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Central West LHIN Catchment Consultation Study Wave II March 2009

Central West LHIN Catchment Consultation Study Wave II March 2009. 2. 69 Yonge St. Toronto, ON. M5E 1K3 • Tel. 416.815.0330 • Fax. 416.815.0393 • legermarketing.com. Agenda. Methodology Key Findings Conclusions Satisfaction and Confidence Ratings Awareness and Familiarity

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Central West LHIN Catchment Consultation Study Wave II March 2009

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  1. Central West LHINCatchment Consultation StudyWave II March 2009 2 69 Yonge St. Toronto, ON. M5E 1K3 • Tel. 416.815.0330 • Fax. 416.815.0393 • legermarketing.com

  2. Agenda • Methodology • Key Findings • Conclusions • Satisfaction and Confidence Ratings • Awareness and Familiarity • Priorities • Public Engagement and Demands • Communications • Awareness of Seniors Investment

  3. Methodology INSTRUMENT • Data collection for the study was conducted via CATI telephone interviewing between February 1st to February 20th, 2009. SCOPE • A randomly-selected, representative sample was achieved by inviting catchment residents aged 18 years of age and older to complete the survey. A total of 600 interviews were completed. The margin of error for a sample of this size is +/- 4.0%, 19 times out of 20. QUOTA REGIME AND WEIGHTING • In order to ensure the statistical reliability and comparability of regional results, a regional quota regime was employed as illustrated in the chart on the following slide. • However, the final data are statistically weighted using the most current Census and government data to ensure the results are representative of the actual population of the Central West LHIN catchment. REPORTING • A similar study took place in August 2006. Where possible results of this survey will be compared to this previous wave. • Throughout this report, an * will signify a statistically significant difference, to a 95% confidence level, between the two waves.

  4. Regional Breakdown

  5. Key Findings and Conclusions 2

  6. Key Findings While satisfaction with health care services remains high, there is less confidence that it will continue to get better • There is a mixed reaction on whether health care has improved or worsened, with one-quarter thinking it is better, one-quarter worse and the remainder saying it has stayed the same. • However, residents remain satisfied with the health care services in their area. There is a stronger satisfaction with the accessibility and efficiencies of these services than there was in 2006. • Confidence in the sustainability of this health care service has increased, however, there has been a decrease in the confidence of further improvements in the future. There has been little change in the awareness of LHINs • Both name and concept awareness of the Local Health Integration Networks remains low. However, fewer residents now say that they have never heard of them at all compared to the 2006 test. Instead, almost half say they are not at all familiar with it. • However, most of those who are familiar with LHIN are also aware of the Central West LHIN. Residents feel LHINs should focus on overall quality and accessibility, particularly of primary health care, cancer, cardiac and seniors care. • While all improvement strategies are rated important, improving the overall quality and accessibility of health care is seen as most important. However, there has also been a rise in the importance of sustainability. • Most health care services are also considered important, with primary health care being seen as the most important, followed by cancer, cardiac and seniors care. Not surprisingly, more family doctors will be an indication to residents that the LHIN is on the right track.

  7. Key Findings Residents continue to have high expectations of local health care • While four-fifth remain willing to travel outside their region for specialty health care, there is an even stronger importance on being able to received care in one’s own community, compared to 2006. Residents continue to want to be treated by a team, want health care focused on wellness, rather than illness and want help to manage complicated condition. The desire to play an active role in one’s own healthcare has increased since the first wave of study. Residents want communication and consultation, particularly through direct mail • Residents believe it is important that LHIN’s consult with the public as well as healthcare workers, and communicate their plans back to residents. • While doctors and newspapers remain the most used source of information about local health care services, there has been an increased use of the Internet in this role. Most say they would prefer a direct mail communication. There is low awareness of seniors investment • Most residents are unaware of the LHIN investment to support seniors living in their own home. Those who are aware of it, simply know that the government is supporting care to seniors to allow them to live at home.

  8. Conclusions • Overall, the Central West LHIN is managing health care services in its catchment area well, with residents having a high satisfaction with these services. In particular, satisfaction with accessibility and efficiencies has increased in the past three years. Residents believe that overall quality and accessibility of health care is of utmost importance, and these are two areas that residents of the Central West area are particularly satisfied with. • However, despite the fact that residents believe communication and consultation are important, awareness of the LHIN itself remains low, as does awareness in its investment to seniors. • Increased awareness in the LHIN, and its investments in healthcare, may help strengthen a waning confidence that the future of the health care system in the Central West catchment area can continue to improve.

  9. Detailed Results 2

  10. Satisfaction and Confidence Ratings 2

  11. A4. Overall would you say that the quality of health services in your community is better, about the same or worse than it was about three years ago? Base: All (n=600) Almost Half Feel Quality of Health Care has Remained the Same – Mixed Feeling From Remainder • While almost half believe the quality of healthcare has remained the same over the past three years, one-quarter feel it has improved and the same proportion feel it has worsened. • Residents of Caledon are most positive with 16% saying it is much better and only 8% saying it is worse. Men also feel more positively, with 28% saying it has improved. Better 24% Worse 25%

  12. A4. Overall would you say that the quality of health services in your community is better, about the same or worse than it was about three years ago? Base: All (n=600) Caledon/Bolton are Least Likely to Feel Service is Worse • Residents of Caledon/Bolton are less likely than those in Mississauga, Etobicoke, Woodbridge, and Brampton to feel the health services in their community is worse than it was three years ago. C C C C Significantly higher than B=Brampton, C=Caledon/Bolton, D=Dufferin, E=Etobicoke, M=Mississauga, W=Woodbridge at a 99 % Confidence level 12

  13. A5. Why do you feel that way?Base: Those who mentioned the quality of health services in their community was better (n=140)Base: Those who mentioned the quality of health services in their community was worse (n=134) Availability of Service Most Influential in Opinion of Change to Quality of Health Care in Past Three Years • When asked why they feel that the quality of health care has improved in the past three years, a new hospital was most often mentioned, particularly by residents of Brampton (36%) and Caledon (41%). • Availability also topped the list when examining reasons residents believed quality of service had gotten worse, particularly a lack of doctors and long wait times.

  14. A1a + A1b. Are there any other important health care issues in your area? (Total Mentions)Base: All (n=600) Wait Times Becomes Top of Mind Health Care Priority • In 2006, the availability of doctors was most often named the most important community health care issue. While that is still considered a priority to almost one-fifth, wait times was mentioned more often, with one-quarter feeling this is the most important priority. * * * * * Any other issues not listed above were mentioned by less than 5% of the respondents

  15. A1a + A1b. Are there any other important health care issues in your area? (Total Mentions)Base: All (n=600) Most Regions Have Similar Concerns • There were few differences in the areas of concern of the various regions within the Central West Catchment area. • However, residents of the Dufferin are most concerned about a lack of doctors than any other region * * * * * 15

  16. A2a. Overall, are you very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied with the following aspects of health care in your area? Base: All (n=600) Increase in Satisfaction of Health Care Accessibility and Efficiency • Satisfaction with community health care remains moderately high, with almost four-fifths being satisfied with the overall quality of this care. • While this has not changed significantly since 2006, residents are significantly more likely to say they are very satisfied with the accessibility and efficiencies of health care services. • Satisfaction with accessibility and coordination is highest in Etobicoke (76% and 73%) and Mississauga (75% and 76%) and lowest in Dufferin (59% and 61%). Men are also more satisfied with these aspects (accessibility 76%, coordination 75%), while 18-34 year olds are more satisfied with most aspects (accessibility 83%, efficiency 80%, coordination 80%). Overall satisfaction is similar across demographic sub-groups. % Very Satisfied Total Satisfied Wave IIWave I 79%77% * 71%68% 69%70% * 68%68%

  17. A2a. Overall, are you very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied with the following aspects of health care in your area? Base: All (n=600) While Satisfaction Has Increased, There is Less Hope for Future Change • While there has been a higher trend in satisfaction, and residents are more likely to be very confident that the health care system is sustainable, they are slightly less confident that there will be improvements in the future. Confidence in the vision for the future has decreased significantly. • Residents of Woodbridge are most confident in the vision for the future (64%), while Mississauga is least so (46%). Residents of Caledon are most likely to be very confident in improvement of overall quality (27%) and accessibility (25%), while this is felt much less in Brampton (15% and 14%) and Dufferin (14% and 11%). • Men, and residents between the ages of 18 and 34 are more likely to be confident about all aspects. Total Confident % Very Confident Wave IIWave I * 71%71% 63%67% 63%67% * 53%59%

  18. A2a. Overall, are you very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied with the following aspects of health care in your area? Base: All (n=600) Dufferin Region Less Satisfied with Accessibility and Coordination of Health Care Services and Providers • Residents of Dufferin are less satisfied with the overall accessibility of health care services and providers, with 59% being satisfied (significantly lower than results in Etobicoke and Mississauga) and 40% being dissatisfied (significantly higher than results seen in Brampton, Etobicoke or Mississauga). • Likewise, Dufferin residents are less likely to be satisfied with the overall coordination and integration of health care services and providers when compared to Mississauga. % Very/Somewhat Satisfied 18

  19. A2a. Overall, are you very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied with the following aspects of health care in your area? Base: All (n=600) All Regions Feel Similarly About the Sustainability and Future of Health Care in Their Area • Residents of all areas feel similarly about the sustainability of health care in their area, and that this health care will improve. % Very/Somewhat Satisfied 19

  20. LHIN Awareness and Familiarity 2

  21. B1. Over the past three years, have you seen, read, or heard anything about Local Health Integration Networks - also known as LHINs ('LINS')?Base: All (n=600) Awareness of LHINs Remains Consistent • Awareness of LHINs remains consistent to the 2006 findings, with 14% having seen, read or heard something about the Local Health Integration Network. • Awareness is highest in Dufferin (26%) and Caledon (23%). Women are more likely than men to have heard of them (19% vs. 9%) and 18 to 34 years are most likely to have not (95%).

  22. B1. Over the past three years, have you seen, read, or heard anything about Local Health Integration Networks - also known as LHINs ('LINS')?Base: All (n=600) Dufferin and Caledon/Bolton Lead for Awareness of LHINs CD CD D EMW EM Significantly higher than B=Brampton, C=Caledon/Bolton, D=Dufferin, E=Etobicoke, M=Mississauga, W=Woodbridge at a 99 % Confidence level 22

  23. B4a + B4b. And, what is the main thing that you have heard about LHINs? (Total Mentions)Base: Those aware of LHINs (n=83) Still Not Strong Awareness of What LHIN is (Among LHIN Aware) • Those who are aware of LHINs are not strongly aware of what a LHIN is. One-fifth understand that they are coordinating efforts and information of health care service providers, and that it is a new approach to health care, which is significantly higher than the finding in Wave I. Fewer people said it was moving to a team approach. * * * Any other issues not listed above were mentioned by 1% of the respondents or less

  24. Regional Breaks for Those Aware of LHINs Significantly higher than B=Brampton, C=Caledon/Bolton, D=Dufferin, E=Etobicoke, M=Mississauga, W=Woodbridge at a 99 % Confidence level B4a + B4b. And, what is the main thing that you have heard about LHINs? (Total Mentions)Base: Those aware of LHINs (n=83) 24

  25. B5. Thinking about this, are you very familiar, somewhat familiar, not very familiar, or not familiar at all with Local Health Integration Networks - also known as LHINs? Base: All (n=600) Aided Awareness and Familiarity Remains Low • Aided awareness of LHINs remains low, with one-quarter being at all familiar with the LHINs, with only 13% saying they are even somewhat familiar with it. • This awareness has not changed significantly since 2006, dropping only slightly. However, significantly more residents say they are not at all familiar with the LHINs in this test, while significantly less say they are unaware. * Aware 29%26% *

  26. Familiarity with LHINs is Similar Across Regions • Regionally, the low levels of familiarity are consistent across the areas. • Respondent in Etobicoke are significantly less familiar than those Mississauga, however Mississauga has the highest levels of respondents who are completely unaware of or have never seen, read or heard of the LHINs. M Significantly higher than B=Brampton, C=Caledon/Bolton, D=Dufferin, E=Etobicoke, M=Mississauga, W=Woodbridge at a 99 % Confidence level B5. Thinking about this, are you very familiar, somewhat familiar, not very familiar, or not familiar at all with Local Health Integration Networks - also known as LHINs? Base: All (n=600) 26

  27. B6. Thinking about this, are you very familiar, somewhat familiar, not very familiar, or not familiar at all with the Central West LHIN?Base: Those who have some familiarity with LHINs (n=159) Those Familiar with LHINs Also Familiar with Their Specific LHIN • Those residents who expressed some familiarity with LHINs were asked their familiarity with the Central West LHIN in particular. Seven-in-ten expressed some familiarity with it, with one-third saying they are at least somewhat familiar with it. • While one-quarter said they were not at all familiar with Central West LHIN, only 4% said they had never heard of it at all. Aware 71%

  28. Consistent Levels of Familiarity Across the Central West LHIN • Those residents who expressed some familiarity with LHINs were asked their familiarity with the Central West LHIN in particular. B6. Thinking about this, are you very familiar, somewhat familiar, not very familiar, or not familiar at all with the Central West LHIN?Base: Those who have some familiarity with LHINs (n=159) 28

  29. LHIN Priorities 2

  30. C1aa. For each, I would like you to tell me how important it is to you and the members in your household. Base: All (n=600) Increased Emphasis on Sustainability and Overall Quality • While all improvement strategies continue to be important to the vast majority of residents, the importance of improving overall quality of health care and ensuring sustainability of the health care system has increased significantly. • Improving overall quality of health care is particularly important to Etobicoke residents (92% very important), while focusing on health and wellness is of higher importance in Mississauga and Woodbridge (87% and 89% respectively rating it very important). Total Important % Very Important Wave IIWave I * 98%98% * 97%99% 99%99% 98%97%

  31. RegionalSummary of Important Issues • Residents of Woodbridge were significantly more likely to view accessibility to healthcare services and increasing the focus on health and wellness promotion and illness prevention, as important issues than those respondents in Dufferin. Very/Somewhat Important Significantly higher than B=Brampton, C=Caledon/Bolton, D=Dufferin, E=Etobicoke, M=Mississauga, W=Woodbridge at a 99 % Confidence level C1aa. For each, I would like you to tell me how important it is to you and the members in your household. SUMMARY TABLE OF IMPORTANT Base: All (n=600) 31

  32. C1b. And, of these overall improvement strategies, which ONE - if any - is the MOST important to you? Base: All (n=600) Access and Overall Quality Remain the Top Priority • As in the 2006 study, residents consider improving overall quality and accessibility to be the most important strategies, with importance of quality increasing somewhat. Focusing on health and wellness remains a second tier priority, while sustainability remains of tertiary importance. • Residents of Mississauga and Woodbridge are particularly concerned with improving overall health care (40% and 41% respectively), while a focus on wellness is of less importance in Woodbridge (7%). • Residents under the age of 54 place more importance on a focus on wellness (24%) than do those over 65 (12%).

  33. Overall Accessibility and Quality are Regionally the Most Important • Health and wellness promotion and illness prevention are significantly higher priorities for those respondents in Brampton (21%) and Etobicoke (22%) than those respondents in Woodbridge. Significantly higher than B=Brampton, C=Caledon/Bolton, D=Dufferin, E=Etobicoke, M=Mississauga, W=Woodbridge at a 99 % Confidence level C1b. And, of these overall improvement strategies, which ONE - if any - is the MOST important to you? Base: All (n=600) 33

  34. C4a + C4b. QC4A/QC4B: Ultimately, your LHIN’s vision is to foster a health care system in your area that will help keep people healthy, will get them good care when they are sick, and will be there for their children and grandchildren. Thinking about this, what would be the one LHIN accomplishment or initiative that you would have to hear about in order to consider your LHIN to be on the right track to improving health care in your area? Is there anything else? (Total Mentions) Base: All (n=600) Residents Continue to Request More Family Doctors • As with the 2006 study, more family doctors would be an accomplishment that would make people think that the LHIN was on the right track. • Residents are more likely this year to mention short wait times and more hospitals, and are less likely to mention better access and more public education. • More family doctors were mentioned most by residents of Dufferin (24%), while Woodbridge residents were more interested in seeing more hospitals (24%). * * * * * * Any other issues not listed above were mentioned by less than 5% of the respondents

  35. C1c. And now, I am going to read you some specific health care services. For each, I would like you to tell me how important it is to you and the members in your household. Base: All (n=600) Importance of Specific Health Care Service Remains High • As with the Wave I survey, the importance of specific health care services remains high, with the vast majority rating each at least somewhat important. However, health care for people with addictions is considered somewhat less vital with only half rating this very important. • The importance of primary health care services is paramount, with the proportion rating it very important increasing significantly since 2006. Likewise, residents are more likely to consider palliative care to be very important. Total Important % Very Important Wave IIWave I * 98%98% 95%98% 95%97% 91%91% 92%90% * 91%92% 85%81%

  36. C1c. And now, I am going to read you some specific health care services. For each, I would like you to tell me how important it is to you and the members in your household. Base: All (n=600) Cancer and Cardiac Care Also Considered Very Important • This year, residents were also asked to rate the importance of four new services. Of these, cardiac and cancer services are considering of utmost importance to four-fifths. While dialysis and orthopedic services are also considered important, they are not as strongly so. • Cancer services are of most importance to residents of Mississauga and Etobicoke (98% and 97% total important), orthopedic services are most important in Etobicoke and Dufferin (96% and 90% total important) and dialysis services are most important in Mississauga (91% total important). Total Important % Very Important 94% 95% 85% 90%

  37. Consistent Levels of Importance Across the Region • While all tested health care services are important across regions, residents of Caledon/Bolton find many of these services somewhat less important, particularly in comparison with Etobicoke residents. Very/Somewhat Important Significantly higher than B=Brampton, C=Caledon/Bolton, D=Dufferin, E=Etobicoke, M=Mississauga, W=Woodbridge at a 99 % Confidence level C1c. And now, I am going to read you some specific health care services. For each, I would like you to tell me how important it is to you and the members in your household. Base: All (n=600) 37

  38. C1e. And, of these specific health care services, which ONE - if any - is the MOST important to you? Base: All (n=600) Top Tier Importance: Primary Health Care Services • When asked which service is most important, primary health care services was mentioned most often. Second tier services are Cancer services, health care for seniors and health care for new mothers. One-in-ten believe cardiac care is most important. • While residents of Mississauga and Etobicoke are more likely to rate cancer care as important, they are least likely to say it is most important (8% and 11% respectively). Mississauga residents are more likely to rate health care for new mothers as the most important (25%).

  39. Regional Breaks for Most Important Health Care Services • Cancer services are significantly more important to residents in Caledon/Bolton (23%) and Woodbridge (24%), than those in Mississauga (8%). While residents of Mississauga place a much higher level of importance on Health care for new Mothers and their Children than every other region than Brampton. Significantly higher than B=Brampton, C=Caledon/Bolton, D=Dufferin, E=Etobicoke, M=Mississauga, W=Woodbridge at a 99 % Confidence level C1e. And, of these specific health care services, which ONE - if any - is the MOST important to you? 39

  40. Public Engagements and Demands 2

  41. C3aa. For each, please tell me if you strongly agree, somewhat agree, somewhat disagree, or strongly disagree with it. Base: All (n=600) Even Greater Importance on All Health Care in One Region • While results of the 2006 study saw a strong agreement that patients should not have to travel outside their region for any health care service, this has increased even further, with 84% agreeing with this strongly. As with Wave I results, approximately half agree strongly that they should not have to travel further than a neighbouring region to obtain even specialty care. • Residents are also more likely to strongly believe that patients need to take an active role in their own health. Total Agree % Agree Strongly Wave IIWave I * 96%96% 98%99% 92%n/a 97%96% * 94%95% 94%91% 81%78%

  42. Most Regions Feel Similarly Regarding Focus and Location of Health Care • Mississauga residents are less likely to feel that patient should have an active, empowered role in making decisions about their own health care, particularly when compared to Caledon/Bolton and Dufferin. Agree Strongly/Somewhat Significantly higher than B=Brampton, C=Caledon/Bolton, D=Dufferin, E=Etobicoke, M=Mississauga, W=Woodbridge at a 99 % Confidence level C3aa. For each, please tell me if you strongly agree, somewhat agree, somewhat disagree, or strongly disagree with it. 42

  43. C3b. What are the basic services that you feel need to be available in your local community? Base: Those who feel basic services need to be available in their community (n=487) Doctors Need to be Available • Those who felt that basic services needed to be available in their local community were asked what services should be available. A number of answers were given with doctors in general and family doctors in particular being mentioned most often. • One-in-ten felt their needed to be more walk-in clinics. A similar proportion mentioned better emergency and specialty services. Any other issues not listed above were mentioned by less than 2% of the respondents

  44. Regional Breaks for Basic Services You Feel Need to be Available in Your Area Significantly higher than B=Brampton, C=Caledon/Bolton, D=Dufferin, E=Etobicoke, M=Mississauga, W=Woodbridge at a 99 % Confidence level (PAGE 1 of 2) 44

  45. Communications 2

  46. D2. Thinking about your LHIN, I am going to read to you some communications and consultation initiatives it might do. For each, please tell me how important it is to you. Base: All (n=600) LHIN Communication and Consultation Equally Important • The vast majority if residents believe that consulting the public and health care service providers on decisions it makes about health care services as well as communicating these plans is important, with two-thirds saying each is very much so. • Residents of Etobicoke are more likely to feel that communicating these plans is important (96%). Total Important % Very Important 91% 91% 91%

  47. Regions Feel Similarly About LHINs Communication Plans Very/Somewhat Important Significantly higher than B=Brampton, C=Caledon/Bolton, D=Dufferin, E=Etobicoke, M=Mississauga, W=Woodbridge at a 99 % Confidence level D2. Thinking about your LHIN, I am going to read to you some communications and consultation initiatives it might do. For each, please tell me how important it is to you. Base: All (n=600) 47

  48. D1a + D1b. What is your main source of information about health care services or facilities in your community? Anything else? (Total Mentions)Base: All (n=600) Doctors and Newspapers Remain Primary Source of Information about LHINs • While residents continue to be most likely to get information about LHINs from doctors and newspapers, the likelihood of naming either source has decreased since 2006. This year, residents are more likely to name the Internet and word-of-mouth in general as their source of information. • Residents of Etobicoke and Dufferin are most likely to rely on doctors (36% and 30%) while residents of Brampton are least likely to (18%). Residents of Mississauga are most likely to look online (28%) while those in Dufferin are least likely to (3%). * * * * Any other issues not listed above were mentioned by less than 6% of the respondents

  49. D3. And, of the following, what method would you MOST prefer that your LHIN use to communicate such information to you? Would it be ...Base: All (n=600) Direct Mail Continues to be Preferred Method of Communication • As with the Wave I study, residents would most prefer that their LHIN communicate with them using direct mail, with newspapers and brochures being a secondary source of information. • Residents of Etobicoke would most like to see the information mailed to them (54%), while those in Dufferin would rather see it in the local newspaper.

  50. Regional Breaks – Most Preferred Communication Method • Information mailed directly to the home is the most preferred method in every region, with the exception of Dufferin; where the preferred method through the local community newspaper. Significantly higher than B=Brampton, C=Caledon/Bolton, D=Dufferin, E=Etobicoke, M=Mississauga, W=Woodbridge at a 99 % Confidence level D3. And, of the following, what method would you MOST prefer that your LHIN use to communicate such information to you? Would it be ...Base: All (n=600) 50

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