Cost & Value in Healthcare
Established in December, 2016, the Research Exchange Group on Cost and Value in Healthcare brings together partners from government, academic institutions, the health system, and the broader community who share an interest in improving cost-efficiency and promoting better value in healthcare. The group aims to promote knowledge exchange, to build local research capacity, and to encourage the use of evidence-based decision making for this important issue in Newfoundland and Labrador.
The Research Exchange Group on Cost and Value in Health Care fosters research collaboration and knowledge exchange among partners from community organizations and programs, educators, practitioners, health system officials, government partners, students, and academic researchers
All meetings take place at NLCAHR at 2:30pm on Mondays.
January 28, 2019 Dr. Anne Kearney will lead a group discussion on the new breast screening recommendations of the Canadian Task Force on Preventive Health Care . The Task Force released updated breast cancer screening recommendations in 2018, meaning that the 2011 clinical practice guideline is no longer current. Importantly, the new guidelines recommend that women should be engaged in shared decision making. They also cite low-certainty evidence to indicate that screening for breast cancer with mammography results in a modest reduction in breast cancer mortality for women aged 40 to 74 years with the absolute benefit being the lowest for women less than 50 years of age. Moreover, the task force concluded that screening leads to overdiagnosis resulting in unnecessary treatment of cancer that would not have caused harm in a woman’s lifetime, as well as physical and psychological consequences from false positives with women under the age of 50 being at greater risk of these harms than older women. A review of patient values and preferences about screening suggested that a substantial proportion of women aged 40 to 49 years would choose not to be screened if they were aware of outcomes for their age group. In contrast, many women aged 50 years and older would choose screening given their more favourable balance of benefits and harms. The recommendation is to screen women who decide to undergo mammography screening every two to three years.
February 25, 2019 David Buckle, Regional Director of Paramedicine, Western Health on Western Health's Alternate Transportation Systems, based on a project that utilizes non-medical transport for patients.
April 29, 2019: Joanne Thompson, Executive Director of the Gathering Place, on programs and services to support vulnerable communities
May 27, 2019: Drs. Stephanie Young and Rufaro Chitsike on a new comprehensive care program for thrombosis patients in Newfoundland & Labrador.
- November 26, 2018 | 2:30pm NST | Better Now: Six Big Ideas to Improve Health Care for All Canadians |Dr. Danielle Martin on what she has learned from Canadians about their desire for change. Link to Slides
- December 17, 2018 | 2:30pm NST |Quality of Care/ Choosing Wisely NL| Dr. Brendan Barrett and Dr. Robert Wilson update the healthcare costs savings achieved through the Quality of Care/ Choosing Wisely initiative in Newfoundland & Labrador. Link to Slides
- October 29, 2018 How social innovation can address youth homelessness and school disengagement in Newfoundland & Labrador | Sheldon Pollett and Kris Kelly of Choices for Youth
- October 30, 2017 | Dr. Anne Kearney: It is time to re-evaluate population-based mammography screening
- Link to Poster
- Link to references list
- November 27 2017 | Phil Murphy: Using Health Administrative Data to evaluate practice and outcomes./ Surveillance, Data Capture and Quality, Burden on the System, Getting Quality Information to Assist with Informed Decision Making
- January 29, 2018 | Lisa Browne, CEO, Stella's Circle : Determinants of Health: A Community Lens
- February 26, 2018 | Emily Doyle| Why Complexity Matters: An assessment of the NL School Food Environment
- Farm-to-Cafeteria Canada Website: a pan-Canadian school food initiative
- March 26, 2018 | Michelle Zwicker: The Children's Dental Health Plan-- A Success Story to Build On | Jill Allison and Katrina Bartellas: Integrating dental services into a primary health care initiative for low-income individuals in St. John’s
- April 30, 2018 | Gerard Gibbons, Manager, Decision Support Eastern Health and Justin Swain, Manager, Eastern Health's Performance Office | Process Improvement with Lean: Eastern Health's Journey
- May 28, 2018 | Dr. Catherine deBoer | Drop-in Counselling Services in a Non-Profit Community-Based Agency: An Exemplar of Responsive, Effective, Accessible and Cost Efficient Mental Health Service Delivery
- February 17, 2017 |Determining the appropriateness of services and care being delivered (e.g. prescribing, screening, testing, procedures)
- Dr. Robert Wilson: Choosing Wisely NL program and its approach to helping clinicians and patients engage in conversations about unnecessary tests, treatments and procedures.
- March 17, 2017 | Accelerating cost saving and cost-effective health technology solutions
- Dr. Gerard Farrell: “eHealth: What’s New?“
- Elizabeth Wallack of the telegerontology research team presented, on behalf of Dr. Roger Butler: "Research findings and a recent cost-analysis from a tele-gerontology study that used online interventions for community-dwelling seniors with dementia."
- April 21, 2017 | Identifying administrative, clinical, and service delivery innovations
- Dr. Daryl Pullman: “Toward a two-tiered publicly administered health care system: a 'fourth way' in the public vs. private debate.”
- Dr. Hai Van Ngyuen: “Using bundled payment to promote quality and improve efficiency of health care: Evidence and implications for NL healthcare reform.”
- May 19, 2017 |Identifying administrative, clinical, and service delivery innovations
- Dr. Kris Aubrey-Bassler: “Designing primary care to optimize efficiency and effectiveness.”
- Dr. Kristin Harris Walsh and Dr. Olga Heath: “Enhancing Inter-professional Education in Pre- and Post-Licensure Health/Social Care Professional Education in Newfoundland and Labrador (NL)”
The group has identified the following as its key objectives:
- Informing health policy to reduce costs and increase value in healthcare;
- Reviewing research in progress/existing research literature on cost and value in healthcare; and
- Building research teams on issues identified by the group and looking for research funding to support their work.
- Networking with peers
- Examining best practices around the world
- Looking at collaborative research to examine challenges in healthcare
- Identifying programs that have been a good use of healthcare dollars.
- Ensuring that any new health care initiatives include evaluative components to assess new programs
Proposed Research Themes
Ethics and Access will be considered sub-themes of each of the five topics below:
- Determining the appropriateness of services and care being delivered (e.g. prescribing, screening, testing, procedures)
- Identifying administrative, clinical and service delivery innovations
- Accelerating cost saving and cost-effective health technology solutions
- Patient/Citizen engagement (e.g. in addressing gap between spending, appropriateness and outcomes)
- Linking social determinants of health with specific health care policy and care delivery solutions