The U.S. and Canadian Health Care Systems: Views of Resident Physicians

1991 ◽  
Vol 115 (4) ◽  
pp. 308 ◽  
Author(s):  
Rodney A. Hayward
2018 ◽  
Vol 46 (4) ◽  
pp. 833-837
Author(s):  
Gregory P. Marchildon ◽  
Capri S. Cafaro ◽  
Adalsteinn Brown

The U.S. and Canadian health care systems are more similar than is commonly believed. This article debunks some of the powerful myths about these health care systems and opens up the discussion for greater policy learning from both sides of the border. Cross-border comparisons can yield a number of lessons from common policy challenges such as cost control, physician organization and payment, and the organization of health coverage and services for Native Americans and Indigenous Canadians.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Andrei V Alexandrov ◽  
Georgios Tsivgoulis ◽  
Katherine Nearing ◽  
Marc Malkoff ◽  
Odysseas Kargiotis ◽  
...  

Background: An increasing shortage of vascular neurologists forced an academic provider to find a city-wide solution to offer 24x7 access to intravenous thrombolysis (IVT) across independent and competing health care systems in the area. We sought to prospectively evaluate the annual IVT treatment delivery in our population and compare it to leading stroke centers worldwide. Methods: The largest single ER system and 3 other independent hospital providers in the area agreed to work with a single practice plan vascular neurology team (catchment area of 1,344,127 individuals). All acute ischemic stroke patients that were treated with IVT across all primary or tertiary care centers in our area were prospectively documented over a 12-month period (January-December 2015). A literature search was performed using narrative review methodology to document similar population-based treatment rates across leading stroke centers in North America, Europe and Australasia. Results: A total of 552 patients received IVT with tissue plasminogen activator (tPA) in 2015. Single ER system delivered 433 IV tPA treatments and 119 more patients were treated in the remaining hospitals. The annual tPA treatment rate was 41 per 100.000 individuals (95%CI: 38-44) favorably comparable to published annual treatment rates from leading international stroke centers (Table, 1998 thru 2015). Conclusions: A city-wide vascular neurology team can attend to patient populations across competing health care systems in the U.S. and deliver IVT at volumes and rates above those reported by leading treatment centers worldwide. Communities with competing systems can improve tPA delivery by sharing vascular neurology resources.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S331-S331
Author(s):  
Shalini Sahoo ◽  
Roberto J Millar ◽  
Takashi Yamashita ◽  
Phyllis Cummins

Abstract Routine cancer screening is widely recognized as an effective strategy for reducing cancer mortality – the second leading cause of death in the U.S. Research shows cancer screening rates need to be improved, and men are less likely to uptake recommended screening than women. Cancer screening requires an array of tasks such as seeking up-to-date guidelines, making appointments, planning a hospital visit, and communicating with health care professionals in the complex health care systems. Importantly, modern health care systems are rapidly adopting technology such as web-based applications for information dissemination and communication with patients. This current study is designed to better understand the roles of problem-solving skills in the technology-rich environment (PSTRE) in two selected cancer screening behaviors among middle-aged and older men. We obtained nationally representative data with a sophisticated PSTRE assessment from the 2012/2014 Program for the International Assessment of Adult Competencies (PIAAC). Binary logistic regression models with survey weights were used to estimate the association between PSTRE scores (1 – 500 points) and two cancer screening behaviors of men who meet the recommended guideline of age between 45 to 74 years old (n = 1,168). Results showed that greater PSTRE scores were positively associated with prostate cancer screening (OR = 1.005, p < 0.05). Improvement in PSTRE may promote the specific cancer screening behaviors. Our findings also inform future interventions that seek to improve cancer screening among a vulnerable section of older populations.


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