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Health Services Research Priorities in Prince Edward Island

1. Prince Edward Island Priorities

(1) Behavioural Research on Disease Prevention and Management

How can individuals be assisted in changing lifestyles which contribute to preventable diseases (e.g., addictions, smoking, gambling, obesity) beyond well established cancer research?
How can we improve health outcomes, which are determined by lifestyle behaviours?
What incentives are required to encourage physicians and other health professionals to use clinical practice guidelines (e.g., diabetes management)
Why is there such a gap between knowledge and behaviour?
What is the evidence that can demonstrate to health service providers and policy makers the value of investing in programs for early childhood interventions beyond the health care system, e.g., daycare?

(2) Alternative Models of Service Delivery in the Community

What models of primary care and home care are most cost-effective and have the best outcomes for both patients and providers? Are there unintended consequences of changes in the approach to provision of primary care and home care and what benchmarks are available to evaluate the effectiveness of these models?
How much can effectively be done in the home and community? Can home care be expanded to include mental health services and physicians as part of the home care team?
How can we change public perception that health services are best provided in an acute care setting?
How can integration of services be advanced from concept to actual implementation?

(3) Utilization of Pharmaceuticals

How much are we improving health outcomes for senior through the provincial Drug Cost Assistance Program?

(4) Health Outcomes Research

What indicators are available to measure the cost-effectiveness and outcome of health programs and services?
What is the evidence to support evidence-based decision making and the new federal-provincial accountability framework?
What is the cost-benefit of new preventive and treatment technologies? Currently this type analysis is not possible because provincial health accounting systems do not have the capacity to accurately capture the full costs of different interventions. CCOHTA's assessment of the technical effectiveness of new technologies is very helpful but needs to be connected to the economics.
From an ethical perspective, how much are we willing to invest in the health care system and in interventions of uncertain benefit?

(5) Chronic Diseases

What are the longer term implications of chronic disease for the allocation of resources within the health system?

(6) Health Human Resources

What models can we use to accurately project future health human resource requirements?
What is the right mix of health professionals and scope of practice?
What are the implications of potential changes in scope of practice and mix of providers for the patient, provider and training institutions?

2. Priorities for the Conference of Deputy Ministers

(1) Population and Preventive Health

How much benefit can we achieve for the health status of the population from moving resources to health promotion, disease prevention, early intervention and understanding health outcomes?
What are the levers to affect behavioural change?
What is the impact of the new vaccines (e.g., flu) on health status across Canada? Is this an appropriate investment?

(2) Privatization

Is there a difference in health outcomes from private sector health services delivery?

(3) Utilization of Pharmaceuticals

What is the impact of provincial drug programs on health outcomes?
What are the levers for controlling cost and volume increases?

(4) Alternative Models of Service Delivery in the Community

Are there unintended consequences of changes in the approach to service delivery, e.g., will there be decreased service to the population if primary care funding models and related physician incentives are changed?

(5) Aboriginal Issues

What are the disparities in health status and why?

3. Top Three Priorities

The top three priorities for both PEI and the Conference of Deputy Ministers are

Evidence to support the value of and investment in primary prevention and the shifts required in both government resource allocation and individual behaviour;
Impact of alternative models of service delivery;
Utilization of pharmaceuticals.

4. Anticipated Locus of Research Implementation

The PEI Department of Health and Social Services has limited internal resources to undertake these research priorities. Also as a small province, PEI has an insufficient population base to support most population health research and therefore needs to partner with other jurisdictions as one of several centres in a larger sample size.

It is expected that the research priorities identified would be primarily undertaken by national research organizations.