hcic 2018 master slide deck - mcgill university...2019/07/12 · pollara strategic insights has...
TRANSCRIPT
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Results of the 2018 Health Care in Canada SurveyA National Survey of Health Care Providers, Managers and the Public
August 22, 2018
https://www.mcgill.ca/hcic-sssc/
Disclaimer
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The information herein being shared is for educational purposes and is not
intended for publication without the prior consent of the Health Care in Canada
Knowledge Translation Committee. Contact coordinate: [email protected]
Pollara Strategic Insights has provided this master slide deck of 2018 HCIC results
which includes section summaries with their interpretations of key 2018 findings.
www.pollara.com
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• Canadian Cancer Society (CCS)• Canadian Home Care Association (CHCA)• Canadian Hospice Palliative Care Association (CHPCA) • Canadian Medical Association (CMA)• Canadian Nurses Association (CNA)• Canadian Pharmacists Association (CPhA)• Constance Lethbridge Rehabilitation Center (McGill University) • Health Charities Coalition of Canada (HCCC)• HealthCareCAN• Innovative Medicines Canada• Institute of Health Economics (IHE)• Merck Canada • Studer Group Canada• POLLARA• CareNet / Strive Health
HCIC Members 2018
https://www.mcgill.ca/hcic-sssc/about-us
• Results derived from online survey questionnaires (POLLARA)• Conducted April to May 2018• With nationally representative samples of:
• Canadian adult public, doctors, nurses, pharmacists, administrators, other health care providers (including nutritionists/dieticians, occupational therapists, physical therapists, psychologists and social workers.)
• As a guideline, margins of error for comparable probability samples for each sample group are illustrated below:
Groups Sample Size ComparableMargin of Error
Public 1500 + 2.5%Doctors 100 + 9.8%Nurses 100 + 9.8% Pharmacists 100 + 9.8% Administrators 100 + 9.8%Other Providers 100 n/a
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Methodology
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5
Key Sections Public Professionals
Trends in quality of and access to care Trends in quality of and access to careHealth status Health status / workplace engagement
Chronic disease Prevalence Management
PharmacarePatient-centred care
Chronic disease Management
PharmacarePatient-centred care
End of Life Options End of Life Options
eHealth eHealth
Caregiving Opioids
Future innovations Future Innovations
TrendsWhere Were We?
Where Are We Now?
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61%
58%
58%
57%
55%
58%
53%
36%
37%
38%
37%
37%
38%
42%
2018
2016
2013
2007
2006
2003
2002
Receiving Quality Health Care Not Receiving Quality Health Care
7QB1: Overall, would you say that Canadians are or are not receiving quality health care services right now? (n=1500)
Quality of Care – In General Public Perceptions
8QB1: Overall, would you say that Canadians are or are not receiving quality health care services right now? (n=1500)
Quality of Care – By RegionPublic Perceptions
59%
61%
52%
65%
64%
52%
38%
38%
40%
32%
32%
43%
BC
Alberta
Prairies
Ontario
Quebec
Atlantic
Receiving Quality Health Care Not Receiving Quality Health Care
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9*NOTE: Name changed in 2018 previously Allied ProfessionalsQB1: Overall, would you say that Canadians are or are not receiving quality health care services right now? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers* (n=100)
Quality of Care – In GeneralProfessional Perceptions
72%
58%
67%
74%
56%
Doctors
Nurses
Pharmacists
Administrators
Other Provider*
2016 2013 2007 2006 2003 2002
77% 76% 72% 78% 70% 72%
46% 62% 66% 66% 58% 64%
75% 75% 76% 80% 74% 81%
69% 73% 91% 86% 88% 74%
52% NA NA NA NA NA
2018
NOTE: Responses less than 3% in 2018 not shownQB2: What is the most important health care issue facing Canada today? (n=1500)
Most Important Care IssuesPublic Perceptions
10
43%
14%
13%
8%
8%
4%
4%
3%
Wait times
Availability/Accessibility
Shortage of doctors
Aging population
High cost of care
Shortage of staff
Quality of care
Health coverage
2016 2013 2007 2000 1999 1998
36% 31% 20% 7% 6% 4%
11% 5% n/a n/a n/a n/a
13% 16% 19% 5% 5% 3%
10% 8% 8% 5% 5% 5%
7% 8% n/a n/a n/a n/a
3% 3% 3% 10% 4% 2%
6% 1% n/a n/a n/a n/a
n/a n/a n/a n/a n/a n/a
2018
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NOTE: Responses less than 3% not shownQB2: What is the most important health care issue facing Canada today? (n=1500)
Most Important Care Issue – By Region Public Perceptions
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BC AB Prairies ON PQ Atl
43% 49% 46% 40% 47% 34%
10% 10% 15% 14% 23% 11%
21% 4% 7% 12% 11% 25%
9% 8% 6% 13% 3% 8%
9% 11% 9% 9% 3% 6%
2% 1% 1% 3% 8% 4%
1% 4% 9% 5% 2% 2%
3% 6% 1% 2% 0% 7%
2018 Overall
43%
14%
13%
8%
8%
4%
4%
3%
Wait times
Availability/Accessibility
Shortage of doctors
Aging population
High cost of care
Shortage of staff
Quality of care
Health coverage
Wait times
Availability/Accessibility
Lack of funding
Shortage of doctors
Aging population/ Seniors
Health coverage
High cost of care
Shortage of staff
Quality of care
QB2: What is the most important health care issue facing Canada today? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)
Most Important Care Issue Professional Perceptions
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31%
30%
14%
14%
15%
7%
6%
2%
3%
37%
27%
5%
6%
9%
5%
3%
10%
9%
34%
18%
12%
11%
9%
16%
10%
6%
1%
31%
13%
6%
7%
0%
3%
9%
6%
6%
Doctors Nurses Pharmacists Administrators
41%
27%
11%
3%
6%
4%
1%
1%
4%
Other Providers
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QB5: Which of the following do you use regularly to get health care information? (n=1500)
Sources of Health Care InformationPublic Perceptions
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61%
48%
37%
27%
19%
16%
16%
15%
15%
12%
5%
6%
My primary care provider
Google or other online search engine
Family members or friends
Web MD (Website)
Other health care providers (not primary)
Print media like books, journals, newspapers or magazines
Other website
Fellow patients or others with similar health conditions
Broadcast media like radio and TV
Wikipedia
Other
I do not access health care information
Source of Information about Health Care
66%HCP
62%Internet
19%Media
Wait times continue to negatively impact the perception of the quality of health care in Canada
• Six in ten Canadians believe they are receiving quality health care, which has been a consistent finding for the past 15 years. Wait times continues to be the biggest challenge our health care system faces, with perceptions of this problem getting worse year over year.
• Regionally, those in Canada’s most populous provinces, Quebec and Ontario, have the most optimistic view, with almost two thirds saying they are receiving quality care. This compares to only half of those living in Atlantic and Prairie provinces holding this view.
• Doctors and administrators remain more optimistic about the quality of Canadians’ health care than the general public. While pharmacists are also slightly more optimistic than the general population, they are less optimistic than they have been since tracking began. Both nurses and other providers are slightly less optimistic than the general population this year; however, their opinions have shifted somewhat more positive compared to 2016.
• While wait times are also thought to be an issue to the professional groups, they also think access and availability affects the quality of health care in Canada.
• The main sources of information about health care for Canadians are health care providers and the Internet, with health care providers being used slightly more often.
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AccessWhat Care Is All About
QE1. For each of the following, please indicate whether timely access over the past five years has improved, worsened or remained the same. (n=1500)
Timely Access to CarePublic Perceptions
16
10%38%
19%15%13%13%13%12%12%
10%9%8%6%6%
37%35%
27%32%
20%24%
34%35%
33%23%
30%25%28%
21%
47%15%
21%48%
39%22%
25%34%
45%31%
53%59%
50%43%
6%12%
33%6%
27%40%
28%19%
10%37%
8%8%
16%30%
Health Care system in general
Pharmacists primary care services
Nurse practitioner
Family doctors
Mental health services
Hospice palliative and end-of-life care
New medicines
Treatments
Diagnostic procedures
Home care services
Emergency dept care
Specialists
Non-urgent surgery
Long term care
Improved Remained the same Worsened Don't know
Timely access to... 2018 2016 2013
-37% -35% -39%23% 21% NA-3% -4% NA
-33% -35% -41%-26% -29% -32%-9% -13% -19%
-12% -11% -14%-23% -22% NA-33% -28% -34%-21% -26% -24%-44% -39% NA-51% -49% -45%-43% -37% -40%-37% -36% -37%
Net Momentum
NOTE: Net Momentum equals Total Improve minus Total Worsen
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NOTE: Net Momentum equals Improve minus WorsenQE1. For each of the following, please indicate whether timely access over the past five years has improved, worsened or remained the same. (n=1500)
Timely Access to Health Care System in GeneralPublic Perceptions – By Region
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Negative Net Momentum
-37%Overall
-40%
-42%
-26%
-34%
-34%
-51%
BC
Alberta
Prairies
Ontario
Quebec
Atlantic
QE1. For each of the following, please indicate whether timely access over the past five years has improved, worsened or remained the same. Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)
Timely Access to Health Care System in GeneralProfessional Perceptions
18
10%
16%
11%
39%
7%
19%
25%
29%
18%
28%
70%
59%
58%
43%
59% 6%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
Improved Remained the same Worsened Don't know
Negative Net Momentum2018 2016 2013
-60% -25% -28%
-43% -36% -27%
-47% -32% -30%
-4% -19% -19%
-52% -37% NA
Net Momentum
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QE1. For each of the following, please indicate whether timely access over the past five years has improved, worsened or remained the same. Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)
Timely Access to Care - Health Care ProfessionalsProfessional Perceptions
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Improved Remained the same Worsened Don’t knowImproved Remained the same Worsened Don’t know
Family doctor
14%
18%
14%
35%
15%
24%
17%
30%
32%
17%
60%
65%
53%
30%
66%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
NetMomentum
-46%
-47%
-39%
5%
-51%
Nurse practitioner
31%
43%
45%
30%
45%
24%
27%
21%
34%
14%
17%
20%
11%
32%
12%
28%
10%
23%
4%
29%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
NetMomentum
+14%
+23%
+34%
-2%
+33%
Primary care by pharmacists
51%
44%
65%
32%
53%
22%
24%
21%
36%
24%
15%
21%
10%
29%
14%
12%
11%
3%
9%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
NetMomentum
+36%
+23%
+55%
+3%
+39%
Specialists
8%
10%
6%
25%
6%
15%
18%
32%
34%
23%
74%
70%
57%
40%
68%
3%
5%
3%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
NetMomentum
-66%
-60%
-51%
-15%
-62%
QE1. For each of the following, please indicate whether timely access over the past five years has improved, worsened or remained the same. Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)
Timely Access to Care - Facilities for CareProfessional Perceptions
20
Care in emergency departments
11%
11%
17%
37%
11%
27%
24%
26%
36%
24%
58%
63%
52%
25%
51%
4%
5%
14%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
NetMomentum
-47%
-52%
-35%
+12%
-40%
Hospice palliative and end-of-life care
24%
22%
23%
36%
25%
26%
23%
36%
27%
25%
34%
30%
30%
32%
24%
16%
25%
11%
5%
26%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
NetMomentum
-10%
-8%
-7%
+4%
+1%
Home care services
13%
13%
19%
27%
12%
23%
26%
27%
35%
22%
50%
51%
39%
35%
48%
14%
10%
15%
3%
18%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
NetMomentum
-37%
-38%
-20%
-8%
-36%
Long term care
5%
10%
6%
32%
4%
19%
18%
22%
30%
16%
66%
62%
60%
35%
66%
10%
10%
12%
3%
14%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
NetMomentum
-61%
-52%
-54%
-3%
-62%
Improved Remained the same Worsened Don’t knowImproved Remained the same Worsened Don’t know
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QE1. For each of the following, please indicate whether timely access over the past five years has improved, worsened or remained the same. Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)
Timely Access to Care - Care ServicesProfessional Perceptions
21
Mental health service
9%
15%
15%
41%
12%
15%
24%
16%
22%
13%
65%
51%
58%
34%
64%
11%
10%
11%
11%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
NetMomentum
-56%
-36%
-43%
+7%
-52%
Non-urgent surgery
9%
5%
32%
5%
21%
27%
30%
33%
22%
68%
58%
48%
34%
57%
9%
6%
17%
16%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
NetMomentum
-66%
-49%
-43%
-2%
-52%
Improved Remained the same Worsened Don’t knowImproved Remained the same Worsened Don’t know
QE1. For each of the following, please indicate whether timely access over the past five years has improved, worsened or remained the same. Doctor (n=102), Nurse (n=102), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)
Timely Access to Care - Test and TreatmentsProfessional Perceptions
22
New medicines
13%
29%
22%
33%
21%
35%
35%
41%
33%
23%
46%
30%
31%
32%
24%
6%
6%
6%
32%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
NetMomentum
-33%
-1%
-9%
+1%
-3%
Diagnostic procedures or screening tests
19%
20%
19%
35%
18%
28%
28%
35%
37%
22%
52%
50%
40%
27%
54%
6%
6%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
NetMomentum
-33%
-30%
-21%
+8%
-36%
Access to treatments
6%
15%
8%
33%
16%
31%
36%
35%
21%
28%
55%
44%
44%
44%
49%
8%
5%
13%
7%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
NetMomentum
-49%
-29%
-36%
-11%
-33%
Improved Remained the same Worsened Don’t knowImproved Remained the same Worsened Don’t know
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QF1: To what extent would you support or oppose each of the following policies to increase access to health professionals using a scale from one to 10, where one means you would ‘strongly oppose’ it and 10 means you would ‘strongly support’ it? (n=1500)
Access Improvement ProposalsPublic Perceptions
23
Mean
53%
46%
36%
36%
33%
29%
25%
16%
27%
27%
32%
30%
27%
29%
26%
21%
10%
15%
18%
17%
20%
21%
23%
21%
2%
5%
4%
8%
7%
8%
10%
15%
6%
7%
7%
19%
6%
6%
7%
5%
7%
6%
9%
7%
Encouraging health professionals to work in teams with other types of health care providers
Increasing medical and nursing school enrolment levels
Investing in formal training and development so health professionals are better equipped to coordinate patient …
Enabling health professionals (nurses and pharmacists) to expand roles re: diagnose, treat, prescribe medications, etc.
Recruiting health professionals back from the US
Making it easier for foreign trained doctors to practice in Canada
Mandating that designated health professionals work in underserviced rural and remote locations
Requiring patients to register with one family doctor or other primary health care professional
Strongly Support (9,10) Somewhat Support (7,8) Neutral (5,6)
Somewhat Oppose (3,4) Strongly Oppose (1,2) Don't know 2018 2016 2013 2007
8.4 7.7 7.5 7.7
8.0 7.8 7.9 8.4
7.7 7.5 NA NA
7.4 7.4 6.7 NA
7.2 7.2 7.3 7.3
6.9 7.0 6.9 7.5
6.7 7.0 6.8 6.2
5.5 5.8 6.2 6.0
QF2. Which three policies would you say are most important to increase access to health professionals? Please choose up to three options. (n=1500)
Most Important Access Improvement ProposalPublic Perceptions
24
54%
51%
47%
37%
28%
25%
23%
17%
4%
Encouraging health professionals to work in teams with other types of health care providers
Enabling health professionals (nurses and pharmacists) to expand roles re: diagnose, treat, prescribe medications, etc
Increasing medical and nursing school enrolment levels
Making it easier for foreign trained doctors to practice in Canada
Investing in formal training and development so health professionals are better equipped to coordinate patient care
Recruiting health professionals back from the US
Mandating that designated health professionals work in underserviced rural and remote locations
Requiring patients to register with one family doctor or other primary health care professional
No other policies are important to me
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QF1: To what extent would you support or oppose each of the following policies to increase access to health professionals using a scale from one to 10, where ones means you would ‘strongly oppose’ it and 10 means you would ‘strongly support’ it? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)
Access Improvement ProposalsProfessional Perceptions
25
37%
49%
32%
28%
36%
35%
64%
69%
35%
62%
23%
28%
26%
48%
33%
29%
21%
22%
47%
24%
22%
12%
23%
19%
18%
23%
10%
6%
18%
8%
9%
8%
11%
5%
8%
3%
3%
6%
5%
9%
3%
3%
3%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
Doctors
Nurses
Pharmacists
Administrators
Other Providers
Strongly Support (9,10) Somewhat Support (7,8) Neutral (5,6)
Somewhat Oppose (3,4) Strongly Oppose (1,2) Don't know
2018 2016 2013 2007 2006 2005
7.1 6.2 6.5 8.2 8.4 NA
7.9 7.5 7.7 9.1 8.8 NA
6.9 6.8 7.0 8.0 7.9 NA
7.5 7.3 7.3 8.7 8.2 NA
7.5 7.2 NA NA NA NA
7.3 6.2 6.3 6.3 6.1 6.0
8.7 8.3 8.5 8.6 8.7 8.3
8.8 7.6 8.0 8.1 8.4 8.3
7.8 7.9 8.3 8.8 8.9 8.6
8.7 8.0 NA NA NA NA
MeanIncreasing medical and nursing school enrolment levels
Encouraging health professionals to work in teams with other types of health care providers
15%
22%
26%
27%
16%
14%
47%
54%
20%
27%
14%
27%
26%
44%
29%
16%
28%
20%
54%
37%
33%
19%
27%
25%
21%
18%
12%
12%
17%
17%
9%
17%
13%
13%
22%
4%
6%
7%
29%
13%
5%
18%
26%
3%
6%
3%
4%
7%
10%
5%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
Doctors
Nurses
Pharmacists
Administrators
Other Providers
Strongly Support (9,10) Somewhat Support (7,8) Neutral (5,6)
Somewhat Oppose (3,4) Strongly Oppose (1,2) Don't know
QF1: To what extent would you support or oppose each of the following policies to increase access to health professionals using a scale from one to 10, where ones means you would ‘strongly oppose’ it and 10 means you would ‘strongly support’ it? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)
Access Improvement ProposalsProfessional Perceptions
26
Mandating that designated health professionals work in underserviced rural and remote locations
Enabling health professionals such as nurses and pharmacists to expand their existing roles further in diagnosing patients, treating illnesses and prescribing medications, etc.
2018 2016 2013 2007 2006 2005
5.0 4.2 4.1 3.9 3.7 4.7
6.1 5.2 4.9 5.9 6.3 6.1
6.7 6.1 6.7 6.0 5.9 6.6
7.4 6.4 6.1 5.9 6.3 6.4
5.7 5.8 NA NA NA NA
4.8 4.4 3.8 NA NA NA
8.1 8.2 7.2 NA NA NA
8.4 8.3 8.4 NA NA NA
7.1 7.1 6.2 NA NA NA
7.1 7.0 NA NA NA NA
Mean
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18%
27%
15%
22%
29%
18%
21%
18%
26%
22%
24%
31%
23%
40%
19%
22%
32%
24%
41%
28%
29%
27%
40%
34%
17%
27%
28%
20%
25%
26%
8%
6%
8%
11%
11%
15%
19%
4%
13%
18%
6%
10%
17%
18%
17%
3%
9%
3%
4%
6%
4%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
Doctors
Nurses
Pharmacists
Administrators
Other Providers
Strongly Support (9,10) Somewhat Support (7,8) Neutral (5,6)
Somewhat Oppose (3,4) Strongly Oppose (1,2) Don't know
*Wording change 2007=“Requiring health professionals to work in specific geographic areas”QF1: To what extent would you support or oppose each of the following policies to increase access to health professionals using a scale from one to 10, where ones means you would ‘strongly oppose’ it and 10 means you would ‘strongly support’ it? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)
Access Improvement ProposalsProfessional Perceptions
27
Recruiting health professionals back from the U.S.
Making it easier for foreign trained doctors to practice in Canada
2018 2016 2013 2007 2006 2005
5.8 5.0 5.8 7.0 NA NA
6.9 6.1 6.6 7.8 NA NA
6.0 5.8 6.1 7.4 NA NA
7.2 6.7 6.9 7.3 NA NA
6.2 6.5 NA NA NA NA
5.6 4.3 5.4 6.4 6.4 NA
6.5 5.7 5.7 7.3 7.7 NA
5.6 5.3 5.2 6.8 7.0 NA
7.1 6.4 6.3 7.3 7.8 NA
6.4 6.4 NA NA NA NA
Mean
21%
26%
16%
27%
13%
26%
45%
33%
27%
38%
30%
27%
29%
38%
22%
33%
23%
38%
47%
28%
19%
22%
27%
26%
23%
23%
23%
18%
24%
18%
19%
16%
13%
4%
14%
12%
3%
8%
10%
10%
8%
14%
5%
24%
6%
4%
3%
3%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
Doctors
Nurses
Pharmacists
Administrators
Other Providers
Strongly Support (9,10) Somewhat Support (7,8) Neutral (5,6)
Somewhat Oppose (3,4) Strongly Oppose (1,2) Don't know
QF1: To what extent would you support or oppose each of the following policies to increase access to health professionals using a scale from one to 10, where ones means you would ‘strongly oppose’ it and 10 means you would ‘strongly support’ it? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)
Access Improvement ProposalsProfessional Perceptions
28
Requiring patients to register with one family doctor orother primary health care professional (e.g. nurse practitioner)
Investing in formal leadership training and development so HCPs are better equipped to coordinate patient care among a team of health professionals
2018 2016 2013 2007 2006 2005
6.1 5.8 6.0 5.9 6.1 5.5
6.5 6.2 6.4 6.6 7.8 7.5
5.8 6.1 6.4 6.0 7.4 7.4
7.1 5.9 6.3 6.6 7.4 7.1
5.2 5.3 NA NA NA NA
6.7 6.3 NA NA NA NA
7.8 7.9 NA NA NA NA
7.5 7.1 NA NA NA NA
7.5 8.0 NA NA NA NA
7.4 7.7 NA NA NA NA
Mean
18-08-22
15
Increase medical and nursing school enrolment levels
Encouraging health professionals to work in teams with other types of health care providers
Recruiting health professionals back from the US
Making it easier for foreign trained doctors to practice in Canada
Mandating that designated health professionals work in underserviced rural and remote locations
Enabling health professionals (nurses and pharmacists) to expand their roles re: diagnosing,
treating, prescribing medications, etc.
Requiring patients to register with one family doctor or other primary health care professional
Investing in formal leadership training and development
No other policies are important to me
QF2. Which three policies would you say are most important to increase access to health professionals? Please choose up to three options.Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)
Most Important Access Improvement ProposalProfessional Perceptions
29
55%
67%
20%
28%
21%
21%
31%
35%
12%
Doctors Nurses Pharmacists Administrators Other Providers
43%
62%
17%
20%
21%
65%
23%
38%
3%
27%
69%
6%
12%
34%
86%
24%
26%
2%
36%
38%
32%
38%
25%
44%
34%
43%
2%
49%
70%
14%
28%
20%
56%
10%
37%
6%
1
2
1 1
12 2
2
2
1
NOTE: Net Momentum equals Total Improve minus Total WorsenQB3: Over the next five years, do you believe that Canadians’ access to the following will significantly improve, somewhat improve, somewhat worsen or significantly worsen? (n=1500)
Future of Health CarePublic Perceptions
30
4%
4%
29%
41%
38%
35%
18%
9%
10%
11%
Timely Health Care Services
Quality of Health Care Services
Significantly improve Somewhat Improve Somewhat Worsen Significantly worsen Don’t know
2018 2016 2013
-23% -21% -24%
0% 0% -4%
Net Momentum
Perceptions of Health Care over Next 5 Years
18-08-22
16
NOTE: Net Momentum equals Total Improve minus Total WorsenQB3: Over the next five years, do you believe that Canadians’ access to the following will significantly improve, somewhat improve, somewhat worsen or significantly worsen? (n=1500)
Future of Health Care Access – By Region Public Perceptions
31
Timely Health Care Services Quality Health Care Services
-31%
-30%
-21%
-26%
-8%
-24%
BC
Alberta
Prairies
Ontario
Quebec
Atlantic
-11%
-12%
-1%
0%
13%
11%
QB3: Over the next five years, do you believe that Canadians’ access to the following will significantly improve, somewhat improve, somewhat worsen or significantly worsen? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)
Future of Health Care Access Professional Perceptions
32
Tim
ely
Heal
th C
are
Serv
ices
Qual
ityHe
alth
Car
e Se
rvice
s
1%
6%
1%
20%
5%
6%
1%
24%
19%
28%
21%
38%
22%
27%
44%
37%
52%
43%
40%
45%
63%
31%
51%
41%
39%
49%
16%
38%
34%
18%
9%
9%
18%
19%
7%
6%
7%
9%
6%
3%
6%
2%
9%
8%
4%
7%
1%
10%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
Doctors
Nurses
Pharmacists
Administrators
Other Providers
Significantly improve Somewhat improve Somewhat worsen Significantly worsen Don't know 2018 2016 2013
-54% -42% -41%
-29% -53% -34%
-50% -54% -36%
+18% -28% -17%
-47% -50% NA
-28% -32% -7%
+4% -31% -19%
-17% -4% =
+53% +7% +17%
-4% -21% NA
Perceptions of Health Care over Next 5 Years
Net Momentum
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17
Timely access remains a concern to Canadians and providersand is thought to be getting worse
• Generally, Canadians feel that timely access to health care has gotten worse in the past five years. Results are similar to the 2016 and 2013 findings, showing at best stagnation in efforts, and at worst, a health care system that continues to fail to provide the timely care Canadians expect.
• Access to pharmacists and nurse practitioners is rated highest and most likely to have seen improvements.
• Timely access to hospice palliative / end-of-life care and to mental health services have seen some positive net momentum in the past five years, while timely access to other health care services and providers are either seen to have declined slightly more, or stayed the same.
• There is an apparent lack of access to many areas of health care, which is leading to general pessimism. Specific areas that have been on the steadiest decline in the minds of the general public and health care professionals are, in order of worse net momentum (most decline), the access to:
• Specialists• Emergency care• Non-urgent surgery• Long term care• Diagnostic procedures• Family doctors
33
Canadians are not optimistic about future access; team care seen as the most important factor to drive improvements
• When it comes to the future, the majority of Canadians feel that access to timely health care will get worse in the next 5 years. However, they are mixed on whether the quality of health care services will get better or worse.
• Health care professionals also agree that timely access to health care has declined in the past five years. While doctors areparticularly pessimistic about changes to the system, nurses, pharmacists and other providers are also seeing more negative momentum than they did in the past.
• Of all suggested policies that may help improve access to the system, the Canadian public most supports team care, attracting and training more health care professionals and expanding the roles and duties of nurses and pharmacists.
• The idea of health care teams is also gaining support among professionals, in particular among doctors and pharmacists. While a majority of nurses, pharmacists and other providers would like to see themselves take on more roles traditionally only doctors are allowed to do, such as diagnosing, treating and prescribing medications, this is not something most doctors find important.
34
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18
Personal Health /Engagement
Status / Impact
35
QG1: In general, how would you rate your health? (n=1500)
Personal HealthPublic Perceptions
36
3% 4% 6% 4%11% 10%
15%12%
34% 34%
39%
27%
39% 40%
34%
39%
14% 12%6%
18%
2018 2016 2013 2007
Excellent
Very Good
Good
Fair
Poor
18-08-22
19
QG1: In general, how would you rate your health? (n=1500)
Personal HealthPublic Perceptions - By Region
37
3% 3% 3% 3%
12% 12% 12% 10% 10% 12%
30% 37% 35% 35% 36%28%
41% 35% 32% 40% 37%43%
14% 15% 19%12% 13% 15%
BC Alberta Prairies Ontario Quebec Atlantic
Excellent
Very Good
Good
Fair
Poor
QG1: In general, how would you rate your health? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers Professional (n=100)
Personal HealthProfessional Perceptions
38
8%2% 9% 4% 3%
35%
29%24% 30%
18%
29%48% 51%
42%49%
25% 20% 16%24% 28%
Doctor Nurse Pharmacist Administrator Other Providers
Excellent
Very Good
Good
Fair
Poor
18-08-22
20
QG2. In general, how would you rate your level of engagement in your current job using a scale from one to 10, where one means your level of engagement is “very poor” (i.e., with long-term exhaustion, cynicism and inefficiency) and 10 means your level of engagement is “excellent” (i.e., with high energy, involvement and performance efficacy)? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers Professional (n=100)
Level of Job EngagementProfessional Perceptions
39
11% 6% 6% 5%
10%12% 17%
8%12%
42% 47%
53%69%
44%
37% 35%24% 23%
39%
Doctor Nurse Pharmacist Administrator Other Providers
Very good (9-10)
Good (7-8)
Fair (5-6)
Poor (1-4)
Don't know
Increased stress in my workplace
Lack of meaningful voice within the organization
Decreased sense of empowerment in my work
Increased workload
Relentless change in my workplace
Functionally disorganized workplace
QG3. Please rate the following factors using a scale from one to 10, where one means it is “not a contributing factor” to lesser workplace engagement and 10 means it is a “major contributing factor.”Less Engaged: Doctor (n=86), Nurse (n=89), Pharmacist (n=91), Admin (n=98), Other Providers (n=85)
Factors Contributing to Work Place DisengagementProfessional Perceptions
40
38%
30%
29%
27%
27%
21%
33%
30%
22%
40%
33%
33%
40%
25%
21%
34%
40%
22%
23%
28%
15%
52%
45%
15%
25%
28%
19%
27%
27%
21%
Doctors Nurses Pharmacists Administrators Other ProvidersMajor Factor (9-10)
18-08-22
21
My patients (NET impact)
Health in general
Quality of life
Mental health
I do not think I have impacted any patient outcomes through
my work in the past week
QG4. Thinking about your most recent week at work, what patient outcomes do you think you have impacted through your work? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)
Impact on Patient OutcomesProfessional Perceptions
41
89%
76%
58%
51%
11%
92%
72%
70%
54%
8%
85%
79%
59%
33%
15%
76%
58%
63%
42%
24%
93%
56%
77%
56%
7%
Doctors Nurses Pharmacists Administrators Other Providers
Have Impacted Patient Outcomes in the Past Week
42
Most Canadians, as well as health care providers, continue to rate their health as good to excellent, yet providers are feeling stressed, overworked.
• Just over half of Canadians describe their health as very good (four in ten) or excellent (one in seven), which is unchanged since 2016.
• Health care providers continue to view their overall health more positively than general Canadians, with around a quarter of doctors, administrators and other providers, and one in five nurses and pharmacists saying they are in excellent health. While this is higher than perceptions of the general public, it is lower than what they rated their health in 2016.
• Overall, health care providers continue to feel a high level of engagement, with their jobs with between nine-in-ten (administrators) and eight-in-ten (doctors and pharmacists) rating it at least good.
• Increased workload and increased stress are the most prominent reasons for a lack of engagement among most professionals.
• Most professionals feel they have a weekly impact on the general health and quality of life of their patients.
18-08-22
22
Chronic DiseaseBurden / Management
43
Heart disease, high cholesterol,stroke or high blood pressure
Arthritis
Asthma, bronchitis or emphysema
A mental health condition
Diabetes
Cancer
Osteoporosis
A memory problem that interfereswith day-to-day function
Any other chronic health condition
None of the above
QG5. Have you or has anyone in your household, been diagnosed by a health care professional (e.g., physician, nurse practitioner) with any of the following? (n=1500)
Prevalence of Chronic DiseasesPublic Perceptions
44
22%
17%
14%
13%
8%
7%
5%
2%
10%
47%
26%
16%
12%
12%
14%
12%
8%
6%
7%
49%
58%
70%
75%
78%
79%
82%
87%
92%
84%
1%
Myself
OtherIn HH
NONEIn HH
18-08-22
23
QG6. Please consider the condition(s) that you personally have been diagnosed with. Do you work with a doctor or other health care professional(s) to manage your condition(s)?(Those with a chronic condition n=824)
Health Care Providers for Chronic ConditionsPublic Perceptions
45
89%
22%
11%
6%
5%
1%
16%
5%
Doctor
Pharmacist
HCP team that works together about your personal health care
Nurse practitioner
Registered nurse
A health navigator
Other health care professional(s)
None of the above
Health Care Providers Used for Chronic Conditions
Inadequate access to care
Poor patient adherence to treatment regimen
Non-diagnosis of disease
Inadequate prescribing of medications
Other
Don't know
QP1. It has been estimated that half of all Canadian adults have one or more chronic diseases. Many of these Canadians are experiencing care gaps, or gaps between recommended care and the care actually received. Which one of the following do you see as the primary cause of these care gaps?Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)
Improving Chronic Care - Identifying Care Gap Causes Professional Perceptions
46
46%
35%
6%
3%
6%
4%
Doctors Nurses Pharmacists Administrators Other Providers
53%
24%
9%
7%
6%
1%
46%
33%
7%
3%
5%
6%
42%
14%
11%
29%
2%
2%
Primary Cause of Gaps
62%
18%
4%
2%
12%
2%
18-08-22
24
QP2. Do you work with at least one other health care professional on a routine basis for the care of your patients? Work together means you communicate with and coordinate the care of your patients.Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)
CollaborationProfessional Realities
47
91%
99%
84%
93%
77%
Doctor
Nurse
Pharmacist
Administrator
Other Providers
Incidence of Working in Teams
QG10. As a direct result of your chronic condition(s), over the past 12 months, how many times were you…? n=821)
Part of the Burden - Acute Care Needs Public Perceptions
48
17% Admitted to ER
89%
7%
3%
0%
0%
None
Once
2 to 5 times
6 to 10 times
More than 10 times
83%
10%
6%
0%
0%
11% Hospitalized
Average Number of Hospitalizations – 0.21
Average Number of ER Visits – 0.29
18-08-22
25
QG7. Do you receive the support that you need from health professionals to help you manage your condition(s)? (Have been diagnosed with condition n=843)
Managing Chronic Care Public Perceptions of Professional Support
49
30%
30%
26%
7%
6%
Always
Often
Sometimes
Rarely
Never
Frequency of Receiving Needed Support for Chronic Condition
QG8. Do you have access to the treatments you need to manage your condition(s)? (Have been diagnosed with condition n=824)QG9. What are some of the reasons why you don’t always have access to the treatments you need to manage your condition(s)?(Do not always have access to treatments to manage condition(s) n=522)
Managing Chronic Care - Access to Treatments Public Perceptions
50
35%
31%
22%
6%
6%
Always
Often
Sometimes
Rarely
Never
36%
21%
19%
17%
16%
15%
11%
10%
7%
4%
3%
3%
2%
15%
Wait times were too long
Treatment was ineffectiveCan't afford the other forms of prescribed
treatment (other than medication)Can't afford the prescribed medication
Treatment was inadequate
Treatment not required
Did not get referred to the treatment in time
Treatment caused unbearable side effects
Can't get to or otherwise access the treatmentThe treatment is available in my province, but it is
too far or I have no way to access itThe prescribed treatment was refused
The treatment is not available in Canada
The treatment is not available in my province
Other
Reasons For Not Always Receiving Treatments
Frequency of Receiving Needed Treatments
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26
QL4. After discharge?
QL1: How many times have you or someone in your household been hospitalized within the past year for any reason? (n=1500)QL2: And have you, or has someone in your household needed these types of health care within the past year? (n=1500)QL3: Was there a smooth transition from the primary care provider to the following other health care services? (Need specialty healthcare in past year (n=493)QL4: Upon discharge, do you feel that adequate support/care was provided when the following members of your household returned to the community? (Been in the hospital in past year n=330)
Managing Care TransitionsPublic Perceptions
51
23%23%QL1.Self or household
member has beenhospitalizedin past year
QL2. Self or householdmember
has neededspecialty health care
in past year
QL2. Self or householdmember
has neededspecialty health care
in past year
33%33%
66% 34%Adequate care/ support
67%
64%
55%
43%
17%
18%
35%
31%
16%
18%
11%
26%
Specialized care
Home care
Hospice Palliative Care
Long-term care
Home care 4%Long-term care 2%Hospice palliative care 1%
Yes No DK
QL3. Smooth transition from primary care provider?
52
Many Canadians live with or with someone who has a chronic health condition.
• Half of Canadians have one or more chronic health conditions and half live in a household where another family member (also) suffers from at least one.
• One in ten Canadians have been hospitalized in the past year as a results of their chronic condition(s), and one in six have been admitted to the ER. These proportions have been unchanged since 2016.
• Nine in ten patients work with a doctor to manage their condition(s). Those who feel they don’t always have access to the treatments they need in order to manage their condition(s), most often cite long wait times as the main cause for this. Providers also blame poor access to care as the main reason for a gap in care for those suffering from chronic conditions. They are less likely to blame patient adherence than they were two years ago. A vast majority of all providers say they work in teams to provide care to their patients.
• Hospital admittance stood at a quarter of households, which is a decrease from three in ten in 2016 and back to 2013 levels. Most (two-thirds) say they received adequate support when released from the hospital.
• One-third of households (steady since 2016) have (also) depended on specialty care in the past year, with most saying the transition to specialty from primary care was smooth. For most, the transition to home care and hospice palliative care was also smooth, while experiences with the transition to long-term care were more mixed. The likelihood of having a smooth transition has decreased since 2016.
18-08-22
27
Prescription MedicationsUse and Adherence
53
WhichConditions?
QH1. Do you currently take any prescription medications on a regular (daily or weekly) basis? (n=1500)QH2. How many different types of prescription medications are you currently taking in total? (Take Rx regularly n=583)
Managing Chronic Care - MedicationsPublic Realities
54
81%
77%
59%
50%
42%
37%
34%
17%
67%
Diabetes
Heart disease, stroke or high bloodpressure
A mental health condition
Osteoporosis
Asthma, bronchitis or emphysema
A memory problem that interferes withday-to-day function
Arthritis
Cancer
Other
39%39%Take Rxregularly
Mean # of Rx’s
3.3Mean # of Rx’s
3.3
NB: 53% (n=795) of public respondents have been diagnosed by a health professional with at least one chronic condition.
18-08-22
28
QH1: Do you currently take any prescription medications on a regular (daily or weekly) basis? (n=1500)QH2: How many different types of prescription medications are you currently taking in total? (Take Rx regularly n=583)
Managing Chronic Care - MedicationsPublic Realities - By Region
55
39%39%OverallTake Rxregularly
OverallMean # of Rx’s currently taking
3.3
OverallMean # of Rx’s currently taking
3.3
BC44%4 Alberta
51%3
Prairies42%4 Ontario
47%4
Quebec38%4
Atlantic56%5
Take Rx regularlyMean # of RX currently taking
BC44%3.0 Alberta
47%3.7
Prairies36%3.0 Ontario
40%3.2
Quebec33%3.4
Atlantic33%3.0
Take Rx regularlyMean # of RX currently taking
QH3: Do you do any of the following when it comes to taking your prescribed medication? (Take Rx regularly n=583) 56
16%
14%
11%
11%
4%
3%
3%
1%
2%
22%
20%
16%
13%
12%
8%
6%
17%
16%
25%
15%
13%
9%
9%
33%
39%
54%
68%
72%
81%
81%
Spoke to your health care provider about how you take your medication (including when you do not follow
instructions)
Your health care provider has asked you about how you take your medication (including if you do not follow
instructions)
Take any of your medications less frequently than prescribed (e.g., twice daily instead of three times)
Stopped taking your medication for a short period of time (i.e., a medication holiday) or permanently
Take a lower dosage of any of your medications than prescribed (e.g., two pills per dosage instead of four)
Take a higher dosage of any of your medications than prescribed (e.g., two pills per dosage instead of one)
Take any of your medications more frequently than prescribed (e.g., twice daily instead of once)
Always Often Sometimes Rarely Never
Patterns of Non-Adherence
60% non-adherent, meaning not saying “never” to all five
behaviours
Chronic Medications - Adherence BehavioursPublic Perceptions
18-08-22
29
I forget to take pills
Take depending onhow I feel
Side effects/reactions
Cost of medication/can't afford it
Does not work/not effective
Other
No Answer
Don't know
11%
46%
0%
16%
2%
14%
12%
52%
9%
9%
8%
9%
10%
2%
12%
21%
15%
13%
1%
14%
23%
2%
9%
40%
1%
10%
9%
21%
6%
TakeMore Frequently(n=97)
TakeLess Frequently(n=254)
TakeHigher Dosage(n=92)
TakeLower Dosage(n=152)
Reasons for Non-Adherence
QH4: Why do you at least occasionally do the following when it comes to taking your prescribed medication?
Chronic Medications – Reasons for Adherence BehavioursPublic Perceptions
12%
26%
13%
9%
3%
13%
16%
8%
Med Vacation(n=174)
57
QH5: How much would you say you understand about each of the following? (Take Rx regularly n=583)
Understanding MedicationsMedication Adherence - Public Perceptions
58
90%
86%
77%
64%
9%
12%
19%
29%
4%
7%
When and how to take medicine
The reasons why medication(s)were prescribed
What medication(s)are supposed to do
Potential side effects of medicine
Understand very well Understand a bit Do not understand
18-08-22
30
QH1B. How often do you tell patients why the medication(s) was prescribed? Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99) 59
Clinicians Provide Reason For Prescription
72%
68%
68%
31%
11%
18%
22%
26%
41%
23%
7%
8%
6%
22%
26% 18%
3%
21%
Doctor
Nurse
Pharmacist
Administrator
Other Providers
Always Often Sometimes Rarely Never
Managing Chronic Care MedicationsProfessional Perceptions
QH1A. How often do you provide patients with instructions on how to take or use their prescribed medication properly? Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99) 60
43%
57%
73%
29%
5%
33%
31%
19%
34%
12%
15%
8%
7%
29%
19%
8%
4%
21% 42%
Doctor
Nurse
Pharmacist
Administrator
Other Providers
Always Often Sometimes Rarely Never
Clinicians Provide Instruction for Use
Managing Chronic Care MedicationsProfessional Perceptions
18-08-22
31
QH1C. How often do you tell patients what their medication(s) are supposed to do? Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99) 61
Clinicians Provide Information About How Medications Work
60%
68%
75%
34%
9%
29%
26%
19%
35%
21%
7%
5%
6%
22%
34%
3%
4%
16%
5%
19%
Doctor
Nurse
Pharmacist
Administrator
Other Providers
Always Often Sometimes Rarely Never
Managing Chronic Care MedicationsProfessional Perceptions
QH1D. How often do you tell patients about potential side effects to expect from their medications?Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99) 62
Clinicians Provide Information About Side Effects
54%
62%
72%
32%
5%
30%
26%
24%
36%
20%
12%
9%
4%
24%
22%
3%
5%
29% 23%
Doctor
Nurse
Pharmacist
Administrator
Other Providers
Always Often Sometimes Rarely Never
Managing Chronic Care MedicationsProfessional Perceptions
18-08-22
32
QH1E. How often do you Ask your patients’ about how they take their medication?Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99) 63
Clinicians Ask Patients About How They Take Medications
30%
49%
43%
35%
15%
41%
31%
40%
33%
29%
23%
15%
17%
23%
30%
5%
4%
11%
5%
14%
Doctor
Nurse
Pharmacist
Administrator
Other Providers
Always Often Sometimes Rarely Never
Managing Chronic Care MedicationsProfessional Perceptions
QH1F. How often do you Receive questions from patients about how they take their medication?Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)
Managing Chronic Care MedicationsProfessional Perceptions
64
Clinicians Receive Questions About How to Take Medications
33%
35%
41%
23%
4%
40%
42%
43%
37%
24%
18%
19%
15%
33%
35%
7%
17%
4%
19%
Doctor
Nurse
Pharmacist
Administrator
Other Providers
Always Often Sometimes Rarely Never
18-08-22
33
QH1G. How often do you Ask your patients if they have any drug coverage before prescribing a new medication or treatment?Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)
Managing Chronic Care MedicationsProfessional Perceptions
65
Clinicians Ask About Drug Coverage Before Prescribing
49%
34%
47%
28%
8%
30%
32%
29%
30%
7%
10%
16%
15%
31%
5%
5%
6%
7%
6%
9%
6%
11%
5%
71%
Doctor
Nurse
Pharmacist
Administrator
Other Providers
Always Often Sometimes Rarely Never
QH6. In the past six months, have you taken any medication that was prescribed to you for a condition that was not considered a chronic condition, such as an acute or short term illness such as antibiotics for an infection or medication for an injury? (n=1500) QH7. When it comes to taking medication you have been prescribed in the past six months for conditions that are not chronic (an acute or short term illnesses or injuries), do you do any of the following? (n=477)
Acute/Short Term Medications - Adherence BehavioursPublic Perceptions
66
Yes31%
No69% Acute
Rx
23%
9%
9%
9%
4%
4%
3%
21%
15%
17%
12%
12%
6%
6%
14%
16%
17%
15%
12%
9%
8%
33%
51%
62%
66%
72%
84%
85%
Spoke to your health care provider about how you take your medication (including when you do not follow
instructions)Your health care provider has asked you about how you
take your medication (including if you do not follow instructions)
Take any of your medications less frequently than prescribed (e.g., twice daily instead of three times)
Stopped taking your medication for a short period of time (i.e., a medication holiday) or permanently
Take a lower dosage of any of your medications than prescribed (e.g., two pills per dosage instead of four)
Take a higher dosage of any of your medications than prescribed (e.g., two pills per dosage instead of one)
Take any of your medications more frequently than prescribed (e.g., twice daily instead of once)
Always Often Sometimes Rarely Never
% Who Are Non-Compliant
51%% Who Are Non-Compliant
51%
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34
I forget to take pills
Take depending onhow I feel
Side effects/reactions
Cost of medication/can't afford it
Does not work/not effective
Other
Nothing
Don't know
12%
17%
0%
19%
7%
34%
11%
41%
21%
6%
3%
4%
16%
8%
9%
27%
13%
4%
1%
6%
26%
2%
12%
21%
0%
22%
4%
28%
12%
TakeMore Frequently(n=75)
TakeLess Frequently(n=177)
TakeHigher Dosage(n=73)
TakeLower Dosage(n=130)
Reasons for Non-Adherence
QH4: Why do you at least occasionally do the following when it comes to taking your prescribed medication?
Acute/Short Term Medications – Reasons for Adherence BehavioursPublic Perceptions
15%
23%
11%
5%
3%
12%
9%
8%
Med Vacation(n=152)
67
QH8. How much would you say you understand about each of the following for your acute illness or injury? (n=477)
Understanding Medications for Acute / Short Term IllnessPublic Perceptions
68
88%
83%
72%
62%
11%
14%
25%
32%
4%
7%
When and how to take your medicine
The reasons why your medication(s) wereprescribed
What your medication(s) are supposed to do
Potential side effects to be expected from yourmedications
Understand very well Understand a bit Do not understand
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35
69
Four in ten Canadians take regular meds; patients continue to be non-adherent
• As was seen in 2016, four in ten Canadians take prescription medication on a regular basis. Those who do, on average takemore than three. Three in ten have been prescribed medication for non-chronic illnesses or conditions in the past 6 months.
• Use of prescription medications for chronic conditions has remained stable overall, but is down in Atlantic Canada and up inAlberta compared to two years ago.
• Levels of non-adherence are high: 60% for those taking medication for chronic conditions and 51% of those takingmedications for acute conditions. Non-adherence is most likely to come in the form of taking too little medication ratherthan taking too much.
• Health care providers who deal with prescription drugs (doctors, pharmacists and nurses) also feel they are informing theirpatients about their medications, particularly why they are on it and what it should do for them. However, doctors are lesslikely to do so than they were in 2016.
• Despite this, non-adherence does not come from a lack of information, with most understanding their medications.
• Providers believe that care gaps for those with chronic conditions are more to blame on the health care system than onpatients. They say that the gap it mostly due to inadequate access, more so than the number two cause – poor patientadherence to their treatment regimen.
PharmacareSearching for the Best Direction
70
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36
* Wording Change from 2016.QI1: Which one of the following three options would you choose as the best approach for ensuring that all Canadians have access to prescription medications? (n=1500)
Best Approach for Accessible Prescription MedicinePublic Perceptions
71
32%
29%
12%
26%
Have the federal government allocate funds to fill in the gaps for drug costs for those not currently covered by any public or
employer sponsored drug plan, those who have insufficient funding and those who can not afford their medications*.
A single national public Pharmacare plan operated by the federal government and funded by taxes collected by the federal
government.
Separate regional public Pharmacare plans in each province and territory, funded by taxes collected by both the federal
government and the provincial governments.
Don't know
QI1. Which one of the following three options would you choose as the best approach for ensuring that all Canadians have access to prescription medications?Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)
Best Approach for Accessible Prescription MedicineProfessional Perceptions
72
Have the federal government allocate funds to fill in the gaps for drug costs for those not
currently covered by any public or employerdrug plan, those who have insufficient funding
and those who can not afford their medications.
A single national public Pharmacare plan operated by the federal government and funded
by taxes collected by the federal government.
Separate regional public Pharmacare plans in each province and territory, funded by taxes
collected by both the federal government and the provincial governments.
Don't know
36%
35%
13%
16%
Doctors Nurses Pharmacists Administrators Other Providers
54%
29%
10%
7%
31%
46%
15%
8%
54%
20%
24%
2%
38%
32%
11%
18%
18-08-22
37
QI2. Please consider the following statements if that could be included in a Canadian national Pharmacare program. Please rank the statements from 1 to 5, with 1 being the attribute you feel is most important and 5 being the attribute you feel is least important. (n=1500)
Best Approach for Accessible Prescription MedicinePublic Perceptions
73
39%
25%
17%
11%
7%
19%
27%
25%
16%
13%
16%
20%
25%
20%
19%
12%
15%
16%
31%
26%
14%
13%
18%
21%
35%
Access to prescription medications and treatments for allCanadians, regardless of the ability to pay
Lower overall prescription medication and treatment costs forCanadians
Coverage for medications and treatments not covered by otherplans (private, provincial or federal plans)
Access to a wide range of prescription medications and treatments
Access to newly approved prescription medications and treatments
Ranked #1 Ranked #2 Ranked #3 Ranked #4 Ranked #5
Access to prescription medications and treatments for all Canadians,
regardless of the ability to pay
Lower overall prescription medication and treatment costs for Canadians.
Access to a wide range of prescription medications and treatments.
Coverage for medications and treatments not covered by other plans
(private, provincial or federal plans).
Access to newly approved prescription medications and treatments.
QI2. Please consider the following statements if that could be included in a Canadian national Pharmacare program. Please rank the statements from 1 to 5, with 1 being the attribute you feel is most important and 5 being the attribute you feel is least important.Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)
Top 3 PrioritiesProfessional Perceptions
74
71%
69%
63%
59%
38%
Doctors Nurses Pharmacists Administrators Other Providers
68%
65%
52%
66%
46%
73%
58%
66%
51%
52%
59%
65%
54%
69%
53%
75%
70%
51%
60%
41%
Top 3 - Most Important
1 1
1
11
2
2
2
2 2
3
3
33
3
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38
QI3. When thinking of the development of a Pharmacare plan for Canada, who should lead this development? (n=1500)
Best Approach for Accessible Prescription MedicinePublic Perceptions
75
50%
33%
17%
The leadership of the development of the Pharmacare plan in Canada should be shared between the
government (Federal and Provincial) and other organizations such as research hospitals, pharmaceutical
/ biotech companies, health authorities, etc
The government (Federal and Provincial) should lead the development of the Pharmacare plan in Canada
Don't know
The leadership of the development of the Pharmacare plan in Canada should be shared
between the government (Federal and Provincial) and other organizations such as
research hospitals, pharmaceutical / biotech companies, health authorities, etc.
The government (Federal and Provincial) should lead the development of the
Pharmacare plan in Canada.
Don't know
QI3. When thinking of the development of a Pharmacare plan for Canada, who should lead this development?Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)
Who Should LEAD Pharmacare Plan for Canada?Professional Perceptions
76
52%
35%
13%
Doctors Nurses Pharmacists Administrators Other Providers
68%
27%
5%
67%
23%
10%
55%
44%
1%
56%
34%
10%
18-08-22
39
77
Support for a national, universal Pharmacare plan has subsided, preference for gap-filling government initiatives
• The public and providers are split on whether a single federal universal Pharmacare plan, or a scenario where the federalgovernment ensures gaps are filled for those not covered/can’t afford their prescriptions, would be the best option toensure equal access to medications.
• Half of Canadians say that leadership of Pharmacare development should be shared across governments and otherorganizations, while a third believe it should be government-lead. Providers also prefer shared leadership.
• When it comes to prescription drugs, the most important attribute for Canadians and health care providers alike is toensure access to all, regardless of the ability to pay. Lowering the overall cost for Canadians is also ranked high.
Patient-Centred CareChallenges / Opportunities
78
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40
QM1: Below is a list of attributes that have been proposed as elements that could help create a culture and practice of patient-centred care. Please indicate to what extent you oppose or support the widespread implementation of each attribute as an effective contribution to enhance patient-centred care using a scale from one to 10, where one means you would ‘strongly oppose’ it and 10 means you would ‘strongly support’ it. (n=1500)
Support for Enhancing Patient-Centred CarePublic Perceptions
79
66%
64%
65%
61%
60%
56%
53%
52%
19%
20%
16%
22%
23%
24%
26%
26%
6%
8%
7%
8%
9%
10%
10%
11%
4%
6%
4%
4%
4%
4%
4%
5%
5%
6%
5%
5%
6%
6%
7%
Care that is readily, and timely, accessed
Care that is provided in a caring, respectful context
Care that is based on need and not on the ability to pay
Care that is guided, and transparently communicated, by providers
Care decisions that are made in partnership between informed patients and their providers
Care that is supported by current research and expert opinion
Care policy that is shaped by interaction with, and learning from, patients
Care and system outcomes that are measured (evaluated) and presented in a manner meaningful to
most Canadians
Strongly Support (9,10) Somewhat Support (7,8) Neutral (5,6) Oppose (1-4) Don't know2018 2016 2013
8.8 8.8 8.6
8.7 8.7 8.6
8.7 8.6 NA
8.6 8.4 8.0
8.5 8.4 8.1
8.4 8.3 7.9
8.3 8.2 7.8
8.3 8.2 7.9
Mean
QM1. Below is a list of attributes that have been proposed as elements that could help create a culture and practice of patient-centred care. Please indicate to what extent you oppose or support the widespread implementation of each attribute as an effective contribution to enhance patient-centred care using a scale from one to 10, where one means you would “strongly oppose” and 10 means you would “strongly support”. Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99)
Support for Enhancing Patient-Centred CareProfessional Perceptions
80
Care that is readily, and timely, accessed
Care that is provided in a caring, respectful context
Care that is supported by current research and expert opinion
Care that is based on need and not on the ability to pay
Care that is guided, and transparently communicated, by providers
Care decisions that are made in partnership between informed patients and their providers
Care and system outcomes that are measured (evaluated) and presented in a manner
meaningful to most Canadians
Care policy that is shaped by interaction with, and learning from, patients
71%
69%
67%
65%
52%
47%
45%
38%
19%
18%
20%
21%
33%
41%
30%
37%
90%
87%
87%
86%
85%
88%
75%
75%
Doctors Nurses Pharmacists Administrators
72%
75%
71%
69%
67%
77%
65%
62%
19%
14%
19%
19%
23%
13%
21%
25%
91%
89%
90%
88%
90%
90%
86%
87%
79%
64%
71%
61%
62%
59%
47%
40%
13%
26%
16%
26%
26%
28%
33%
31%
92%
90%
87%
87%
88%
87%
81%
72%
39%
32%
31%
29%
43%
28%
34%
30%
38%
46%
44%
47%
34%
45%
45%
44%
77%
78%
75%
76%
77%
73%
79%
74%
Strongly SupportSomewhat Support
Strongly SupportSomewhat Support
Strongly SupportSomewhat Support
Strongly SupportSomewhat Support
84%
77%
81%
79%
78%
76%
62%
66%
10%
18%
12%
10%
16%
18%
25%
23%
94%
95%
93%
89%
94%
94%
87%
89%
Other Providers Strongly SupportSomewhat Support
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41
QM2: Which three attributes would you most strongly support? Choose only three. (n=1500)
Priorities for Enhancing Patient-Centred CarePublic Perceptions
81
75%
56%
37%
36%
35%
18%
16%
13%
Care that is readily, and timely, accessed
Care that is based on need and not on the ability to pay
Care that is provided in a caring, respectful context
Care that is supported by current research and expert opinion
Care decisions that are made in partnership between informed patients and their providers
Care that is guided, and transparently communicated, by providers
Care and system outcomes that are measured (evaluated) and presented in a manner meaningful to most Canadians
Care policy that is shaped by interaction with, and learning from, patients
2016 2013
76% 72%
60% NA
38% 55%
29% 32%
35% 46%
17% 25%
16% 24%
12% 26%
QM2: Which three attributes would you most strongly support? Choose up to three.Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99)
Priorities for Enhancing Patient-Centred CareProfessional Perceptions
82
Care that is readily, and timely, accessed
Care that is supported by current research and expert opinion
Care that is based on need and not on the ability to pay
Care that is provided in a caring, respectful context
Care decisions that are made in partnership between informed patients and their providers
Care and system outcomes that are measured (evaluated) and presented in a manner
meaningful to most CanadiansCare that is guided, and transparently
communicated, by providers
Care policy that is shaped by interaction with, and learning from, patients
I do not support any other attribute
Doctors Nurses Pharmacists Administrators Other Providers
71%
57%
49%
36%
31%
25%
15%
9%
3%
60%
38%
48%
40%
43%
22%
23%
14%
3%
65%
55%
48%
28%
47%
22%
20%
10%
0%
47%
41%
33%
32%
33%
31%
44%
27%
1%
63%
64%
39%
33%
44%
16%
19%
17%
0%
3
2
1
3
2
1
3
2
1
3
2
1
3
2
1
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42
QM3. Which ONE attribute is most lacking in order for you to feel you are receiving patient-centred care. Please choose only the MOST important attribute for you.. (n=1500)
Most Lacking Aspect When it Comes to Receiving Patient-Centered CarePublic Perceptions
83
38%
17%
8%
7%
5%
4%
4%
3%
14%
Care that is readily, and timely, accessed
Care that is based on need and not on the ability to pay
Care decisions that are made in partnership betweeninformed patients and their providers
Care that is provided in a caring, respectful context
Care that is supported by current research and expertopinion
Care policy that is shaped by interaction with, andlearning from, patients
Care that is guided, and transparently communicated, byproviders
Care and system outcomes that are measured(evaluated) and presented in a manner meaningful to…
I am not lacking any attribute. I am receiving patient-centred care
QM3. And which one aspect is most lacking when it comes to patients in Canada receiving patient-centred care?Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99)
Most Lacking Aspect When it Comes to Receiving Patient-Centered CareProfessional Perceptions
84
Care that is readily, and timely, accessed
Care that is based on need and not on the ability to pay
Care that is supported by current research and expert opinion
Care policy that is shaped by interaction with, and learning from, patients
Care decisions that are made in partnership between informed patients and their providers
Care and system outcomes that are measured (evaluated) and presented in a manner
meaningful to most CanadiansCare that is guided, and transparently
communicated, by providers
Care that is provided in a caring, respectful context
Nothing is lacking
Doctors Nurses Pharmacists Administrators Other Providers
58%
10%
7%
6%
5%
5%
4%
1%
4%
40%
16%
7%
9%
6%
12%
3%
4%
2%
46%
17%
4%
8%
7%
7%
7%
3%
0%
21%
8%
12%
10%
13%
10%
7%
16%
3%
53%
6%
8%
8%
10%
7%
4%
3%
1%
18-08-22
43
85
Support for patient-centred care continues to be strong
• Support for patient-centred care continues to be strong, both among health care professionals and the general public,although support has waned somewhat in strength among administrators since 2016.
• Support for all factors of this care has increased marginally among the general public since the 2016 and 2013 studies.Support is especially strong for care that is readily, and timely accessed; care that is provided in a caring, respectfulcontext, and care that is needs-based, rather than based on ability to pay.
• To most health care providers, care that is readily and timely accessed also receives the highest support. Care that issupported by current research and expert opinion ranks in the top three for all providers but nurses. Care that is basedon need rather than wealth is important to doctors, nurses and pharmacists, while partnerships between patients andproviders are important to nurses and other providers.
• Not surprising in the context of what has been seen in other findings regarding access, health care providers are most likely to feel that the aspect most lacking in order for Canadians to receive patient-centred care is care that is readily, andtimely, accessed.
End of Life CareSupport of Options
86
18-08-22
44
QN1: Please consider each of the following options for end-of-life health care. Please indicate to what extent would you oppose or support each option using a scale from one to 10, where one means you would ‘strongly oppose’ it and 10 means you ‘strongly support it.’ (n=1500)
Support for End-of-Life OptionsPublic Perceptions
87
67%
66%
62%
56%
17%
18%
18%
17%
7%
8%
9%
9% 6%
5%
5%
6%
7%
Enhanced pain management practices and availability so that those reaching the end of their life can do so comfortably
Enhanced hospice and palliative care so that those reaching the end of their life can have easy access to the most
appropriate health care available
Enhanced home care supports for family and other non-professional caregivers so that those reaching the end of their
life can do so at home
Enhanced medically assisted death to enable those reaching the end of their life to have the option of ending it before it
gets worse, should they choose to do so
Strongly support Somewhat support Neutral Somewhat oppose Strongly oppose Don't know Prefer not to answer2018 2016
8.9 8.9
8.9 8.9
8.7 8.7
8.2 8.1
Mean
QN2. In your personal opinion, which one of the following should be the top priority for end-of-life care in Canada going forward? (n=1500)
Priorities for End-of-Life OptionsPublic Perceptions
88
32%
22%
21%
18%
8%
Enhanced medically assisted death to enable those reaching the end of their life to have the option of ending it before it gets worse, should
they choose to do so
Enhanced hospice and palliative care so that those reaching the end of their life can have easy access to the most appropriate health care
available.
Enhanced home care supports for family and other non-professional caregivers so that those reaching the end of their life can do so at
home.
Enhanced pain management practices and availability so that those reaching the end of their life can do so comfortably.
Prefer not to answer
Top Priority
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45
Enhanced hospice and palliative care so that those reaching the end of their life can have easy
access to the most appropriate health care available
Enhanced pain management practices and availability so that those reaching the end of
their life can do so comfortably
Enhanced home care supports for family and other non-professional caregivers so that those reaching the end of their life can do so at home
Enhanced medically assisted death to enable those reaching the end of their life to have the option of ending it before it gets worse, should
they choose to do so
QN1. Please consider each of the following options for end-of-life health care. Please indicate to what extent would you oppose or support each option using a scale from one to 10, where one means you would 'strongly oppose' it and 10 means you 'strongly support' it. - Enhanced hospice and palliative care so that those reaching the end of their life can have easy access to the most appropriate health care available
Support for End of Life OptionsProfessional Perceptions
89
71%
69%
65%
47%
21%
22%
22%
26%
92%
91%
88%
74%
Doctors Nurses Pharmacists Administrators
80%
76%
74%
53%
11%
19%
16%
20%
91%
95%
90%
73%
80%
74%
75%
48%
14%
15%
18%
28%
94%
89%
93%
77%
38%
45%
29%
37%
40%
45%
47%
40%
78%
90%
76%
77%
Strongly SupportSomewhat Support
Strongly SupportSomewhat Support
Strongly SupportSomewhat Support
Strongly SupportSomewhat Support
79%
74%
78%
54%
11%
15%
12%
18%
90%
89%
90%
72%
Other Providers Strongly SupportSomewhat Support
Enhanced hospice and palliative care so that those reaching the end of their life can have
easy access to the most appropriate health care available.
Enhanced home care supports for family and other non-professional caregivers so that those
reaching the end of their life can do so at home.
Enhanced medically assisted death to enable those reaching the end of their life to have the option of ending it before it gets worse, should
they choose to do so.
Enhanced pain management practices and availability so that those reaching the end of
their life can do so comfortably.
Prefer not to answer
QN2. In your personal opinion, which one of the following should be the top priority for end-of-life care in Canada going forward?Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99)
Priority for End of Life CareProfessional Perceptions
90
42%
26%
19%
9%
4%
Doctors Nurses Pharmacists Administrators Other Providers
28%
35%
22%
14%
0%
Top Priority
33%
33%
13%
15%
5%
27%
22%
26%
23%
2%
35%
36%
14%
14%
0%
18-08-22
46
QN3. In the future, if you were ever to be personally involved in facilitating the provision of medically assisted death in your current role, to what extent would you fear legal or regulatory reprisals even if the federal government has passed legislation expressly allowing for the provision of such services? Please use a scale from one to 10, where one means “not at all” it and 10 means “a great deal” Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99)
Fear of Legal Reprisals for Medically Assisted Death Professional Perceptions
91
5% 9%6% 5% 3%
16%19% 15% 23%
4%
12%16%8%
18%
4%
12%13%
18%
10%
5%
12%
22%28%
22%
65%
23%
23% 23% 20% 19% 15%
Doctor Nurse Pharmacist Administrator OtherProviders
A great dealSomewhatNeutralNot muchNot at allDon't knowPrefer not to answer
QN5. If asked to facilitate the provision of medically assisted death in your current role, to what extent do you feel like you have the necessary system supports in place to easily implement these wishes?Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99)
Necessary System SupportsProfessional Perceptions
92
3% 4% 9%7% 4%
17%26% 29% 28%
4%
41%16% 11% 11%
3%
11%
19%12% 12%
10%
7%22%
24% 25%
54%
9%8%
16% 17%27%
5%
Doctor Nurse Pharmacist Administrator Other Providers
Strong supportSome supportNeutralNot much supportNo support at allDon't knowPrefer not to answer
18-08-22
47
93
Support for medically assisted death among the general public
• The general public continues to strongly support all scenarios to help those reaching the end of their life. Whilemedically assisted death receives somewhat less support than options which help to support and comfort those dyingand their families, almost three quarters of Canadians express support for medically assisted death, with a majoritysupporting this option strongly. However, when asked to choose only one option as the top priority, medically assisteddeath was chosen most often (by a third of respondents.)
• Among health care providers, medically assisted death also received support from the majority. However, at three-quarters, this support is not as strong as what is seen by the general public, nor is it as strong as other end of life careoptions, which received about the same levels of support, with around nine in ten showing support for enhancedhospice/palliative care, enhanced pain management and enhanced home care support.
• When asked to choose one priority for end-of-life care in Canada from a professional perspective, doctors emphasizedtraining and education for health care professionals around pain management the most, while for nurses, more trainingand research to use a harm reduction approach was ranked higher. Pharmacists and other providers ranked these twoaspects equally high.
• A plurality of health care providers also have some fear of reprisal, even if this service has been legalized by the federalgovernment. Moreover, this fear is felt somewhat stronger now than in 2016. Providers are also not all convinced that theappropriate system support is in place to facilitate medically assisted death.
eHealthAccess and Support
94
18-08-22
48
QG2: As far as you know, do you have access to the following? – A) Your health record B) The information that you need that is important to manage your health Base: All (n=1500)
Access to Needed Health InformationPublic Perceptions
95
45%31%
15%
19%
24%
16%
18%24%
32%
9%11%
22%
8% 11% 15%
Electronic health record Paper health record Important informationto manage health
Always
Often
Sometimes
Rarely
Never
QG2. As far as you know, do you have access to the following? (n=1500)
Access to Needed Health InformationPublic Perceptions – By Region
96
Important information to manage health
Electronic health records8%
15%
6%
10%
9%
8%
9%
15%
9%
7%
12%
4%
9%
18%
21%
16%
20%
23%
11%
16%
19%
18%
24%
15%
16%
20%
20%
45%
31%
45%
49%
40%
61%
47%
TotalBCAB
PrairiesOntQue
Atlantic
Paper health records
Often Sometimes NeverAlways Rarely
11%
12%
9%
10%
11%
7%
17%
11%
15%
8%
9%
16%
5%
8%
24%
24%
23%
26%
26%
17%
27%
24%
26%
28%
19%
20%
30%
24%
31%
24%
32%
35%
28%
41%
23%
TotalBCAB
PrairiesOntQue
Atlantic
15%
22%
13%
17%
15%
6%
22%
22%
26%
25%
18%
26%
13%
21%
32%
29%
33%
35%
33%
32%
28%
16%
15%
16%
15%
14%
19%
16%
15%
7%
13%
15%
12%
30%
13%
TotalBCAB
PrairiesOntQue
Atlantic
18-08-22
49
QG3. To what extent do you support or oppose the use of an integrated eHealth system which allows your health records to be easily shared between your health care providers so you do not need to remember or continually repeat your medical history? (n=1500)
Support for eHealthPublic Perceptions
97
58%
33%
5%
1%
4%
Strongly support
Somewhat support
Somewhat oppose
Strongly oppose
Don't know
Support of the use of an integrated eHealth system which allows your health records to be easily shared between your health care providers so you do not
need to remember or continually repeat your medical history
QP3. To what extent do you support or oppose the use of an integrated eHealth system which allows patient health records to be easily shared across health care providers so patients do not need to remember or continually repeat their medical history.Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99) 98
Support For the use of Integrated eHealth System
64%
76%
82%
37%
75%
26%
20%
17%
56%
17%
4%
4%
7%
6%
4%Doctor
Nurse
Pharmacist
Administrator
Other Providers
Strongly support Somewhat support Somewhat oppose Strongly oppose Don't know 2018
90%
96%
99%
93%
92%
Total Support
Support for eHealthProfessional Perceptions
18-08-22
50
QG4. How concerned are you about the security of your information if it is shared online through the eHealth system? (n=1500)
Concern about eHealthPublic Perceptions
99
11%
28%
36%
23%
2%
Not concerned at all
Not very concerned
Somewhat concerned
Very concerned
Don't know
Concern about the Security of Information through Integrated eHealth System
QP4. How concerned are you about the security of your patients’ information if it is shared online through the eHealth system?Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99) 100
Concern about the Security of Information through Integrated eHealth System
11%
14%
15%
2%
14%
28%
22%
29%
7%
32%
28%
35%
30%
54%
37%
32%
26%
24%
35%
16%
Doctor
Nurse
Pharmacist
Administrator
Other Providers
Not concerned at all Not very concerned Somewhat concerned Very concerned Don't know 2018
60%
62%
55%
89%
54%
Total Concerned
Concern about eHealthProfessional Perceptions
18-08-22
51
101
Both public and professionals support eHealth, yet are concerned
• While most Canadians support an integrated eHealth system, most are also concerned about security.
• Currently, access to EHRs is limited, with almost half saying they don’t have access to it. However, three in ten Canadiansalso say they don’t have access to their paper health record. EHR access is currently the highest is BC and by far lowest inQuebec; again, this trend is also seen with paper records.
• Health care professionals also express both support and concern, at about the same levels as the general population in fact.Administrators express the highest levels of concern.
Continuing Role –Caregivers
Challenges / Opportunities
102
18-08-22
52
Actions Taken While Providing Care Health Care Professionals Worked With During Caregiving
QL5: Have you personally had to care for a family member or close friend with a serious health problem in the past 12 months? (n=1500)QL6: When caring for this person did you... (Provided care n=286)QL8: Did you work with a doctor or other health care professional(s) to help you manage the condition of the person under your care? (Provided care n=284)QL9: Do you receive the support that you need from health professionals to help you manage the condition of the person under your care? (Provided care n=284)QL10: Do you have access to the information you need to manage the condition of the person under your care? (Provided care n=284)
Care Burden of Family/FriendsPublic Realities
103
18%18%
Have cared for family/close friend in past 12 months
46%
29%
22%
17%
13%
12%
6%
5%
Used personal savings to manage
Cared for other family members at same time
Took one or more months off work
Accessed other benefits from employer
Quit work to care for this person
Took advantage of other government tax benefitsAccessed Federal Employment Insurance
Compassionate Care BenefitClaimed the Caregiver Tax Credit
20%
24%
30%
31%
30%
29%
12%
8%
8%
8%
Receive support from health professionals
Have access to information needed to manage condition
Always Often Sometimes Rarely Never
58%
22%
16%
15%
11%
8%
5%
22%
Doctor
HCP as a team
Registered nurse
Pharmacist
Other HCP
Nurse practitioner
Health navigator
None of the above
QL7. Why did you not take advantage of all the tax benefits that may have been available to you as a caregiver? (Base: Those who did not take advantage of tax credits n=282)
Tax Benefits – Reasons for not Taking AdvantagePublic Perceptions
104
41%
33%
13%
8%
5%
4%
21%
3%
Did not think I would qualify for them
Did not know about them
The application process was toodifficult/confusing
Knew about them, but just didn't accessthem
Applied, but did not qualify
Somebody else handles all my finances
Other reason(s)
Don't know
18-08-22
53
QL5: Have you personally had to care for a family member or close friend with a serious health problem in the past 12 months? (n=1500)
Care Burden of Family/FriendsPublic Realities – By Region
105
BC21%
Alberta25% Prairies
15%
Ontario20%
Quebec12%
Atlantic15%
QL11: Do you have access to the treatments you need to manage the condition of the person under your care? (Provided care n=295)QL12: What are some of the reasons why you don’t always have access to the treatments you need to manage the condition of the person under your care? (Provided care and didn’t always have access to treatment n=209)Responses under 5% not shown.
Caregiver Obstacles: Knowledge / AccessPublic Perceptions
106
26%
30%
28%
8%
8%
Always
Often
Sometimes
Rarely
Never
37%
20%
17%
17%
14%
13%
12%
10%
6%
5%
Wait times were too long
Treatment was ineffective
Did not get referred to the treatment in time
Treatment was inadequate
Treatment not required
Treatment caused unbearable side effects
Can't afford the other forms of prescribed treatment
Can't afford the prescribed medication
The prescribed treatment was refused
Treatment is available in province, but it is too far or I am unable to access it
Reasons For Not AlwaysHaving Access to Treatments
Having Access to Treatments (Caregivers)
18-08-22
54
107
Caregivers face challenges
• In the past year, 18% of people in Canada have been a caregiver to a family or friend with a serious health problem in thepast year (compared to 16% in 2016). This is still down from almost a quarter of respondents in 2007. These caregivers areoften juggling the care of multiple family members and they have to dip into savings to do so.
• Only small percentages of caregivers either accessed the EI Compassionate Care Benefit, claimed the Caregiver tax credit ortook advantage of other government tax benefits. Among those who did not take advantage of all three, the most commonreason for this was that they did not think they would qualify. Many also did not know about them.
• While they are most likely to rely on their ward’s doctor for care, they often also work with other health care providers.
• As was seen in 2016, only a quarter of caregivers say that access to treatment is always there, with wait times remaining themost common obstacle.
Opioid Crisis
108
18-08-22
55
QO1. How serious a problem would you say the opioid crisis is, in Canada? Would you say it is Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100) 109
Opioid Crisis Severity
5%
2%
2%
11%
5%
8%
5%
10%
37%
41%
42%
77%
38%
41%
51%
48%
16%
45%
6%
5%
Doctor
Nurse
Pharmacist
Administrator
Other Providers
Not at all serious Not very serious Neutral Serious Very serious Don't know 2018
78%
92%
90%
93%
83%
Total Serious
Opioid CrisisProfessional Perceptions
QO2. How important is each of the following option to addressing opioid issues in Canada?Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99) 110
Training and education for health care professionals around pain management (pharm
and non-pharm treatments)
Education of the general public of the dangers of opioid use and addiction
Training, education and resources for health care professionals around mental health and
addictions treatments.
More training and resources for health care professionals to use a harm reduction approach
in their facilities and practices.
Better integration of health and social services that improve treatment and patient outcomes.
The availability of safe injection sites for those who need them
Policy change such as decriminalization of personal use psychoactive substances.
58%
58%
54%
45%
43%
31%
19%
27%
21%
26%
35%
38%
33%
17%
85%
79%
80%
80%
81%
64%
36%
Doctors Nurses Pharmacists Administrators
65%
61%
68%
58%
63%
46%
24%
22%
24%
25%
28%
29%
23%
24%
87%
85%
93%
86%
92%
70%
48%
63%
58%
55%
47%
58%
31%
18%
30%
32%
33%
37%
27%
30%
19%
93%
90%
88%
85%
85%
62%
37%
31%
34%
23%
34%
30%
27%
20%
40%
41%
49%
42%
45%
39%
44%
71%
75%
72%
76%
75%
66%
64%
Very ImportantSomewhat Important
Very ImportantSomewhat Important
Very ImportantSomewhat Important
Very ImportantSomewhat Important
67%
55%
70%
45%
65%
40%
21%
18%
20%
17%
26%
16%
21%
21%
85%
75%
87%
72%
81%
62%
42%
Other Providers Very ImportantSomewhat Important
Support for Addressing Opioid CrisisProfessional Perceptions
18-08-22
56
QO3. Which one option is MOST important to help with the opioid issues in Canada? Please select only one.Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99)
Top Priorities for Addressing Opioid CrisisProfessional Perceptions
111
Education of the general public of the dangers of opioiduse and addiction
Training, education and resources for health careprofessionals around mental health and addictions
treatments.
More training and resources for health care professionalsto use a harm reduction approach in their facilities and
practices.
Better integration of health and social services thatimprove treatment and patient outcomes.
Training and education for health care professionalsaround pain management (pharmacological and non-
pharmacological treatments).
Policy change such as decriminalization of personal usepsychoactive substances.
The availability of safe injection sites for those who needthem
Doctors Nurses Pharmacists Administrators Other Providers
25%
18%
16%
15%
14%
8%
4%
20%
20%
15%
25%
10%
3%
6%
20%
9%
11%
22%
30%
4%
3%
12%
18%
14%
27%
9%
10%
10%
11%
20%
14%
29%
22%
2%
1%
112
The Opioid Crisis is Real
• Health care providers agree that the opioid crisis in Canada is serious, with many saying it is very serious.
• Virtually all options to address the crisis tested are seen as important pieces to solve the puzzle, with the exception ofpolicy changes such as decriminalization of the use of opioids.
• While a majority believes safe injection sites are important, support for this is lower than for other options such astraining and education for health care professionals on pain management, harm reduction, mental health and addictiontreatments, and for public education.
18-08-22
57
Looking ForwardInnovative Options /
Responsibilities
113
QB4. Which one of the following best describes what is needed to improve Canada’s health care system? (n=1500)
Approach Required to Improve Care Public Perceptions
114
16%
17%
17%
17%
14%
17%
13%
10%
21%
13%
12%
13%
12%
55%
55%
51%
41%
41%
54%
51%
51%
46%
50%
49%
42%
45%
23%
21%
25%
34%
38%
23%
30%
35%
29%
32%
34%
40%
37%
5%
4%
3%
4%
4%
2%
4%
3%
3%
4%
2018
2016
2013
2007
2006
Fall 2004
Spring 2004
2003
2002
2001
2000
1999
1998
Complete rebuild from ground up Some fairly major repairs Some minor tuning up Everything fine the way it is
18-08-22
58
QB4: Which one of the following best describes what is needed to improve Canada’s health care system? (n=1500)
Approach Required to Improve CarePublic Perceptions – By Region
115
12%
13%
16%
12%
32%
11%
49%
50%
55%
57%
58%
61%
33%
29%
23%
25%
8%
24%
BC
Alberta
Prairies
Ontario
Quebec
Atlantic
Complete rebuild from ground up Some fairly major repairs Some minor tuning up Everything fine the way it is
QB4: Which one of the following best describes what is needed to improve Canada’s health care system? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)
Approach Required to Improve CareProfessional Perceptions
116
13%
18%
8%
40%
15%
59%
64%
70%
48%
70%
26%
16%
20%
10%
15%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
Complete rebuild from ground up Some fairly major repairsSome minor tuning up Everything fine the way it is 2018 2016 2013 2007 2006 2003
72% 79% 75% 62% 68% 69%
82% 84% 91% 69% 66% 72%
78% 73% 73% 52% 54% 56%
88% 78% 70% 66% 63% 72%
85% 74% n/a n/a n/a n/a
TotalComplete Rebuild/Major Repairs
18-08-22
59
QK3. Innovations in health care can include new treatments, use of best practices in providing care, approaches to the management and administration of the health care system and use of new technologies and medicines. To what extent do you agree or disagree with each of the following statements? (n=1500)
Support for InnovationPublic Perceptions
117
51%
48%
49%
42%
44%
39%
42%
33%
38%
40%
37%
44%
41%
44%
39%
46%
5%
4%
5%
5%
7%
8%
10%
10%
5%
7%
8%
9%
6%
8%
6%
9%
More disease prevention education and support
Increase access to home and community care services to help me stay independent
Accelerate shared leadership, that is, governments, health industry, universities, research hospitals and health authorities working more
closely together to address challenges in health care
An increased responsiveness of the health care system to the patient’s and family experience
More wellness promotion
Accelerate the use of personal electronic health records that patients can access
Increase the use of non-physician health care providers, meaning patients could see a nurse practitioner, pharmacist or other qualified
practitioner instead of a physician
Increase patient involvement in decision making about the health care system
Strongly support Somewhat support Somewhat oppose Strongly oppose Not sure2018 2016 2013 2007 2006 2005
89% 85% 83% 72% * *
88% 85% 85% 78% 80% 81%
86% NA NA NA NA NA
86% NA NA NA NA NA
85% 82% NA NA * *
83% NA NA NA NA NA
81% 82% 79% 58% 59% 55%
78% 79% 81% 72% NA NA
Total Support
*Before 2016: Combined as More Wellness promotion and Disease PreventionNA: Not asked in this year
QK4. Which three initiatives do you think are most important to lead to a better health care system? Please select up to three. (n=1500)
Top Supported Initiatives for InnovationPublic Perceptions
118
1st
Increase the use of non-physician health care providers, meaning patients could see a nurse practitioner, pharmacist or other
qualified practitioner instead of a physician
51%
2nd
Accelerate shared leadership, that is, governments, health industry, universities,
research hospitals and health authorities working more closely together to address
challenges in health care
44%
3rd
More disease prevention education and support (e.g., screening and early detection,
tele-health for patient coaching, etc.).
42%Increase access to home and community care services to help me stay independent 35%More wellness promotion 33%An increased responsiveness of the health care system to the patient’s and family experience 31%Accelerate the use of personal electronic health records that patients can access 25%Increase patient involvement in decision making about the health care system 19%No other initiatives are important to me 4%
18-08-22
60
QK3. Below is a list of initiatives that may lead to a better health care system. Thinking of how effective these might be, indicate the degree to which you support or oppose the implementation of these initiatives. Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)
Support for InnovationProfessional Perceptions
119
Strongly support Somewhat support Somewhat oppose Strongly oppose Not sure
14%
66%
73%
43%
57%
41%
60%
63%
34%
64%
30%
51%
57%
37%
49%
37%
26%
20%
34%
34%
48%
31%
34%
42%
32%
38%
36%
25%
45%
35%
28%
5%
4%
19%
6%
6%
7%
2%
21%
3%
15%
11%
11%
17%
9%
18%
3%
3%
2%
12%
4%
3%
5%
2%
4%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
Doctors
Nurses
Pharmacists
Administrators
Other Providers
Doctors
Nurses
Pharmacists
Administrators
Other Providers
2018 2016 2013 2007
51% 55% 62% 55%
92% 96% 94% 87%
93% 91% 95% 79%
77% 82% 83% 92%
91% 87% n/a n/a
89% n/a n/a n/a
91% n/a n/a n/a
97% n/a n/a n/a
76% n/a n/a n/a
96% n/a n/a n/a
68% 73% 77% 57%
87% 90% 83% 63%
82% 88% 83% 79%
82% 91% 85% 88%
85% 94% n/a n/a
Total SupportIncrease the use of non-physician health care providers, meaning patients could
see a nurse practitioner or other qualified individual instead of a physician
Accelerate shared leadership, health authorities working more closely together to address challenges in health care.*
* Indicates a new category in 2018
Accelerate the use of personal electronic health records that patients can access
QK3. Below is a list of initiatives that may lead to a better health care system. Thinking of how effective these might be, indicate the degree to which you support or oppose the implementation of these initiatives. Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)
Support for InnovationProfessional Perceptions
120
58%
74%
65%
33%
78%
20%
56%
29%
43%
45%
35%
48%
49%
28%
60%
35%
18%
34%
33%
21%
46%
40%
57%
38%
44%
42%
46%
38%
45%
35%
6%
6%
32%
20%
4%
10%
15%
8%
14%
3%
11%
23%
11%
5%
3%
3%
3%
4%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
Doctors
Nurses
Pharmacists
Administrators
Other Providers
Doctors
Nurses
Pharmacists
Administrators
Other Providers
2018 2016 2013 2007
93% 94% 96% 81%
92% 99% 99% 91%
99% 96% 95% 87%
66% 95% 100% 93%
99% 99% n/a n/a
66% 73% 80% 63%
96% 96% 93% 85%
86% 92% 85% 72%
81% 85% 89% 81%
90% 93% n/a n/a
77% 81% n/a n/a
95% 97% n/a n/a
87% 89% n/a n/a
73% 93% n/a n/a
95% 94% n/a n/a
Total SupportIncrease access to home and community care
services to help me stay independent
Increase patient involvement in decision making about the health care system
An increased responsiveness of the health care system to the patient's and family experience
Strongly support Somewhat support Somewhat oppose Strongly oppose Not sure
18-08-22
61
QK3. Below is a list of initiatives that may lead to a better health care system. Thinking of how effective these might be, indicate the degree to which you support or oppose the implementation of these initiatives. Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)
Support for InnovationProfessional Perceptions
121
60%
63%
56%
43%
73%
60%
69%
65%
43%
67%
28%
32%
36%
34%
20%
31%
24%
30%
37%
26%
9%
4%
7%
18%
5%
7%
5%
3%
18%
3%
5%
4%
Doctors
Nurses
Pharmacists
Administrators
Other Providers
Doctors
Nurses
Pharmacists
Administrators
Other Providers
2018 2016 2013 2007
88% 92% n/a n/a
95% 96% n/a n/a
92% 97% n/a n/a
77% 96% n/a n/a
93% 95% n/a n/a
91% 89% n/a n/a
93% 98% n/a n/a
95% 97% n/a n/a
80% 96% n/a n/a
93% 97% n/a n/a
Total SupportMore wellness promotion
(e.g., nutrition counseling, exercise and healthy living education, etc.)
More disease prevention education and support (e.g., screening and early detection, tele-health for patient coaching, etc.)
Strongly support Somewhat support Somewhat oppose Strongly oppose Not sure
QK4. Which three initiatives do you think are most important to lead to a better health care system? Please select up to three. Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)
Top Supported Initiatives for InnovationProfessional Perceptions
122
More disease prevention
Increase access to home and community care services to help me stay independent
More wellness promotion
Accelerate shared leadership, health authorities workingmore closely together to address challenges in health
care.*Increase patient involvement in decision making about
the health care system
Increase the use of non-physician health care providers,meaning patients could see a nurse practitioner or other
qualified individual instead of a physician
Accelerate the use of personal electronic health recordsthat patients can access
Increase patient involvement in decision making aboutthe health care system.
No other initiatives are important to me
55%
53%
53%
38%
21%
19%
18%
18%
4%
Doctors Nurses Pharmacists Administrators Other Providers
53%
39%
40%
42%
16%
57%
19%
24%
0%
47%
39%
40%
45%
14%
65%
26%
15%
0%
37%
32%
32%
41%
31%
39%
38%
35%
0%
Three Most Important Initiatives
44%
53%
48%
41%
24%
44%
21%
17%
0%
1
2
3
1
1
11
2
2
22
3
3
33
3
18-08-22
62
QK1: Which one health care stakeholder do you think is currently most responsible for introducing new innovation into the health care system in Canada? (n=1500)
Current Responsibility to Drive Innovation?Public Perceptions
123
22%
15%
13%
7%
7%
4%
3%
2%
1%
24%
Federal and provincial governments/funding agencies
Research hospitals
The pharmaceutical / biotech industry
Regional health authorities
Individual researchers, clinicians and health practitioners
Universities and colleges
Private corporations outside the pharmaceutical / biotech industry (e.g., Amazon, Google)
The general public
Foundations and not-for-profit organizations
Don't know
2016 2013/14
15% 21%
20% 18%
15% 14%
3% NA
10% 9%
7% 7%
NA NA
4% 4%
3% 3%
24% 23%
QK1: Which one health care stakeholder do you think is currently most responsible for introducing new innovation into the health care system in Canada?QK2. And which one health care stakeholder do you think should be most responsible for leading the implementation of diagnostic and treatment innovations into the health care system in Canada?(n=1500)
Who Is and Should Be Responsible to Drive Innovations?Public Perceptions
124
22%
15%
13%
7%
7%
4%
3%
2%
1%
24%
27%
18%
3%
10%
10%
5%
2%
3%
3%
19%
Federal and provincial governments/funding agencies
Research hospitals
The pharmaceutical / biotech industry
Regional health authorities
Individual researchers, clinicians and health practitioners
Universities and colleges
Private corporations outside the pharmaceutical / biotech industry (e.g., Amazon, Google)
The general public
Foundations and not-for-profit organizations
Don't know
Currently responsible
Should be responsible
18-08-22
63
QK1. Which one health care stakeholder do you think is currently most responsible for leading the implementation of diagnostic and treatment innovations into the health care system in Canada?Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99)
Who is Most Responsible to Drive Innovations?Professional Perceptions
125
The pharmaceutical / biotech industry
Federal and provincial governments/funding agencies
Research hospitals
Individual researchers, clinicians and health practitioners
Regional health authorities
Universities and colleges
The general public
Private corporations outside the pharmaceutical / biotech industry (e.g., Amazon, Google)
Foundations and not-for-profit organizations
Don't know
25%
18%
14%
14%
12%
8%
1%
1%
0%
6%
12%
30%
11%
9%
16%
4%
1%
2%
11%
18%
26%
15%
10%
21%
2%
2%
1%
5%
14%
26%
10%
9%
15%
4%
1%
3%
12%
6%
19%
22%
14%
10%
9%
5%
4%
1%
11%
Doctors Nurses Pharmacists Administrators Other Providers
QK2. And which one health care stakeholder do you think should be most responsible for leading the implementation of diagnostic and treatment innovations into the health care system in Canada?Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)
Who SHOULD Be Most Responsible to Drive Innovations?Professional Perceptions
126
Individual researchers, clinicians and health practitioners
Federal and provincial governments/funding agencies
Research hospitals
Regional health authorities
Universities and colleges
The pharmaceutical / biotech industry
The general public
Foundations and not-for-profit organizations
Private corporations outside the pharmaceutical / biotech industry (e.g., Amazon, Google)
Other
Don't know
27%
24%
16%
12%
9%
1%
1%
0%
0%
2%
8%
20%
21%
16%
12%
4%
9%
5%
1%
2%
2%
7%
19%
32%
22%
12%
4%
3%
1%
1%
1%
5%
6%
25%
12%
11%
7%
10%
5%
13%
8%
1%
2%
Doctors Nurses Pharmacists Administrators Other Providers
22%
24%
21%
12%
5%
3%
3%
1%
1%
5%
18-08-22
64
127
Most Canadians feel the current health care system is salvageable, however, in need of repair
• Canadians and providers agree that the health care system in Canada needs either a complete overhaul, some major work, or at least a tune-up. This sentiment is similar to that seen two years ago among the general population, with some minor fluctuationsamong health care providers.
• Quebecers in particular believe the system needs a serious re-do.
• As a possible improvement to the health care system, Canadians as well as health care providers strongly support all initiativestested. The top two, receiving the most support, are more disease prevention education and support, as well as increased access to home and community-based care services.
• When Canadians are asked to choose which initiatives are most important for a better system, the top three is made up of: increasing of the uses of non-physician health care providers; accelerating shared leadership of governments, health industry, research institutions and health authorities; and more disease prevention education and support (e.g., screening and early detection, tele-health for patient coaching, etc.).
• While more disease prevention is in the top three initiatives to help the health care system among doctors, nurses, pharmacists and other providers, this is less important to administrators. This group places the most value on accelerated shared leadership.Increased use of non-physician health care providers ranks in the top three for all providers except doctors, who place a higheremphasis on more wellness promotion and increased community and home care supports.
• There is some sense among providers that innovation is not always driven by the correct players: while they feel that pharmaceutical companies and governments currently are the most responsible, they feel that researchers and research hospitals should have a bigger role.
Help us help you!
128
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