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Transcript of Health Care in Canada Survey 2004. 2 Health Care in Canada Partners Association of Canadian Academic...
Health Care in Canada Survey 2004
Health Care in Canada Survey 2004
2
Health Care in Canada Partners Association of Canadian Academic Healthcare OrganizationsAssociation of Canadian Academic Healthcare Organizations
Canadian Association for Community CareCanadian Association for Community Care
Canadian College of Healthcare ExecutivesCanadian College of Healthcare Executives
Canadian Healthcare AssociationCanadian Healthcare Association
Canadian Homecare AssociationCanadian Homecare Association
Canadian Medical AssociationCanadian Medical Association
Canadian Nursing AssociationCanadian Nursing Association
Canadian Pharmacists AssociationCanadian Pharmacists Association
Canadian Public Health AssociationCanadian Public Health Association
Health Charities Coalition of CanadaHealth Charities Coalition of Canada
Merck Frosst Canada Ltd.Merck Frosst Canada Ltd.
POLLARA Research POLLARA Research
Rogers Media Rogers Media
3
Table of Contents Methodology
Overview of the Health Care System
Views on the September 2004 Federal-Provincial Health Care Deal
Improving Access
Promoting and Protecting Health
Supporting Innovation
Increasing Accountability
Conclusions
4
MethodologySurvey results are based on telephone interviews with nationally representative samples of the Canadian public, doctors, nurses, pharmacists and health administrators.
Fielding was conducted between October 20th and November 3rd, 2004.
Groups Sample Size Margin of Error
Canadian Public 1,034 + 3.1%
Doctors 200 + 7.1%
Nurses 201 + 7.1%
Pharmacists 200 + 7.1%
Health Administrators 210 + 7.1%
Questionnaires were developed by POLLARA working in close consultation with the HCIC partners.
5
Overview of the Health Care System
6
Most Important Issue Facing Canada: Tracking
Q: In your opinion, what is the single most important issue facing Canada today?
0
0.1
0.2
0.3
0.4
0.5
1stQtr95
1stQtr96
1stQtr97
1stQtr98
1stQtr99
1stQtr00
1stQtr01
1stQtr02
1stQtr03
1stQtr04
Health Care (40%)Concerns About Politicians/Govt (5%)Deficit/Government Spending (5%)Economy (5%)Unemployment (4%)Taxes (3%)Environment/Pollution (2%)
5% Politicians
2% Environment3% Taxes4% Unempl
40% Health
5% Deficit5%Economy
Source: Perspectives Canada – Q3 2004
7
‘Very Concerned’: Tracking
15%
20%
25%
30%
35%
40%
45%
50%
55%
60%
65%
70%
75%
3rdQtr97
1stQtr98
1stQtr99
1stQtr00
1stQtr01
1stQtr02
1stQtr03
2ndQtr03
3rdQtr03
4thQtr03
1stQtr04
3tdQtr04
Standard of health care (58%)Standard of education (48%)State of the environment (45%)Level of crime in community (30%)Canada's security from terrorist attacks (29%)
Q: Now thinking more generally, would you say you are very concerned, somewhat concerned, not too concerned, or not at all concerned about the following issues? How about: (READ AND ROTATE)
% Very Concerned
Source: Perspectives Canada – Q3 2004
8
Tracking of Canadians Confidence in the Health Care
System
Q:Overall, would you say that your confidence in the Canadian health system is rising or falling, or is it about the same as it ever was?
1998
1999
2000
2001
2002
2003
Spring 2004
Fall 2004
9
Confidence of Stakeholders in Canadian Health Care System
Q: Overall, would you say that your confidence in the Canadian health system is rising or falling, or is it about the same as it ever was?
Public
Doctors
Nurses
Pharmacists
Managers
10
Proportion With ‘Falling Confidence’ in Canadian Health System is
Declining
Q: Overall, would you say that your confidence in the Canadian health system is rising or falling, or is it about the same as it ever was?
47%51%
58%54%
51%55%
59%
41%
54%65%61%59%
70%
53%
49%
68%64%
58%62%
33%
51%
31%
47%
45%47%
21%
30%
47%50%
0%
20%
40%
60%
80%
100%
1998 1999 2000 2001 2002 2003 2004
Public Doctors Nurses Pharmacists Managers
11
Canadians’ Views on Health Care
System Reform
Q: What approach would you say that Canada’s health system requires at present - a complete rebuilding from the ground up, some fairly major repairs or some minor tuning up, or is everything fine the way it is?
1998
1999
2000
2001
2002
2003
2004 – Spring
2004 - Fall
Complete Rebuilding
Fairly Major Repairs
Minor Tuning Up
Everything's Fine
Source: HCIC 2004 – Update; POLLARA Omnibus Sept ‘04
12
Views of The Health Care System in Five Nations - 1998 to 2004
Percent saying: AUS CAN NZ UK US
Only Minor Changes Needed 2004 21 21 19 26 16 2001 25 21 18 21 18 1998 19 20 9 25 17
Rebuild Completely
2004 23 14 19 13 33 2001 19 18 20 18 28 1998 30 23 32 14 33
Source: The Commonwealth Fund 2004 International Health Policy Survey of Primary Care in Five Countries; Conducted by Harris Interactive and subcontractors; March – May 2004
13
Views on the September 2004 Federal-Provincial Health Care
Deal
14
Impact of Health Deal
71% 24% 1%3%
57% 38% 3%3%
55% 35% 4% 7%
52% 37% 5% 5%
52% 33% 9% 7%
0% 20% 40% 60% 80% 100%
Managers
Pharmacists
Nurses
Doctors
Public
Improve Have No Impact Worsen DK/Ref.
Q: In your opinion, what impact will the September 2004 Health Deal reached by the Premiers and the Prime Ministers have? Do you think it will significantly improve, improve, have no impact, worsen or significantly worsen Canadians’ access to timely, quality health care?
15
Managers Views on Health Care
Deal Funding
Sufficient Money to Address the
Capital Funding
Sufficient Money forWait Times For
Key Services
Q: Do you think the healthcare deal recently agreed upon by the first ministers provides sufficient dollars to address the capital funding needs in your region/facility?
Q: Do you think the agreement between the first ministers provides sufficient dollars to address the wait times for surgeries, diagnostics or other key services in your region/facility?
16
Improving Access
17
Canadians’ Satisfaction with Health Care Access in Home
and Community
Q: Would you say that you are very satisfied, somewhat satisfied, somewhat dissatisfied or very dissatisfied with access to care in the home or community?
2000
2001
2002
2003
2004
VerySatisfied
SomewhatSatisfied
SomewhatDissatisfied
VeryDissatisfied
DK/Ref.
Total Satisfied
47%
48%
48%
48%
49%
18
Canadians’ Satisfaction with Health Care Access in Home
and Community: Demographics
45% 40% 15%
54% 35% 11%
45% 45% 10%
52% 36% 11%
56% 34% 11%
36% 43% 21%
60% 28% 13%
49% 38% 13%
0% 20% 40% 60% 80% 100%
Women
Men
BC
Prairies
Ontario
Quebec
Atlantic
Total
Satisfied Dissatisfied DK/Ref
Q: Would you say that you are very satisfied, somewhat satisfied, somewhat dissatisfied or very dissatisfied with access to care in the home or community?
19
Timeliness of Access to Care
Q: Would you say that you are very satisfied, somewhat satisfied, somewhat dissatisfied or very dissatisfied with the following aspects of today’s health care system? (READ AND ROTATE) ... Timeliness of access to care
2000
2001
2002
2003
Spring 2004
Source: HCIC 2004 - Update
Total Satisfied
42%
38%
43%
43%
46%
VerySatisfied
SomewhatSatisfied
SomewhatDissatisfied
VeryDissatisfied
DK/Ref.
20
Canadians More Pessimistic About Improvements in Access
to Care
Q: Over the next five years, do you believe that Canadians’ access to timely, quality health care will significantly improve, improve somewhat, worsen somewhat or significantly worsen?
2002
2003
Spring 2004
Source: HCIC 2004 - Update
Total Improved
34%
47%
37%
SignificantlyImprove
ImproveSomewhat
WorsenSomewhat
SignificantlyWorsen
DK/Ref.
21
Summary of Health Care Human Resources
Q: Do you believe that Canada has more than enough, enough, or not enough of each of the following skilled health care professionals to meet our population’s needs? (READ AND ROTATE)
2%11%
86%
1% 2%
13%
81%
4% 6%
66%
20%
8%19%
33%
21%26%
0%
20%
40%
60%
80%
100%
Doctors Nurses Pharmacists Health Care Managers
More Than Enough Enough Not Enough DK/Ref.
DoctorsMore Than Enough=1%Enough=10%Not Enough=89%
Ge
ne
ral
Pu
bli
c T
hin
ks
NursesMore Than Enough=1%Enough=6%Not Enough=92%
PharmacistsMore Than Enough=1%Enough=11%Not Enough=88%
ManagersMore Than Enough=4%Enough=52%Not Enough=40%
22
Doctors’ Views on Solutions to Physician Shortage
Increase MedicalSchool Enrolment
Better Models OfHealthcare Delivery
More InternationalMedical Graduates
Train & DelegateTo Professionals
VeryEffective
SomewhatEffective
Not VeryEffective
Not At AllEffective
DK/Ref.
Q: How effective would you say the following options would be in providing a sustainable solution to address Canada’s physician shortage: very effective, somewhat effective, not very effective, not at all effective?
Total Effective
88%
76%
64%
69%
23
Doctors’ View of Role of Physicians – Compared to 10
Years Ago
Q: Thinking of how patients perceive the role of physicians today, compared to 10 years ago, to what extent do you agree with the following statements, on a 10-point scale where 1 means Totally Disagree and 10 means Totally Agree?
Patients see physicians asprimary HC provider
Physician are now one of many components, as opposed to the sole source, in their
approach to health and wellness
Mass information and the focus on health awareness has improved the traditional
patient/physician relationship
Mass information and the focus on health awareness has threatened the traditional
patient/physician relationship
24
Pharmacists’ View on Role of Pharmacists
Q: To what extent do you agree with the following statements, on a 10-point scale where 1 means Totally Disagree and 10 means Totally Agree:
Pharmacists should play an integral part in providing medication services
to patients receiving care at home
Pharmacists should have greater role in choosing the appropriate
prescription medications for patients
25
Promoting and Protecting Health
26
Promotion of Wellness andDisease Prevention
Q: Do you strongly agree, somewhat agree, somewhat disagree or strongly disagree that Canadians are encouraged/motivated to promote wellness and prevent disease?
Public
Doctors
Nurses
Pharmacists
Managers
StronglyAgree
SomewhatAgree
SomewhatDisagree
StronglyDisagree
DK/Ref.
Total Agree
71%
64%
68%
73%
55%
27
Supporting Innovation
28
Increase Public Sector Funding for Health Research
2004
2003
2004
2003
2004
2003
2004
2003
2004
2003
Q: Health research can include research into medical treatments as well as the best ways to provide care and manage the health care system. Would you say that you strongly agree, agree, are neutral, disagree, or strongly disagree with the following statements: (READ AND ROTATE)
There should be increased public sector funding for health research, such as at universities, teaching hospitals and other not-for-profit organizations.
StronglyAgree
Agree Neutral Disagree StronglyDisagree
DK/Ref.
Public
Doctors
Nurses
Pharmacists
Managers
Total Agree
81%83%
86%82%
82%81%
88%85%
84%80%
29
Incentives to Encourage More Private Sector Investment
2004
2003
2004
2003
2004
2003
2004
2003
2004
2003
Q: Health research can include research into medical treatments as well as the best ways to provide care and manage the health care system. Would you say that you strongly agree, agree, are neutral, disagree, or strongly disagree with the following statements: (READ AND ROTATE)
Incentives should be put in place to encourage more private sector investments in health research such as at universities, teaching hospitals and other not-for-profit organizations
StronglyAgree
Agree Neutral Disagree StronglyDisagree
DK/Ref.
Public
Doctors
Nurses
Pharmacists
Managers
Total Agree
70%76%
79%75%
78%69%
86%78%
75%70%
30
Support for Contracting Out Publicly Covered Services
Q: Do you strongly support, support, oppose or strongly oppose allowing the government to be able to contract out the delivery of publicly covered services to private clinics, for instance having medicare pay for knee surgery at a private clinic rather than a public hospital?
StronglySupport
Support Oppose StronglyOppose
DK/Ref.
2004
2003
2004
2003
2004
2003
2004
2003
2004
2003
Public
Doctors
Nurses
Pharmacists
Managers
53%57%
61%55%
68%66%
51%58%
66%66%
Total Support
31
Support for Contracting Out Publicly Covered Services:
Demographics
49% 46% 4%
57% 38% 5%
53% 41% 6%
55% 41% 5%
43% 52% 4%
69% 28% 3%
45% 47% 8%
53% 42% 4%
0% 20% 40% 60% 80% 100% 120%
Women
Men
BC
Prairies
Ontario
Quebec
Atlantic
Total
Strongly Support/Support Strongly Oppose/Oppose DK/Ref
Q: Do you strongly support, support, oppose or strongly oppose allowing the government to be able to contract out the delivery of publicly covered services to private clinics, for instance having medicare pay for knee surgery at a private clinic rather than a public hospital?
32
Views on Paying for Quicker Access
Q: Do you strongly support, support, oppose or strongly oppose individuals being allowed to pay out of their own pocket for quicker access to health services that are currently funded under the public system?
Total Support
35%
Total Support
59%
Total Support
41%
Total Support
61%
Total Support
45%
33
Paying for Quicker Access: Regional Views
45% 53% 2%
35% 62% 3%
24% 72% 4%
45% 52% 3%
37% 60% 4%
35% 62% 3%
0% 20% 40% 60% 80% 100% 120%
BC
Prairies
Ontario
Quebec
Atlantic
Total
Strongly Support/Support Strongly Oppose/Oppose DK/Ref
Q: Do you strongly support, support, oppose or strongly oppose individuals being allowed to pay out of their own pocket for quicker access to health services that are currently funded under the public system?
34
Canadians Willing to Pay
Q: Would you be willing to pay more, either out-of-pocket or tax payments, to increase the range of services offered or the improve timeliness of care provided by the health care system?
2002
2003
Spring 2004
Source: HCIC 2004 - Update
Total Yes
69%
60%
54%
35
Canadians’ Views on Dealing with Health Care Shortfalls
Q: If the governments through taxation could not cover all of the costs for all health services, they might have to make choices as to how to deal with the shortfall. Would you strongly support, support, oppose or strongly oppose each of the following choices? (READ AND ROTATE)
Restricting the Range ofServices That Are Offered
Asking Patients to Pay forPart of the Cost of Services
Health Care Tax Linked to Income
Cut Other Gov. Services and Direct to Health Care
2004
2003
2004
2003
2004
2003
2004
2003
Total Support
21% 73%
19% 76%
34% 62%
39% 58%
41% 55%
46% 51%
65% 27%
67% 28%
Total Oppose
36
Support for Innovation in Health Care Delivery (Compared
to 2003)
Q: Do you strongly support, support, oppose or strongly oppose each of the following policies to increase access to health care professionals? (READ AND ROTATE)
-5 -3 -6 +4 -8 -3 -1 n/c n/c -1 -3 -6 -1 -1 -8
% Strongly/Support
37
Increasing Accountability
38
Making Sure Every Tax Dollar Intended for Health Care is
Spent on Health Care
4% 23% 36% 28% 6%3%
2% 20% 33% 34% 7% 5%
2%16% 35% 33% 12% 2%
4% 16% 29% 31% 15% 5%
7% 18% 30% 24% 16% 4%
0% 20% 40% 60% 80% 100%
Managers
Pharmacists
Nurses
Doctor
Public
Very Good Good Fair Poor Very Poor DK/Ref.
Q: Thinking of the additional funding that will be made available under the new Health Deal, do you believe that the government will do a very good, good, fair, poor or very poor job of each of the following? (READ AND ROTATE)
Making sure that every tax dollar intended for health care will be spent on health care
Total ‘Very Good
/Good/Fair’
55%
49%
53%
55%
63%
39
Reporting to Canadians the Results of How Those Health Care
Dollars are Spent
6% 20% 42% 25% 6%2%
2%15% 42% 31% 8% 3%
1%16% 35% 34% 12% 2%
6% 19% 29% 28% 12% 6%
5% 18% 28% 29% 17% 4%
0% 20% 40% 60% 80% 100%
Managers
Pharmacists
Nurses
Doctor
Public
Very Good Good Fair Poor Very Poor DK/Ref.
Q: Thinking of the additional funding that will be made available under the new Health Deal, do you believe that the government will do a very good, good, fair, poor or very poor job of each of the following? (READ AND ROTATE)
Reporting to Canadians the results of how those health care dollars are spent.
Total ‘Very Good / Good’
23%
25%
17%
17%
26%
40
Awareness of Health Council of Canada
87% 13%
34% 66%
35% 65%
52% 47%
27% 71%
0% 20% 40% 60% 80% 100%
Managers
Pharmacists
Nurses
Doctor
Public
Yes No
Q: In 2004 the Health Council of Canada was formed to report to Canadians on the progress of health reforms in Canada. Their first report will be in January 2005. Have you heard of this council?
41
Top Priorities for Health Council – All Stakeholders
Q: In 2004 the Health Council of Canada was formed to report to Canadians on the progress of health reforms in Canada. Their first report will be in January 2005. What do you think the priorities of the council should be? (OPEN-ENDED)
42
Conclusions
43
Conclusions Health care remains a top issue of concern for Canadians.
Confidence in the health care system is falling for a large proportion of the public. However, most of the professional stakeholders are not as pessimistic (except nurses). In fact one-quarter of health care managers report raising confidence in the system.
The Federal-Provincial health care deal is viewed as an improvement to system, with managers the most positive.
Access remains a concern, with less than half of Canadians are satisfied with health care access at home and in community. This remains unchanged over the last number of years.
The public and all stakeholder groups say there is a shortage of both doctors and nurses in the system.
Canadians (especially doctors and pharmacists) appear willing to accept alternative ways to deliver health care services, such as contracting out certain publicly funded services, but they are unwilling to accept cuts to services or having to pay more, either directly out of pocket or indirectly through a health care tax.
Meanwhile, while Canadians may accept increased private involvement in the delivery of services, a majority do not support being able to pay to jump the queue to receive quicker service.
44
Conclusions Canadians and all providers groups support increasing public funding
and incentives for private funding of health research. Support for incentives for private funding has risen for all provider groups.
Canadians are looking for innovative solutions in how we deliver care before we seek additional personal contribution from them or restrict services we offer.
Canadians feel sceptical about how government will in ensuring money assigned for health care will be spent on health care, as well as in reporting to Canadians how health care dollars are spent.
Awareness of Health Council is highest among health care managers and doctors, and lowest among general public.
Assessing public and provider priorities for the Health Council will likely require more deliberative approaches combined with public polling.
Canadians are open to reforms and have expectations that the new Health Deal will improve things.
Health Care in Canada Survey 2004
Health Care in Canada Survey 2004