Health Services & Policy Research

Shared decision-making at the end of life: Including the voices of people with dementia


Recent debates about palliative end-of-life (EOL) care and legalized assisted dying have stimulated new questions about EOL care for those living with dementia. However, when discussing preferences for EOL care, individuals with dementia are often excluded from the decision-making process, leaving decision making to family members and/or care providers. 

Primary Investigator: 
Award Type: 
Year: 
2017

Rethinking early intervention therapy with Indigenous communities and families in northern British Columbia

Early intervention therapy (EIT) programs for children with developmental challenges and disabilities have been shown to be highly beneficial for young children (0-5 years) in the wider Canadian population. However, EIT programs are consistently significantly under-utilized by Indigenous communities and families. Indigenous parents and community stakeholder perspectives on EIT are largely absent in current literature, and Indigenous communities are often not consulted on how these programs are delivered. 

Primary Investigator: 
Award Type: 
Year: 
2017

No time for nice? Exploring the nature and influence of workplace incivility and bullying in long-term residential care

Residential care aides (RCAs) provide the majority of hands-on care for individuals in long-term residential care (LTRC). Yet, as they are situated at the bottom of the workplace hierarchy, they receive little respect or recognition for their work. In BC, LTRC workers (mainly RCAs) have the highest rates of on-the-job injury; four times higher than the provincial average and twice as high as acute care workers, due primarily to overexertion and violent or aggressive acts from residents. 

Primary Investigator: 
Award Type: 
Year: 
2017

Addressing HIV/AIDS, sexual health, and substance use among gay and other men who have sex with men

New HIV diagnoses are 71 times higher among gay, bisexual and other men who have sex with men (GBM) than other men in Canada. Since 2010, BC has adopted Treatment as Prevention (TasP) as a policy to increase HIV testing and engage more HIV-positive individuals in effective treatment to reduce transmission at a population level. However, the number of new diagnoses among GBM in BC has remained largely unchanged. Further, surveillance shows an increase of HIV diagnoses among the youngest birth cohorts of GBM.

Primary Investigator: 
Award Type: 
Year: 
2017

Incentivizing the delivery of sustainable care of chronic diseases in Canada: Case studies in musculoskeletal disease

Concerns about the sustainability of publicly funded health systems and the rising cost of care abound, yet there is little research that explores health care efficiency. Simple cost-saving exercises (i.e. cutting services) may risk harming patients, while more sophisticated, efficiency-saving approaches aim to provide health care at a greater benefit per unit of cost. Encouraging quality and value of health care delivery, whilst reducing waste, is also an indirect way to control health care costs.

Primary Investigator: 
Award Type: 
Year: 
2017

Women taking charge of changing childbirth in BC

Childbearing women in Canada are speaking out about their desire for respectful maternity care. The Vancouver Foundation funded Phase 1 of our provincial, community-led participatory action research project entitled "Changing Childbirth in BC: Women exploring access to high quality maternity care". A steering group of women from different cultural and socioeconomic backgrounds worked with researchers and community agencies to study access to preferred models of maternity care and experiences of autonomy, respect, discrimination, or coercion when participating in a decision-making process.

Primary Investigator: 
Year: 
2017

Implementing concussion return to activity guidelines in primary care

Throughout the history of medicine, patients who had a disease that was poorly understood were advised to rest. As scientists and doctors learned more, early mobilization and active therapies (e.g., exercise) gradually replaced rest as the conventional treatment for a variety of medical conditions, such as chronic fatigue, whiplash, stroke, low back pain, and cardiac arrest. We have now reached this same juncture for concussion care. The proposed project aims to figure out how to support doctors in implementing new science-informed return to activity guidelines for concussion.

Primary Investigator: 
Year: 
2017

TEC4Home: Telehealth for emergency-community continuity of care connectivity via home monitoring

Patients with long term medical conditions like heart failure or chronic lung diseases typically get admitted to and discharged from hospitals frequently because their conditions fluctuate. For example, one out of four patients older than 65 with heart failure often needs to return to hospital within one month of a previous emergency room or hospital stay. Today, using electronic monitors, patients can measure their own blood pressure, weight, and blood oxygen from home, and send their measurements to doctors or nurses so they can supervise the patient's state of health.

Primary Investigator: 
Year: 
2017

An international comparative case study of the health equity impacts of medical tourism in destination countries

Canadians take part in medical tourism when they travel to other countries with the intent of accessing private medical care. It has been speculated that medical tourism by patients from countries such as Canada is exacerbating health inequities in destination countries, and particularly in developing countries. However, there is a lack of evidence demonstrating that this is the case.

Primary Investigator: 
Award Type: 
Year: 
2012

Investigating pharmaceutical policies, coverage, and costs

Prescription medicines play a key role in the treatment and prevention of disease, as evidenced by the fact they are the second-largest and fastest-growing component of health care expenditures in British Columbia. Dr. Michael Law's research program includes studies on the broad themes of pharmaceutical policies, coverage, and costs. Pharmaceutical Policies. In January 2009, a policy change in British Columbia gave pharmacists the authority to independently modify and renew prescriptions.

Primary Investigator: 
Award Type: 
Year: 
2011

Funding health care: Strategies for improving access, continuity and efficiency

In Canada, health system funding has reached a crisis point. Not only are health care costs continuing to rise, but there are increasing conflicts about how these funds are allocated. Provinces are exploring different policies to improve the safety, efficiency, and efficacy of care, including patient-based payment for hospitals to increase 'volume' of hospital care, targeted pay-for-performance programs to reduce wait times, and alternative payment plans for physicians.

Primary Investigator: 
Award Type: 
Year: 
2011
Subscribe to RSS - Health Services & Policy Research