The access to health services without financial or

 

The Health Care in Canada is guided by the Canada Health Act of 1984. Through this act, the government guarantees that Health Care system in Canada is publicly funded and paid through taxes. The objective of this act is “to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers.” (Canada Health Act, n.d.). It clearly says that their objective is to have an access to health services without money related or different obstructions, but there are some articles that say that Health Canada is giving a limited access to their services and some article says that Canada has one of the best’s health care services in the world. According to Business Insider, Canada is on the Top 16 world’s best healthcare systems because for the past few years there is an increase of Canadians going south for health care in the United States of America. (Martin, 2017).However, some Canadians are still worried about the Health Care system in Canada in the long run. In 2001, Canadians consistently say that our system covers only limited services. (Mendelsohn, 2002)  This research paper ought to determine the current state of the quality of healthcare in Canada, is it for the best or it is not. In the next pages of this research contains description of the three different types of health care services in Canada which are the emergency care, surgery, and mental health. It will explore the Quality, Availability, Expediency, and Equal Access of the three health care services. This research hopefully informs the people and the Government about the state of health care services here in Canada

 

EMERGENCY DEPARTMENT

 

Emergency care implies the execution of acts or strategies under crisis conditions in the perception, care and guidance of people who are sick or harmed or who have incapacities; in the organization of care or meds as recommended by an authorized doctor, seeing that any of these demonstrations depends on information and use of the standards of natural, physical and sociology as required by a finished course using an affirmed educational modules in prehospital emergency care. (Emergency Care, 2015).

QUALITY

            A new study says that Emergency Care in Canada is better than the United States of America based on money spend and life expectancy. The United States ranks 1st on the GDP they spent on health care, but it appears that they are last in terms of life expectancy. On the other hand, Canada ranks 6th in terms of the GDP spent on health care services, but Canada ranks 7th in terms of life expectancy. (Krywenky, 2014). Based on this information, the quality of emergency department in Canada is great compares to the United States. The quality of care in emergency department will be different if compares to hospitals within the country. Emergency departments have physicians that are dedicated to their work, but Emergency Departments are mostly overcrowded and it always turns out to have a physician’s shortage. According to Health Quality Ontario, majority of the patients are satisfied for the emergency care that they received. (System Performance, 2017). So, the quality of Emergency department is fair because physicians always do their best to cure patients and they always find a solution if there are issues, but not excellent because of the overcrowding that leads to the shortage of physicians.

AVAILABILITY

            This section aims to compare the availability of emergency department in North York General Hospital, Ottawa Hospital, and Peterborough Regional Health Centre. North York General Hospital emergency team is a combination of full time physicians, family physicians, nurses, and other professionals with knowledge of acute care. North York General Hospital has 45 rooms in emergency department with 18 negative pressure rooms. Negative pressure rooms are totally closed and ventilated area to prevent transmission of diseases. North York General Hospital also has Triage area where nurses assess patients’ condition, Resuscitation room where they put sickest patients, Acute care area which has 19 cubicles for cardiac patients, Subacute care area which has 17 cubicles for patients with urgent injuries, and Ambulatory care area for patients with less acute illness. North York General Hospital also has an emergency care area for children. (North York General, 2017). Ottawa Hospital has also an emergency team just like North York General Hospital, it includes volunteers, social workers, nurses, staff emergency physicians, medical students, various technologists, and resident Physicians. Ottawa Hospital has two Emergency Department located at the Civic and General campuses. The Ottawa Hospital also has a triage area, has an area for most ill patients and separate area for less seriously patients. They have Resuscitation room or also known as Emergent care for most ill patients.  (Emergency Department, 2017). Peterborough Regional Health Centre has also an emergency team consists of physicians, nurses, clerical, and volunteers. PRHC has a triage area, isolation room or also called waiting room, they have a red zone where they will treat their most seriously ill patients, orange zone for cardiac patients, yellow zones for patients who needs more time at the emerge, blue zone for testing area, and green zone for minor illness. (Emergency Department, 2017). By comparing these three hospitals and knowing their emergency team, facilities, areas, and other information that were gathered, they were all different. North York General Hospital has an emergency department for children which is great and the other two hospitals do not have an emergency department specifically for children. The Peterborough Regional Health Care has a unique names for the areas of the emergency department.

EXPEDIENCY

            This section contains the waiting times at the emergency department. Emergency department is open 24 hours in a hospital. Many Canadians are upset about the waiting times at the Emergency room. Table 1 shows the peak times in the Emergency Department in Ontario and how long patients are in the Emergency Department. This information is according to Ontario Ministry of Health and Long Term Care. (Ontario Wait Times, 2017)

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

MidNight – 2:59 am

5.4

5.3

5.8

5.7

5.3

5.5

5.7

3:00 – 5:59 am

5.2

4.8

5.0

4.9

4.6

4.9

5.4

6:00 – 8:59 am

3.7

3.8

3.9

3.9

3.8

3.9

3.7

9:00 – 11:59 am

3.9

4.3

4.3

4.2

4.3

4.3

3.9

12:00 – 2:59 pm

4.2

4.8

4.5

4.5

4.5

4.5

4.1

3:00 – 5:59 pm

4.2

4.7

4.5

4.4

4.5

4.4

4.0

6:00 – 8:59 pm

4.1

4.5

4.3

4.2

4.2

4.3

4.0

9:00 – 11:59 pm

4.4

4.7

4.8

4.6

4.7

4.6

4.6

  

Legend :

Less than or equal to 5 hours

5-6 hours

More than 6 hours

*Results shown are based on July 2017 to September 2017 ED visit

As of all hospitals, the most seriously ill patients will be accommodated first even though they came after you. North York General Hospital patient wait times varies on the number of people waiting, severity of their illness, and available rooms. (North York General, 2017). So, it is hard to tell how long patients are going to wait in the emergency room. Hospitals in Winnipeg like Concordia Hospital, Grace Hospital, Health Sciences Centre – Adult, Health Sciences Centre – Children’s, Seven Oaks General Hospital, St. Boniface Hospital, and Victoria General Hospital has a page online that shows how many patients are waiting, how many patients they are treating, and the average wait times at the emergency room. (Emergency Depatments and Urgent Care wait times, 2017). Winnipeg’s online page for wait times are very useful to the patients. Therefore, Winnipeg hospital provides better information of the patient wait times in the emergency room than North York General Hospital.

 

EQUAL ACCESS                

Hospitals require the patients to bring their Ontario Health Insurance Card if they are in the Emergency Room. Patients admitted in the emergency room are patients with chest pain, difficulty breathing, unexpected heavy breathing or shortness of breath, severe bleeding or head trauma/injury, sudden onset of weakness, dizziness, mental health crisis or emergency, Car accident, loss of consciousness, sudden change in speech or vision, or any type of severe pain. In children, high fever, persistent vomiting/diarrhea, will not eat or drink – particularly young children, inactivity, compared to usual activity levels. Everyone can get health care in an emergency department even though they do not have a health card. Visitors in Canada can still get health care service in emergency department, but they have to pay all their expenses. According to CNBC, “Canada does not pay for hospital or medical services for visitors,” notes the government’s Department of Immigration, Refugees and Citizenship. “You should get health insurance to cover any medical costs before you come to Canada.” (Grant, 2016).  Public health care in Canada is for citizens and permanent residents only. Fortunately, everyone has an access to emergency department regardless of someone’s citizenship. The only difference is, visitors will shoulder the expenses.

SURGERY DEPARTMENT

A department in a hospital which regulates arrangement of surgical analytic and therapeutic administrations. (Surgery Department, Hospital, 2017).

QUALITY

The quality of the surgery department in hospital around Canada is excellent. On 2013, CBC had rated hospitals in Canada based on the rates of the patients who died in surgeries. CBC gives an A+ if the hospital outcomes are better than a typical hospital; B if they are similar; C if they are lower; and D if they are substantially lower than a typical hospital. CBC gave an A+ to these following hospitals: St. Joseph’s Health Care London, Perth and Smiths Falls District Hospital, Chaleur Regional Hospital, Victoria General Hospital, Saskatoon City Hospital, Grace Hospital, Sturgeon Community Hospital, High River General Hospital, Lamont Health Care Centre, ad Banff-Mineral Springs Hospital, Covenant Health. There are 20 hospitals with a B grade, there are 34 hospitals with a C grade, and there are only 8 hospitals with a D grade.(Health, 2013). According to this information, surgery department in hospitals around Canada render an excellent quality.

AVAILABILITY

The department of surgery has 7 surgical divisions: Cardiac Surgery, General Surgery, Neurosurgery, Orthopaedic Surgery, Plastic Surgery, Thoracic Surgery, and Vascular Surgery. Hospitals in Canada have different main focus and they have different numbers of surgeons. For example, Sunnybrook Health Sciences Centre has 17 surgeons and their main focus are Surgical Oncology, Trauma and Acute Care surgery. Also, Sunnybrook is the largest trauma centre in Canada. On the other hand, Humber River Regional Hospital has 9 General Surgeons and 1 vascular surgeon. Their main focus is on General Surgery and this hospital is one of the highest volumes of colon cancer surgery. Moreover, Toronto General Hospital has 10 surgeons with different interest, but they are all focuses on General Surgery like breast surgery, neck surgery, thoracic surgery and many more. Lastly, Women’s College Hospital is designated to ambulatory-type surgeries. (General Surgery/Hospitals, 2017). Hospitals in Canada do not offer the same focus of specialities, but they are doing their best to provide excellent service to all.

EXPEDIENCY

Researchers at Ottawa Hospital said that there is a higher risk of death or recovery time if patients are not send to the operating room right away. The main causes of the delay are unavailable operating rooms and unavailable surgeons and nurses. (Ubelacker, 2017). A study suggests that robots can be the solution of the problem. Robots can be a substitute for the nurses or surgeons who are not available during the operation. But, hospitals do not have a budget to buy for medical robots for surgery. Vancouver General hospital is the only hospital. Calgary, Edmonton, Montreal and Quebec City all have at least one surgical robot.

Surgical wait times in Canada had increased for the last 20 years. According to Esmail, the wait times in 1993 was only 9.8 weeks from referral to treatment. This year, wait times would take 18.3 weeks from referral to treatment. Canada has the longest wait times for surgery compares to Australia and United Kingdom. Canadians also wait for an additional three weeks longer than what they consider as clinically reasonable wait times. Also, 3.5 million Canadians did not receive health care needs in 2014. However, wait times in Canada depends on where you live. According to the report, Ontario Hospitals had the shortest wait times in 2013 which took only 13.7 weeks while Prince Edward Island Hospitals had the longest wait times which took 40.1 weeks. Wait times can vary also on what kind of surgery or specialities. In Prince Edward Island, 92% of their patients got a cataract surgery within the medical time frame even though Prince Edward Island Hospitals had the longest wait times. In Ontario, 81% of their patients got the surgery they needed also within the medical time frame. Wait times is shorter for cancer surgeries like oncology, and radiation. (Kohut, 2017). Wait times varies on where do you live and the kind of surgery. According to these information, wait times at surgery is a problem here in Canada. Wait times are increasing for the last 20 years.

EQUAL ACCESS

Medical surgeries are covered by OHIP like aortic valve replacement surgery. The Ontario government will cover the cost of the surgery and other surgeries that are medical related. There are also weight loss surgery that OHIP covers. However, OHIP only covers weight loss procedure like Bariatric surgery if their Body Mass Index is above 40 and if they failed previous attempts of weight loss medically supervised program. Weight loss surgery like liposuction does not covered by OHIP. Liposuction is considered as cosmetic surgery. (Priest, 2013).

In 2015, Health Canada warned British Columbia for charging their patients to pay part of the surgeries. British Columbia has a robots that are performing surgeries. These Robots are expensive, but they are really a good help for them. So, in order to cover the expenses, they let the patients pay some part of the cost of the procedure. (The fight over robots in the operating room, 2017).  Before in British Columbia, only patients who can get the surgeries with the help of the robots are the patients who can only afford the part of the cost.

MENTAL HEALTH

“Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.” (Mental health: a state of well-being, 2014).

QUALITY

According to the Health Statistics Canada, Mental Health should improve their services. “Improve mental health data collection, research, and knowledge exchange across Canada.” It is clear from the study comes about that psychological wellness mind needs keep on going neglected for Canadians. (Diana, 2013).  There are a high percentage of Canadians that did not meet mental health care need. So, the quality of mental health care in Canada is poor and they should improve it.

AVAILABILITY

This section is based in North York general Hospital. North York General hospital has a number of sites that offers mental health services. These include: Inpatient Care – Adult, Geriatric, Child and Adolescent, Partial Hospitalization Program, Outpatient Services, Geriatric Psychiatry Program (GPP), Child and Adolescent Inpatient Mental Health, Women’s Clinic, Consultation Liaison Service to Medical/Surgical/Oncology/Paediatric. They also offer a variety of services at Branson Ambulatory Care Centre such as: Addiction Program – Adult & Transitional Age Youth, Adolescent Eating Disorders Program, Assertive Community Treatment Team (ACTT), Child and Adolescent Mental Health – Day Hospital, Child and Adolescent Outpatient Mental Health, Partial Hospitalization Program, Adult Outpatient Mental Health, Outpatient Groups, Mental Health and Justice Treatment and Support Services, Primary Care Reversed Shared Care Services, and Participants’ Council – Peer Support. North York General Hospital also offers inpatient unit, outpatient program, and day hospital for children and teenagers who are in this condition. (Mental Health, 2017).  North York general Hospital has a lot to offer.

EXPEDIENCY

According to Kim Moran, “Ontario has turned its back on children and youth in desperate need of mental health services. Unacceptable wait times and insufficient access to mental health professionals have created a crisis and many families are struggling tremendously because of this lack of access to care. We can’t let this continue any further – our children deserve better.” Children in Ontario have been waiting for 1.5 years to receive a treatment. But, Ontario is lacking a funding for mental health services. There is also an increase up to 12, 000 kids waiting for long term care psychotherapy. Below is a breakdown of how long Ontarians have been waiting for care.

·         Eastern Ontario kids wait from 2 weeks to 2 years.

·         Central Ontario kids wait from 2 months to 15 months.

·         Northern Ontarian wait times have been exceeded for 1 year for intensive care.

·         In Toronto, patients have been waiting for a year in some mental health services.

·         In Western Ontario, clients waiting for up to 7 months.

This information gathered is according to Children’s Mental Health Ontario. (2017). This is a serious problem here in Canada and Government should increase the funding because there is a growth of people having a mental illnesses.

EQUAL ACCESS

Mental health services do not have an equal access. To see a psychiatrist is covered by OHIP, but to see a psychologist is not covered by OHIP and have to pay the fees. The Ontario Government covers only minor services in mental health. If someone need to see a private psychologist, they need to pay them every session and it is not covered by OHIP. If someone does not have a money to pay for the service, he/she will be stuck in a wait list that will take years. (Goffin, 2016)

CONCLUSION

Canada can be one of the best countries that have a good health care services, but according to the information gathered in quality, expediency, and equal access of emergency department, surgery department, and mental health department, Canada is not best in terms of expediency and availability. Canadians have been waiting so long to get the care that they needed because of the lack of facilities, funds, doctors, nurses and money. 

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