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Why Focus on Health Outcomes? a change in direction Inputs - resources needed to carry out a process or provide a service Outputs – the direct result of the interaction of inputs and processes in the system; the types and quantities of goods and services produced by a service .

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Why Focus on Health Outcomes? a change in direction

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Why Focus on Health Outcomes? a change in direction

Inputs - resources needed to carry out a process or provide a service

Outputs – the direct result of the interaction of inputs and processes in the system; the types and quantities of goods and services produced by a service.

a forty one billion dollar question


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The Measurement of Output and Productivity in the Health Care Sector in Canada: An Overview(Sharpe, Bradley and Messinger)

Conclusions:

  • Price indices for health care output may be overestimated

  • Better documentation of methodologies

  • Quality improvements are not captured

  • Not clear whether increased spending on health is due to higher prices or increasing quality and quantity


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What are Health Outcomes? Care Sector in Canada: An Overview

  • A measure of the effectiveness of our health care system and of the impact of public policies that influence health

  • The effect on health status from performance (or non-performance) of one or more processes or activities carried out by healthcare providers. USAID health and workforce improvement project

  • Health outcomes are used to examine the rate of death or illness (eg, the number of lung cancer deaths per 100,000 people).North Dakota health indicator glossary

  • A health outcome is: A change in the health of an individual, or a group of people or a population that is wholly or partially attributable to a health intervention or a series of interventions.Australian government website


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Choose outcomes that count Care Sector in Canada: An Overview

  • WHO estimates 1/3 of all social and economic costs to society are due to chronic diseases caused by tobacco, alcohol, high BP, high Cholesterol ad obesity

  • 30% of Canadian have at least one of seven high impact chronic health conditions and 1/3 of these people have multiple chronic health conditions


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Health Outcomes – the players Care Sector in Canada: An Overview

  • Public Policy Makers

  • Health Care System Managers

  • Health Care Providers

  • Individuals, families and communities


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Why Focus on Diabetes or Obesity? Care Sector in Canada: An Overview


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How do we provide care now? Care Sector in Canada: An Overview

Canadians with diabetes:

  • < 50% get all the recommended tests and procedures that experts recommend

  • > 50% have poor cardiovascular health

  • ~ 50% do not achieve recommended levels of blood sugar


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We know the problem Care Sector in Canada: An Overview


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Collaborative care makes a difference Care Sector in Canada: An Overview


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Effective health records Care Sector in Canada: An Overview

Australia Canada Germany Netherlands NZ UK US


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Quality Care makes a difference Care Sector in Canada: An Overview

*Quality – receives recommended tests and Rx over 5 yrs


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How can we do it better? Care Sector in Canada: An Overview

Move from find it, fix it to prevent it, find it, manage it


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Approaches to improving quality of care include effectively measuring outcomes

  • Teams: Interprofessional teams and case management improve quality of care

  • Technology: Electronic health records, reminder and clinical-support information systems can improve quality of care and outcomes

  • Tools: Training and support to set and monitor goals improves quality of care


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Conclusions measuring outcomes

  • Health care (not medical care) requires inter-sectoral cooperation as much as inter-provincial cooperation

  • Health care is a major contributor to the health of the economy and healthy communities are more viable

  • Health care with good outcomes is a contributor to society not a cost

  • We must have appropriate information systems to support health outcome assessment (Visa)

  • Concentrate on a few outcomes with the greatest impact

  • We need specific assessment of individuals within communities over time


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Thank You measuring outcomes

www.healthcouncilcanada.ca


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OECD Health Status Ranking measuring outcomes

Adapted from We Can do Better – Improving the Health of the American People. Steven A Shroeder.

Shattuck Lecture, N Engl J Med 357;12 September 20, 2007


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Number of US Deaths from Behavioral Causes, 2000 measuring outcomes(Mokdad et al)

We Can do Better – Improving the Health of the American People. Steven A Shroeder.

Shattuck Lecture, N Engl J Med 357;12 September 20, 2007


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Health Outcomes – measuring outcomesHealth Council of Canada


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