News

Health-care in Canada needs European-inspired updates: new study

Published

11 months ago

December 4, 2023

Canada is trailing behind other Organisation for Economic Co-operation and Development (OECD) countries when it comes to both the number of physicians relative to the population, and its spending on primary care, according to a new analysis published in the Canadian Medical Association Journal.

“Health systems with strong primary care have better outcomes, lower costs and better equity,” write the nine authors of the study, “Primary care for all: lessons for Canada from peer countries with high primary care attachment.”

“Yet, even at the outset of the COVID-19 pandemic, about 17 per cent of people in Canada reported not having a regular primary care clinician.”

Meanwhile, the analysis reveals, Canada is seeing declining enrolment in family medicine as a specialty among medical students, and more graduating family physicians are choosing not to practise generalist office-based care. Post-pandemic, 22 per cent of adults in Canada—more than 6.5 million people—don’t have a family doctor they can see regularly for care.

To solve these dilemmas, the authors say Canada should learn from the successes of other OECD countries with high rates of patients enrolled with primary care clinicians.

‘WE NEED TO DO THE SAME’

The authors compared Canada to nine countries where more than 95 per cent of people have a family doctor, primary care clinician or place of care—including France, Germany, New Zealand, United Kingdom, Denmark, Netherlands, Finland, Italy and Norway—to find opportunities for improvement here. To make their comparison, they studied data from 2018, 2019, 2020 and 2021.

They found that these countries tend to spend more on primary care, that a greater percentage of their health-care is publicly funded, that they have more doctors overall and more of their family doctors are working in family practices. In Canada, by comparison, many doctors work in emergency departments or practice in a specific area, like sports medicine.

Among the nine OECD countries studied, most doctors are paid by salary or a fixed payment arrangement known as capitation, rather than the fee-for-service model common in Canada. They have organized after-hours care and few or no publicly-funded walk-in clinics. They also have smarter information systems that allow doctors to better communicate with patients and allow patients to access their own records online.

While Canada came out in the middle of the pack on health-care spending, the proportion of that spending that was public was the lowest, at 70 per cent. This figure hasn’t changed since the 1990s, the study reports.

Canada had similar numbers of family physicians per capita but the lowest number of total physicians per capita by a wide margin, at 24.4 per 10,000 people. After Canada, the country with the second-lowest per capita number was the United Kingdom, with 30 physicians per 10,000 people. Norway had the highest number per 10,000, at 50.4.

Canada also spent less of its total health budget on primary care, and spent more on private health care than any of the other countries studied.

“Other countries have designed their system so that everyone has access to primary care. We need to do the same,” wrote Dr. Tara Kiran, a family physician at St. Michael’s Hospital and Unity Health Toronto in a media release.

“At the core, we need to guarantee access to primary care and increase how much we spend on it.”

AREAS FOR IMPROVEMENT

To bring Canada up to speed with the OECD countries providing the best primary care, the authors say public health care here needs some important updates.

For one thing, most doctors in Canada are private contractors with “little system accountability,” they said, whereas the authors say they need to be bound by stronger contractual agreements and accountability to government, insurers or both. They also call for changes to the way health-care providers are paid, specifically to move primary care physicians to capitation or salary payments and away from fee-for-service.

They recommend that a higher proportion of the total health budget be spent on primary care, with medicare coverage extended to prescription medications, dental care and expanded mental health care. They say Canada also needs more physicians per capita.

“Canada should move to a model where residents are guaranteed access to a primary care practise near their home and ensure that these practices are funded appropriately,” they write.

Finally, they call for improved patient communications systems, more organized after-hours care and fewer walk-in clinics.

They acknowledge that factors unique to Canada, such as its vast geography, diverse population and proximity to the United States and its health-care system, could pose challenges to emulating its overseas counterparts.

However, they say it’s already partway there, “with respect to regional funding of physician services by governments, overall health spending” and the way primary care serves as an access point to other parts of the health system.

“Canada can learn from OECD countries such as the Netherlands, Norway, the U.K. and Finland, where more than 95 per cent of people have a primary care clinician,” they conclude. “These international examples can inform bold policy reform in Canada to advance a vision of primary care for all.”

Source link

News

Coronato scores twice, but Flames video coach plays hero in Calgary’s win

Published

9 hours ago

November 5, 2024

Anne Joseph

MONTREAL – Matt Coronato scored the game-tying goal and the overtime winner in a dramatic finish, but video coach Jamie Pringle was the hero on Tuesday night.

Before Coronato powered a Calgary Flames comeback, Brendan Gallagher appeared to give the Montreal Canadiens 3-1 lead with 8:24 remaining in the third.

Pringle, however, instantly flagged the goal for offside. Then the Flames challenged successfully, and Coronato did the rest as Calgary flipped the script and won 3-2 in overtime.

“I was just saying that a post is normally a goalie’s best friend, but I think the video coach is now number two,” Flames netminder Dustin Wolf said.

Canadiens forward Josh Anderson had set up Gallagher on an odd-man rush, though it was unclear in real-time if Anderson had full control of the puck when he entered the Flames’ zone backward.

The Bell Centre’s roof nearly blew off with Canadiens fans celebrating like it was a sure thing, but Pringle thought otherwise.

“We’ve always been confident in Jamie,” Flames head coach Ryan Huska said. “He’s the best guy in the league. So another situation where he flashed it up, challenge right away.

“We don’t get this win if it’s not for the courage that he showed. You have a great guy in that chair for a reason. And Jamie did a great job for us, keeping us in this game tonight.”

Pringle, a 49-year-old from Picton, Ont., who’s also known as “Chips,” is in his 14th season with the Flames.

And it wasn’t the first time he played a crucial role in a victory this season.

In Calgary’s 4-1 win over the Edmonton Oilers on Oct. 13, the video coach successfully challenged two goals, including one Corey Perry deflection that the hockey world was convinced should have counted.

Pringle made the snap decision anyway, even though a failed challenge would put his team on the penalty kill.

“He’s hot this year,” forward Blake Coleman said. “You know what? He needed to redeem himself after a tough last year. We had some good chats down the stretch, and he’s been on fire.

“I’d say of all the guys on our team, he’s probably the one who hasn’t missed a night so far.”

Coronato showed up at the right time on Tuesday.

The 21-year-old winger tied the game with 2:46 remaining in regulation when he cruised into the slot and went off the post and in. He then buried the winning goal seven seconds into the extra period, coming one second shy of tying the fastest OT goal in NHL history.

“He’s remarkable. He’s had so many chances to score, and he’s kind of been snaked bit a few times,” Wolf said. “To see him score on two unbelievable shots, that’s a scouting report on him, his shot’s lethal.”

“The kid can shoot it,” Coleman added. “Couple big ones.”

Coronato, a 13th overall pick in the 2021 NHL draft, spent most of last season in the American Hockey League with the Calgary Wranglers.

This season, he’s played two games in the AHL and eight in the NHL. And with performances like Tuesday’s, he can expect plenty more in the big leagues.

“Sometimes with younger players, you put them in the American League for a bit and it’s hard on them,” Huska said. “There’s a long-term plan for sure. We know how good he’s going to be for us. We just want to make sure that we are putting him in situations that he’s going to be ready for and be able to have success.

“He’s done an excellent job of preparing himself to play, and we saw the result of his effort tonight.”

The Flames (7-5-1) picked up their second win in seven games to kick off a three-game road trip. Meanwhile, the Canadiens (4-7-2) dropped their fourth in a row ahead of four games away from home.

“We didn’t throw up on ourselves tonight, but we still feel a bit sick to our stomachs,” head coach Martin St. Louis said, referencing a post-game assessment he delivered after a 6-3 loss last week in Washington.

The Canadiens didn’t paint a picture of doom and gloom in the dressing room despite coming a couple minutes shy of securing two points and snapping their skid, but St. Louis said his players should leave this game “hungry” to get in the win column.

“If I was in their shoes, I’d wish we played tomorrow,” he said. “That’s what I would want to feel like. That’s what I want to be like.”

This report by The Canadian Press was first published Nov. 5, 2024.

Source link

News

Blues Dylan Holloway rushed to hospital after being struck in neck by puck

Published

9 hours ago

November 5, 2024

Anne Joseph

ST. LOUIS (AP) — St. Louis Blues forward Dylan Holloway left Tuesday night’s contest against the Tampa Bay Lightning and departed the rink on a stretcher after being struck by a puck late in the first period.

Holloway was hit in the neck area by a puck with 2:37 remaining in the period, and proceeded to finish his shift, continuing to participate in the play before skating to the bench under his own power.

As play was stopped with 1:11 remaining for a high-sticking penalty that was later called off, teammates started calling and gesturing for assistance.

Blues trainer Ray Barile and medical staff from both teams tended to Holloway for several minutes before emergency medical technicians carted him off the bench on a stretcher.

“I was just sitting beside him and saw something was happening,” Blues forward Alexey Toropchenko said. “I told Ray. He knows what he’s doing. I was just kind of curious to what’s going on. Doctors came in and, like, I think everything is good right now. But we were worried, everybody.”

Holloway was seen raising his arm as he was carted off. The Blues later announced that Holloway was alert and stable and was rushed to a St. Louis area hospital for further observation.

“I think the only way I can put is if you’re at work, and you get a call, and one of your family members is sick, and you rush to the hospital,” Blues coach Drew Bannister said.

“Holly’s a family member. That was tough. I thought we, as a group, showed a lot of fortitude, and the way mentally being able to push through that, because the easiest thing to do is your head goes somewhere else. But, we were able to get updates on Holly and kind of put our minds at ease a little bit and refocus ourselves.”

Referees Wes McCauley and Cody Beach sent the teams to their locker rooms and started the first intermission after Holloway was transported off the bench due to the nature of the injury.

“It’s hard,” Blues captain Brayden Schenn said. “It’s your teammate. Then we got news that he’s going to be fine. And then, you have to wrap your head around it a little bit and go play a hockey game again, right?

“So that’s just, unfortunately, the reality of the sport, and it took us awhile to get going.”

St. Louis rallied to score three goals after falling behind 1-0 early in the second period to beat Tampa Bay 3-2.

—

AP NHL:

Source link

News

Niederreiter scores twice in 900th career game as Jets beat Utah 3-0

Published

9 hours ago

November 5, 2024

Anne Joseph

WINNIPEG – Nino Niederreiter showed his veteran savvy in his 900th NHL career game on Tuesday.

The Winnipeg Jets forward scored twice and Connor Hellebuyck made 21 saves in a 3-0 victory over the Utah Hockey Club that kept the team’s early-season success rolling with a fourth consecutive win (12-1-0).

On his first goal, the 32-year Niederreiter lifted a Utah opponent’s stick in Winnipeg’s end, allowing the Jets to get the puck and head toward the visitor’s net.

Niederreiter then joined the rush, deked and put the puck around netminder Karel Vejmelka for a 2-0 lead at 7:30 of the third period with his sixth goal of the season.

“Obviously, the game wasn’t very pretty,” Niederreiter said. “There wasn’t a whole lot of flow out there. I think that is something that we knew and just had to stick with and do the little things right.

“Eventually, we would create our own luck and that’s what happened there.”

And what about his deke in front of 12,932 fans at Canada Life Centre?

“I still got it somewhere in there,” Niederreiter said with a smile. “It’s a great feeling, like I said. It’s a cool night to score a goal like that.”

His second goal — the 230th of his career — was into an empty net with 2:59 remaining. He also has 225 assists for 455 career points.

Gabriel Vilardi scored the first goal at 17:57 of the second period on the power play and Adam Lowry picked up two assists.

Hellebuyck recorded his second shutout of the season and 39th of this career.

Niederreiter signed a three-year contract extension with the Jets last December. The $12-million deal kicked in this season.

He’s now scored against 33 NHL teams, including the Jets.

“It’s a cool stat, but I think it also says that I’ve been traded a few times,” he said. “But I guess it gives me the chance to do that.”

Niederreiter was drafted in 2010 by the New York Islanders (fifth overall), becoming Switzerland’s highest NHL pick.

He’s also played for the Minnesota Wild, Carolina Hurricanes and Nashville Predators before being traded to the Jets in February 2023.

Jets head coach Scott Arniel was impressed by Niederreiter’s quick-thinking stick lift.

“We’ll throw that on the old system video,” he said. “But that’s just going the distance, coming all the way back and he creates that.

“We’re never out of it. You never know how a puck’s going to bounce. He just kept coming and obviously we turned that offence the other way.”

Arniel said the team recognized Niederreiter’s milestone.

“That’s special. That’s a lot of games,” Arniel said. “We had a little tribute to him, saw all his pictures from all the jerseys he’s worn and the places he’s played.

“He hasn’t changed a bit. He’s a big power forward and that line I thought was really good. They take that (Clayton) Keller line on, those skill guys. They did a really good job.”

Niederreiter is on a line with Lowry and Mason Appleton.

“Those guys on the PK were really strong,” Arniel added. “When that line plays like that they’re a force, they’re hard to handle. They wear teams down because they spend so much time in the offensive zone.”

Utah (5-5-3) ended a run of picking up points in three consecutive games (1-0-2).

Vejmelka stopped 25 shots for Utah in its second game of a four-game road trip.

“They know what to expect of each other. They play a really, really structured game, and they were patient tonight,” Utah head coach Andre Tourigny said of the Jets.

“I think that was a good chess game. They got one on the power play and from there they waited for the opportunity to have a killer goal. They did a good job.”

NOTES: Jets defenceman Josh Morrissey picked up his 14th assist of the season when his point shot with five seconds left in a power play was tipped in by Vilardi. … Kyle Connor had his franchise-record, season-opening points streak end at 12 games. He almost picked up an assist until Vilardi tipped in Morrissey’s shot.

This report by The Canadian Press was first published Nov. 5, 2024.

Source link