Nutrition homepage
Nutrition 3701
Nutrition 3701-lecture 33
29 November 2010
Health and Nutrition Care Delivery Strategies
FEDERAL HEALTH
Canada has a predominantly publicly-financed, privately-delivered
health care system known to Canadians as Medicare. It provides access to universal,
comprehensive coverage for medically necessary hospital, in-patient and out-patient
physician services. Most doctors are private practitioners who work in independent or
group practices, enjoy a high degree of autonomy, and are generally paid on a
fee-for-service basis.
The federal government is responsible for:
- setting
and administering national principles or standards for the health care system (for
example, through the Canada
Health Act)
- assisting
in the financing of provincial health care services through fiscal transfers;
- delivering
direct health services to specific groups including veterans, native Canadians, persons
living on reserves, military personnel, inmates of federal penitentiaries and the Royal
Canadian Mounted Police;
- fulfilling
other health-related functions such as health protection, disease prevention, and health
promotion.
The
provincial and territorial governments are responsible for:
- managing
and delivering health services,
- planning,
financing, and evaluating the provision of hospital care, physician and allied health care
services, and
- managing
some aspects of prescription care and public health.
Federal Nutrition
Canadas
food guide
The mission of the Food Program is to protect and improve the health
of the people of Canada through science-based policies and programs related to safe and
nutritious food.
The Food Program provides information related to food safety and
regulation such as:
- Food
and Drug Regulations
- Novel
foods
- Health
Claims for foods
- Nutrient
content claims
- Nutrition
Labelling proposal
- Addition
of vitamins and minerals to foods
Nova Scotia Health
Nova Scotia health care delivery
Community-based,
family-focused, and person-centred.
This means that: |
|
Everyone in the community (individuals,
families, primary health care providers, community groups, service delivery organizations
and government) works together to identify and build upon community strengths and
capacities, and to define community health needs and the best ways to meet them. |
|
The uniqueness and diversity of individuals,
families and communities are valued and responded to appropriately |
|
Individual, family and community capacities to
improve health status and to participate in health services planning are increased. |
|
All Nova Scotians have an ongoing relationship
with a primary health care provider through whom they can access health care services. |
Comprehensive.
This means that: |
|
The many factors that influence health are
considered in primary health care planning and delivery, including but not limited to
income, social status, education, employment, healthy child development, genetic
endowment, gender, culture, spirituality and race. |
|
The primary health care system provides a
balance between activities that promote health and provide health care services. |
|
A wide range of services is offered by the
primary health care system, including but not limited to primary care, continuing care
(long term and home care), rehabilitative care, public health, emergency care, community
mental health, addictions, nutrition services, palliative care and pharmaceutical
services. |
|
Activities that promote health are supported by
the primary health care system and include but are not limited to community capacity
building to promote health, individual health education, disease and injury prevention and
advocacy for healthy public policy. |
Responsive and
flexible.
This means that: |
|
Communities are supported in gathering and
accessing reliable information to help identify changing capacities, needs and issues. |
|
The changing capacities and needs of
individuals, families and communities are recognized and responded to in a timely manner. |
|
Primary health care services are offered in
ways that value and respond to the cultural, racial, and spiritual experiences of
individuals, families and communities. |
Accessible.
This means that: |
|
Primary health care services are accessible to
all Nova Scotians, as close as possible to where they live, work, or go to school. |
|
Nova Scotians can choose a primary care
provider and have access to a defined range of primary health care services, including
access to urgent care 24 hours a day. |
|
There is equity of
access for those who have historically faced barriers, including but not limited to
barriers related to illness, disability, poverty, culture, race, ethnicity, language,
geography and gender. |
|
Access to other primary, secondary and tertiary
health care services is coordinated, and linkages are made with services outside the
health care system including programs and services offered at the community level by a
variety of providers and organizations. |
|
Activities that promote health are supported in
all communities across the province. |
|
Specific mechanisms are in place to ensure that
where both federal and provincial jurisdictions have responsibilities for service delivery
(e.g. to First Nations), access is assured and coordinated. |
Integrated,
collaborative and innovative.
This means that: |
|
Health care services are coordinated and
integrated in a way that ensures care is provided to individuals and families in the
optimal setting, and assists individuals and families in navigating with ease through the
system. |
|
Linkages are made and maintained with
organizations, agencies and government departments whose contribution is essential to the
improvement of individual, family and community health status. |
|
Collaboration within and outside the primary
health care system results in creative, innovative and effective approaches to the
delivery of health care services and to the implementation of activities that promote
health. |
|
Collaboration among primary health care
professionals, other care providers, community organizations, individuals and families is
supported by structures that foster trust, support for shared decision-making and respect
for professional autonomy. |
Accountable.
This means that: |
|
Those who receive and provide care as well as
those who govern the health system and work on behalf of communities have clearly defined
and specific areas of accountability. |
|
Health information and data are available and
accessible so that individual, family, community, health professional and government
decision-making is based on sound evidence. |
|
There is ongoing evaluation of the primary
health care system related to needs, standards, efficiency and effectiveness. |
|
Communities participate in identifying and
supporting methods used to promote health and to deliver primary health care services. |
Sustainable.
This means that: |
|
Those who govern the health system and work on
behalf of communities ensure the delivery of quality activities to promote health and
health care services that are efficient, effective, affordable, and acceptable to the
community. |
|
Duplication and waste are identified and
eliminated. |
|
Standards and best practices are widely adopted
in the effort to sustain equitable, quality care across the province. |
|
Ongoing
education and resources are available to support primary health care professionals in both
their delivery of services and in collaborating with others.
|
|
Nova Scotia nutritional policies are directed at
all ages from pre-birth to old age and mimic federal guidelines
Objectives of
Health Care and Nutrition care Strategies
Best
possible population health for the lowest possible cost
Lowest possible cost to society
-financial-the cost of keeping people
healthy(prevention), returning people to health and keeping
them healthy or partially cured once they are in a state of improved health
-productivity-fewer missed work days and
more productive when society is on the job-when many in the population are off work or are
not productive when at work then the economy suffers leaving potentially less money for
health care which then causes greater illness
-enjoyment-productivity leads to societal
enjoyment (better societal income, societal
education and services) and in turn enjoyment leads to a better level of societal
productivity which allows more tax dollars to be spent on societal health
Lowest possible cost to individual
-financial-more money to spend on
nutritious food and to meet the concepts of adequacy, balance, energy control, nutrient
density moderation and variety
-productivity-if person is better fed and
is meeting all nutrient intake requirements via the concepts of adequacy, balance, energy
control, nutrient density moderation and variety one is less likely to be ill or ill for
longer periods of time
-enjoyment-a more productive person is
clearly less prone to depression and is therefore less likely to incur both financial and
productivity costs associated with depression
Strategies
Research- new approaches in medicine including nutrition:
-assessment of current and new approaches
in terms of cost of delivery and their effectiveness in terms of reducing both short and
long term costs
-cost/benefit ratios ideally theses
should be as low as possible so as to get the biggest benefit per dollar
-benefits- fewer visits to physicians,
nurses, dieticians
-shorter illnesses
and less severe illnesses
-shorter
hospital stays
-longer life
before serious illness sets in
-requirements for less expensive drugs and
nutritional interventions