Measuring the health impact of waiting for a joint replacement
Dr. Mark Harrison (Queen's University) - $89,692 (for 1 year)
It can be a long wait to see a specialist and then actually have your hip or knee replacement surgery. Health care administrators have techniques to manage their wait lists, but they have little objective information about the impact of the wait on patients' health to help them. Instead, subjective measures and questionnaires are being used to prioritize people on the wait list. Dr. Mark Harrison of Queen's University will use more objective measures to chart how people's physical, physiological and psychological health declines while waiting for surgery. He will then correlate the measures with current ways to manage wait lists, such as the Western Canada Wait List Hip and Knee Prioritization Tool. His research will help to improve patient prioritization techniques and identify pre-operative programs, such as exercise, weight loss and/or counselling, that can improve patients' health status while they wait for surgery.
What are the ingredients of good primary health care?
Dr. Marie-Dominique Beaulieu (CHUM, University of Montreal) - $509,405 (for 3 years)
Health-care systems across the country are investigating the best ways to deliver primary care - is it private practices? Community clinics? Family practice groups? Dr. Marie-Dominique Beaulieu of CHUM at the University of Montreal is comparing these three different models of primary care delivery in 60 centres in three areas of Quebec to find out how they affect quality of care, specifically the management of chronic illnesses. Her goal is to identify structural and organizational factors that support high-quality clinical practices. By linking the different models with measurements of clinical outcomes, Dr. Beaulieu will contribute to the development of a set of tools for measuring primary-care performance taking into account many different dimensions, including clinical outcomes, user satisfaction and the evaluation of care processes.
Do rising drugs costs equal better health, lower expenditures in other areas?
Dr. Steven Morgan, (University of British Columbia) - $513,965 (for 3 years)
Canada will spend roughly $30 billion on pharmaceuticals in 2007, more than half of what we will spend on hospitals and 50% more than we will spend on physicians. It is also more than three times what we spent on drugs just a decade ago, in 1996. If these trends continue, we will spend $85 billion on drugs in 2017, one out of every four dollars spent on health and more than we will spend on hospitals. But there is much we don't know about drug expenditures: Is spending rising because of an aging population? Is increased use of medicines resulting in improved health? Does spending on drugs generate savings in other components of the health system? Dr. Steven Morgan of the University of British Columbia is finding the evidence to help policy makers better understand the causes and consequences of our spending on drugs. He will examine the use and costs of pharmaceuticals, medical services and hospital care by all British Columbians from 1996 to 2007 to quantify the population-based impacts of prescription drugs on health services utilization and population health.
When nursing conflicts with values
Dr. Marie Edwards (University of Manitoba) - $40,045 (for 1 year)
Nurses can feel moral distress when they feel they are not pursuing an ethical action, for any number of reasons, including external constraints and judgment errors. Their response is often frustration or dissatisfaction with their jobs, leading them to leave their positions - or even the profession. Dr. Marie Edwards of the University of Manitoba wants to find out how best to respond to nurses' moral distress, particularly those working in long-term care settings. She will explore with nurses their thoughts on how they respond when faced with situations that produce moral distress, the kinds of organizational factors that can help or hinder them as they respond to it and the supports they believe would be helpful in these situations. Implementation of the study's results could improve patient care and the functioning of the health care team and increase work satisfaction and retention of nurses.
Taking ownership of one's own care
Dr. Carol McWilliam (University of Western Ontario) - $195,966 (for 3 years)
Shorter hospital stays and an aging population that is living longer are increasing Canadians' need for home-based health care. Jurisdictions across the country are struggling with questions about how best to provide this care. Dr. Carol McWilliam of the University of Western Ontario will test an approach to in-home care that allows clients to be partners in their own care to the degree to which they are able and willing. Case managers and care providers will make continuous, conscious efforts to focus on clients' personal knowledge of their care needs, their ability to care for themselves and the degree to which they wish to be involved in decision making. She and her team will follow patients over a two-year period, measuring the impact of the approach and its effect on services used and the cost of these services, compared to clients in other home-care programs managing care in the usual way. The study will help to structure home care to promote clients' independence and provide information about how to make the best use of limited home-care resources.
