Tuesday, June 26, 2012

[EQ] Resolution: Social determinants of health - Sixty-fifth World Health Assembly 2012 WHA65.8

Social determinants of health
Resolution: Sixty-fifth World Health Assembly 2012 WHA65.8

Agenda item 13.6 26 May 2012 A65/16

Social determinants of health: outcome of the World Conference on Social Determinants of Health

Available online at: http://bit.ly/QefRVO

Español:
Resolución WHA65.8, de la última Asamblea.

65.ª ASAMBLEA MUNDIAL DE LA SALUD A65/16

Punto 13.6 del orden del día provisional 22 de marzo de 2012


Determinantes sociales de la salud: resultados de la Conferencia Mundial sobre los Determinantes

Sociales de la Salud Informe de la Secretaría

Enlace: http://bit.ly/MyDb0q

French :
SOIXANTE-CINQUIÈME ASSEMBLÉE MONDIALE DE LA SANTÉ WHA65.8
Point 13.6 de l’ordre du jour 26 mai 2012
Déterminants sociaux de la santé
Résultats de la Conférence mondiale sur les déterminants sociaux de la santé
URL : http://bit.ly/KLk5EK

 

 
KMC/2012/SDE
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[EQ] An Analysis of Nursing and Healthcare System Outcomes

Better Care: An Analysis of Nursing and Healthcare System Outcomes

Gina Browne, McMaster University, Hamilton, Ontario Faculty of Health Sciences: School of Nursing, Health and Social Service Utilization Research Unit, Department of Clinical Epidemiology and Biostatistics

Stephen Birch, McMaster University, Hamilton, Ontario Faculty of Health Sciences: Department of Clinical Epidemiology and Biostatistics, Centre for Health Economics and Policy Analysis

Lehana Thabane, McMaster University, Hamilton, Ontario Faculty of Health Sciences: Health and Social Service Utilization Research Unit, Department of Clinical Epidemiology and Biostatistics, Centre for Health Economics and Policy Analysis

 

Canadian Health Services Research Foundation Canadian Nursing Association CNA/CHSRF
CNA/CHSRF series of reports to inform the CNA National Expert Commission

The Health of Our Nation – The Future of Our Health System: Paper 2, June 2012

Available online PDF [135p.] at: http://bit.ly/NJLAhW


Appendix B: http://bit.ly/LNuI6j

“……The purpose of this review of nursing intervention literature was to document the comparative effects and costs of models of nursing intervention on patient outcomes, such as morbidity and mortality, and on system outcomes, such as health resource use.

 

This information will be used to provide suggestions about innovative, effective and efficient models of nursing intervention in preparation for the 2014 new federal health accord.


Eligible reviews and studies were those of interventions provided by nurses that documented:

- patient outcomes related to mortality and morbidity, such as functional status, quality of life, coronary or adverse events, and caregiver burden; and

- system outcomes related to use of emergency departments, hospitalizations, length of stay, admissions to nursing homes, and/or total direct cost of health service use from a payer perspective; or

- patient impacts related to wait times or access to care.

 

This review was conducted in three stages:

1. In the initial stage we evaluated high-quality reviews.

2. The second stage involved reviewing high-quality studies of nursing interventions because of limitations in the initial reviews.

3. In the third stage we reviewed studies from McMaster University’s System-Linked Research Unit on Health and Social Service Utilization (SLRU) that involved economic evaluations conducted from a societal perspective alongside clinical trials. In addition, these studies included not only patient outcomes but also health and social effects – direct, indirect and cash transfer effects – of comparative treatments for various illnesses. We did this third stage because the description of

costing methods in the previous studies lacked detail.

Results

To determine whether nurse interventions were comparatively more effective and less costly, we used an analytic framework for economic evaluations to simultaneously summarize the patient effects and system costs qualitatively and in aggregate.

We initially examined over 4,000 reviews and studies to determine whether they met both eligibility criteria and “high-quality standards” for the conduct of reviews and studies. Twenty-seven reviews, 29 studies and nine economic evaluations met the initial minimum eligibility criteria and 75% of the 21 standards of quality for reviews and studies. Included studies were conducted in the United Kingdom, Canada, Australia, the United States and the Netherlands. Included economic evaluations were conducted in southern Ontario…..”

Content:


Executive Summary

Introduction

Section 1: Literature Review and Promising Nurse-Led Practices


Section 2: Costs Averted, Key Clinical Programs and Performance Measurement

2.1 Service innovations documenting similar outcomes at a provincial or national level

2.1a Treatment for chronic pressure ulcers

2.1b Adoption of leading practices in home wound care

2.1c Palliative home care
2.1d Ontario’s Chronic Disease Prevention and Management Framework

2.1e Chronic disease management in the community or at home

2.1f Managing people requiring alternative levels of care

2.1g Home telehealth for chronic disease management

2.2 Key clinical programs across the range of determinants of health: Implications for achieving better care for Canadians

2.3 Strategic investments made and required for monitoring , evaluation , performance measurement and research

2.4 A last word

References


Appendix A: Search Terms With Results, Criteria and Strategies

Appendix B: Excluded Reviews and Studies

Appendix C: Results of Our Review of High-Quality Reviews

Appendix D: Characteristics of High-Quality Studies, Participants and Intervention Programs

Appendix E: Economic Evaluations of Nursing Intervention Programs

 

KMC/2012/HSS
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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]
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“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
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[EQ] Analysis of the impact of current healthcare system funding and financing models and the value of health and healthcare in Canada

Better Value:
An analysis of the impact of current healthcare system funding and financing models and the value of health and healthcare in Canada

Stuart N. Soroka, McGill University, Associate Professor, Department of Political Science

Adam Nathaniel Mahon, McGill University

Canadian Health Services Research Foundation Canadian Nursing Association CNA/CHSRF
The Health of Our Nation – The Future of Our Health System: Paper 3, June 2012

Available online PDF [33p.] at: http://bit.ly/Oovbko  

“….This report examines the interrelationship between measures of government spending on healthcare, health policy indicators and public attitudes on health policy to identify policy approaches capable of achieving better value in the Canadian healthcare system.

 

After describing its context, the report considers some of the many ways in which value can be defined, setting out a working definition that deems “better value” to mean improvements in healthcare policy indicators and/or Canadians’ attitudes toward the healthcare system. Subsequent sections then explore the ways in which spending change has thus far been linked to shifts toward better value in healthcare….”

“…..As a first step toward identifying better value in the Canadian healthcare system, we look at cross-sectional differences across a range of health policy indicators. Specifically, examining the variation that exists between Canadian provinces in terms of levels of healthcare expenditure and policy indicators may reveal efficiencies, and difficulties, in translating spending into healthcare.

 

The relationship between numbers of doctors and wait times, for instance, or between hospital spending and the nursing workforce, clearly varies across provinces, and we suggest that these differences may be revealing where “value” in healthcare is concerned……”

Content

Executive summary

1. Context

2. Defining “better value

3. Measures and models

4. Trends in spending on healthcare

5. Interprovincial differences in spending

6.Health policy indicators as measures of better value

7.Public opinion as a measure of better value

8. Conclusions and recommendations

References

KMC/2012/HSS
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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]
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and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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[EQ] Better Health: An analysis of public policy and programming focusing on the determinants of health and health outcomes

Better Health:

 An analysis of public policy and programming focusing on the determinants of health and health outcomes that are effective in achieving the healthiest populations

Carles Muntaner, University of Toronto, Bloomberg Faculty of Nursing

Edwin Ng, University of Toronto, Dalla Lana School of Public Health

Haejoo Chung, Korea University, Department of Healthcare Management

Canadian Health Services Research Foundation CNA/CHSRF series of reports to inform the CNA National Expert Commission

The Health of Our Nation – The Future of Our Health System: Paper 1, 2012

Available online PDF [70p.] at: http://bit.ly/KBUd9B

To advance the role of nursing in reducing health inequalities, this paper conducts a scoping review to assess the empirical association between social determinants and health outcomes and to identify public policies and political activities that reduce health inequalities.

Guided by the CSDH’s conceptual framework, which emphasizes the “causes of the causes” to reduce social inequalities in health, this paper moves beyond the consideration of immediate causes such as medical treatments or lifestyle choices.

Three questions are addressed:

- What is the current scope of knowledge from Canadian research on SDOH, conceptualized as income, housing, food insecurity and social exclusion?

- What is the role of nursing in reducing health inequalities within Canada’s political and economic contexts?

- Which policy recommendations have the potential to narrow health inequalities?

Scoping review methods consisted of five steps.

 

First, the electronic database PubMed was searched using these keywords: “income” or “food insecurity” or “housing” or “social exclusion” and “population health” or “health inequalities” and “Aboriginal Peoples” or “First Nations” or “Métis” or “Inuit” and “Canada”.


Second
, we screened potentially relevant studies and included them if the studies presented empirical findings and tested at least one SDOH measure.


Third, we charted descriptive and empirical data using a coding template.


Fourth, studies grouped by theme were coded as positive (social determinant of health is positively associated with health), negative (social determinant is inversely associated with health), mixed (social determinant is inconsistently related to health) or no impact (relation between social determinant and health is not significant). Effect size metrics were also extracted to compare the strength of associations between social determinants and health-related outcomes.

Fifth, we searched government reports, international commissions and cost-benefit analyses to augment and inform our policy recommendations….”

 

Content

EXECUTIVE SUMMARY

1 CONTEXT

2 METHODS

3 RESULTS

3.1 Descriptive characteristics

3.2 Nature of empirical associations

3.2.1 Food insecurity

3.2.2 Housing

3.2.3 Multiple SDOH

3.2.4 Income

3.2.5 Social exclusion

3.3 Strength of SDOH associations

4 THE ROLE OF NURSING AND PUBLIC POLICY

4.1 The role of nursing in addressing SDOH

4.2 The political economy of public policies

5 POLICY IMPLICATIONS AND RECOMMENDATIONS

5.1 Income

5.2 Food insecurity

5.3 Housing

5.4 Social exclusion

5.5 Wide-ranging SDOH

 

 KMC/2012/HSS
Twitter
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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]
Washington DC USA

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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