare delivery must provide good, safe, quality personal and non-personal health mediations to those who require them, when and where required, with the least waste of resources. In 2016, a HeartLife Foundation was founded which is a patient-led heart failure body with an aim of engaging patients, families, and caregivers in the conversation regarding heart failure and to raise the voice of the patient by spreading awareness and encouraging the need of system change for improvement of accessibility to knowledge and skill-building, interdisciplinary assistance teams, as well as improvement of accessibility to the financial, personal, and environmental resources required to facilitate good self-management. In spite of the establishment of the role of self-management in treatment of heart failure to improve patient’s health outcome, they are not included in service delivery (Sean A. Virani, et al., 2017).
It is recommended that there must be an active engagement among patients, caregivers, and advocacy groups to transform the heart failure service delivery in Canada. Health care providers in Canada must focus on individualized and personalized care model for management of heart failure. There should be an increased number of clinical trials with patient-centred endpoints. Canadian Government must put efforts into offering community-based and remote service delivery. There should be equality in diagnosis and management. To improve the patient outcome inter-institutional partnership and broad stakeholder engagement can come across as a good strategy. Lastly, an emphasis must be placed on behavioural and psychosocial determinants of health in people at risk of heart failure.
The second building block is the health workforce which means that well-performing workforce must be responsive, just and effective in achieving the best possible health outcomes. It must be understood that with a lack of collaborated and coordinated healthcare team, patients with heart disease may not only experience poor medical management but also feel lost, isolated, and stressed regarding prognosis, which may further lead to poor outcomes. A well-performing workforce will also engage the patients as one of the partners in their care since people with heart disease usually have comorbidities, disease complexity and stress. Self-management of heart failure is the basic foundation to improve patient outcomes (Toback & Clark, 2017).
The third building block is an information system which includes a system of information that produces, analyzes and disseminates valid information timely regarding the health status. In Canada, the Canadian Cardiovascular Society (CCS) Project has developed the performance indicators has enabled to evaluate the collective compliance to the heart failure care delivery at a national level. But it is limited by the lack of data backbone which will allow the measurement. Several data systems are available in Canada to explain the inpatient outcomes and quality of care. Many jurisdictions have also included the implementation of live web-based heart failure dashboards aimed at demonstrating performance metrics.
The fourth building block is a health system which guarantees equal access to vital medical products, vaccines and technologies which are good in quality, safe, effective and cost-effective. Canada has placed national policies, guidelines and regulations that ensure safety and efficacy of drugs used in heart disease management. They have set policy for authentic production of practices and quality assessment of priority products. Canada supports the rational use of vital medicines, commodities and instruments, through guidelines, strategies to ensure compliance, lower resistance and increase patient safety.
The fifth building block is the health financing which has sufficient funds for health to ensure that people can use required services and safeguard them from the economic destitute they may experience with having to pay for the services. Canada has placed funding policies and distribution strategies in the context of human resources, technology, and infrastructure needed for collaborative cardiac service delivery.
The sixth building block is leadership and governance which ensures the existence of strategic policy frameworks. The policies encourage collaboration, suitable regulations and wages, appropriate system-design, and accountability. In Canada, the provision of heart failure care fluctuates throughout the country and is mainly based on the jurisdiction and set of patient’s residency (Hayes, et al., 2015). A certain number of provinces regions have invested to develop focused heart failure management programs, while others are largely dependent on the existing primary care for giving mass heart failure care (Wijeysundera, et al., 2012). This has led to an incoherent coalition of the local systems which resulted in huge inequities inaccessibility of suitable heart care (Howlett, 2014). Another governance flaw can be observed in the fact these inequalities in the service delivery is more marked among demographically marginalized groups (Feldman, et al., 2013) (Lyons, et al., 2014). Even though the CCS heart failure guidelines comprise of best practices for interdisciplinary heart failure care, currently there is a lack of a strategic and equitable system for health care management in Canada that covers the care continuum.
It can be concluded that the quality of healthcare for heart disease in Canada is on a road to improvement. It has attained excellence in certain areas while others still require work. An action plan based on strong stakeholder engagement is required to reduce the rate of mortality and morbidity due to heart disease. It will need integration among organizations to assemble resources and work together at local and national levels.
References
Alpert, Smith, Hummel & Hummel, 2017. Symptom burden in heart failure: assessment, impact on outcomes, and management. Heart Fail Rev, Volume 22, pp. 25-39.
Feldman, Huynh & Luriers, D., 2013. Gender and other disparities in referral to specialized heart function clinics following emergency department visits. J Womens Health, Volume 22, pp. 526-31.
Hayes, Peloquin & Howlett, 2015. A qualitative study of the current state of heart failure community care in Canada: what can we learn for the future?. BMC Health Serv Res, Volume 15, pp. 290-299.
Howlett, J. G., 2014. Specialist heart failure clinics must evolve to stay relevant.. Can J Cardiol., Volume 30, pp. 276-80.
Lyons, Ezekowitz & Liu, 2014. Mortality outcomes among status Aboriginals and whites with heart failure. Can J Cardiol, Volume 30, pp. 619-26.
Sean A. Virani, M. M. M. F. F. i. a. t. a. M. M. M. F. A. V. et al., 2017. The Need for Heart Failure Advocacy in Canada. Canadian Journal of Cardiology, 33(11), pp. 1450-54.
Toback & Clark, 2017. Strategies to improve self-management in heart failure patients. Contemp Nurse, Volume 53, pp. 1065-20.
Tran, Ohinmaa & Thanh, 2016. The current and future financial burden of hospital admissions for heart failure in Canada: a cost analysis. CMAJ Open, Volume 4, p. E365–E370.
Wijeysundera, Trubiani & Abrahamyan, 2012. Specialized multi-disciplinary heart failure clinics in Ontario, Canada: an environmental scan. BMC Health Serv Res, Volume 12, p. 236–247.