In this issue of the Longwoods Review we present a paper by Motiwala, Flood, Coyte and Laporte that explores the First Ministers' 2003 Accord and its impact - or lack of - on home care. The paper is critical of the home-care initiatives outlined by the First Ministers as they do not address issues of access to long-term care or to nonprofessional home care - services that are critical to the elderly who wish to stay at home and who represent an increasing proportion of the country's population. The authors also point out that the Accord does not establish legislative protection or separate funding for home care services, both of which are necessary to ensure that home care as a whole receives an adequate share of public resources and political attention over the medium-and long-term. The authors point out that failing to address these concerns may lead to increasing privatization as public services will be inadequate to meet the demand.
We are also pleased to recommend two on-line papers; the abstracts
of which are featured in this issue. In the first, Thompson writes
on cost containment issues in Alberta. He raises some controversial
issues and asserts that in fact Alberta's healthcare costs have not
actually risen in the last 30 years. In his analysis, Thompson
shows that when cost data are adjusted for population growth,
inflation and shift in age distribution increases in healthcare
costs have been quite modest. The main issue from Thompson's
viewpoint is that healthcare policy makers have been setting
direction for healthcare in Canada based on inappropriate
assumptions. Using Alberta data on its expenditures for healthcare,
Thompson shows that increases in expenditures have been minimal and
in fact the general public would be willing to accept higher taxes
for better health services.
In the second paper, Nyhof-Young, Friedman, Wiljer and Catton
discuss the increased risks faced by cancer patients when making
their first visit to Toronto's Princess Margaret Hospital during
the Severe Acute Respiratory Syndrome (SARS) outbreak. These
patients were considered highly vulnerable to negative effects of
the SARS-related disruptions. Semi-structured interviews were
conducted by telephone with 42 patients and eight family members
about how SARS affected their treatment experiences at the
hospital. Results of the interviews suggested that good
communication between patients and the staff at times of crisis are
essential and contribute to the overall coping experiences of
patients and their families. Recommendations are provided for the
development of patient-centered emergency policies.
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