Healthcare quarterly (Toronto, Ont.)
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Several reports have documented the prevalence and severity of emergency department (ED) overcrowding at specific hospitals or cities in Canada; however, no study has examined the issue at a national level. A 54-item, self-administered, postal and web-based questionnaire was distributed to 243 ED directors in Canada to collect data on the frequency, impact and factors associated with ED overcrowding. The survey was completed by 158 (65% response rate) ED directors, 62% of whom reported overcrowding as a major or severe problem during the past year. ⋯ They perceived ED overcrowding to have a major impact on increasing stress among nurses (82%), ED wait times (79%) and the boarding of admitted patients in the ED while waiting for beds (67%). Overcrowding is not limited to large urban centres; nor is it limited to academic and teaching hospitals. The perspective of ED directors reinforces the need for further examination of effective policies and interventions to reduce ED overcrowding.
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The debate of whether Canada's healthcare system is sustainable is mired in ideology. This paper offers a framework that takes us beyond the ideological standoff with a process to deal ethically with the issue of the sustainability of publicly funded healthcare.
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The paper traces Brazil's efforts to fight AIDS in the last 20 years. The analysis concentrates on the efforts to combat and prevent the deadly infectious disease through ingenious efforts of private citizens, government agencies, national and international NGOs, which challenged multinational companies, international organizations and foreign governments. While the investigation led to a positive evaluation of the joint efforts in managing the threat, it is made clear that the fight against the HIV/AIDS virus is far from over in Brazil and will have to be strengthened on the local, national and international level.
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Recently there has been an increasing focus on the role of health innovation as a strategic policy instrument of sustainable economic development. The public nature of our system provides Canada with a unique platform to leverage our investments in health discovery and innovation, while also ensuring that Canadian ideas generate added economic value at home.