1. Primary Health Care and Chronic Illness Care in Canada Canadians Report on Quality and Outcomes Diane Watson CMWF & CHSRF Harkness Fellow June 2007

2. 2 Sept 2004: 10-Year Plan & HCC expanded mandate Context: New Era in Accountability Apr 2001: Royal Commission & Senate Committee Feb 2003: First Ministers Accord & Health Council of Canada (HCC)

3. 3 Context: New Era in Accountability Health Council of Canada fosters accountability and transparency by assessing progress in improving the quality, effectiveness and sustainability of the health care system. –Monitor and report on reforms (2003) –Report on health & health outcomes (2004)

4. 4 Context: Rationale First Ministers commitments and additional investments in sectors primarily outside of universally accessible, first $ coverage, medically necessary, physician & hospital services Thus, in areas where little national or comparable data. What does one do as the Director of Research and Analysis at the Health Council of Canada?

5. 5 Harkness Project: Why? Purpose: To enable the Health Council to begin to report on experiences that Canadians, particularly those with chronic health conditions, have with primary health care as well as outcomes people attribute to those services. Objective: To develop and implement a population-based, pan-Canadian bilingual telephone survey.

6. 6 Harkness Project: How? Pan-Canadian, bilingual telephone survey with Statistics Canada (response rates, publicly accessible) Theoretical framework –Treasury Board of Canada accountability framework for primary health care and chronic illness care Construct and face validity –national consultations with citizens, policy makers, managers, providers Sample frame, sampling and link-ability –Canadian Community Health Survey

7. 7 Page 3 Treasury Board of Canada: Accountability Framework

8. 8 Harkness Project: How? Data collection, cleaning and documentation (February and March 2007) Psychometric and descriptive analyses (April and May 2007) Multivariate analyses (June 2007)

9. 9 Research ?s Activities (Structure) Multidisciplinary care Outputs (Process) 2 nd prevention, coordination, continuity coordination, continuity Quality of PHC or chronic illness care Immediate Outcomes Knowledge of condition and activation Adverse drug reaction resulting in visit Intermediate Outcomes Inappropriate place (ER) & Acceptability Confidence in health system

10. 10 Reports for Canadians The following reports to Canadians will juxtapose information on the progress of health care renewal with adult experiences: PHC and home care (September 2007) Chronic illness care (November 2007) Prescription drugs (November 2007)

11. 11 Reports for Stakeholders Supplemental reports for health care policy, administrative and practice communities: –Canadians experiences with primary health care –Canadians experiences with chronic illness care Potential journal article: –The relationship between experiences with primary health care and confidence in the health care system: The experience in Canada

12. 12 The Legacy, The Future & The Dream The Legacy –Survey data are publicly available for secondary use from Statistics Canada The Future –The First Ministers have committed to a second, similar survey to be conducted in February 2008. –Health Canada funding to support more learning Working on the Dream