(By Amanda & Ramandeep Kaur)
("Source: Media from Wix").
Chronic diseases as per definition of the U.S. National Center of Health Statistics are diseases that prevail more than three months. (Jr, n.d.) According to a publication by Public Services and Procurement Canada published in 2013, chronic diseases are considered the leading cause of death globally based on the World Health Organization statistics. In Canada, there are four major chronic diseases i.e. cancer, diabetes, cardiovascular and chronic respiratory diseases that account for 67 % of deaths. Unfortunately, three out of five Canadians who are 20 years and above possess a chronic disease and four of out five Canadians are subjected to a risk of acquiring one. Amanda and I have investigated the surveillance of these chronic diseases, their management and funding options available in our provinces namely Nova Scotia and Ontario.
Surveillance and management of chronic diseases in Nova Scotia & Ontario Surveillance for chronic disease in Canada is primary completed by the Canadian Chronic Disease Surveillance System (CCDSS). This is a collaborative network of provincial and territorial surveillance systems supported by the Public Health Agency of Canada (PHAC). This is utilized for both provinces, Ontario and Nova Scotia. (Government of Canada, 2019)
Management of chronic diseases in Nova Scotia is becoming patient centered with emphasis on empowering individuals to be active in obtaining and maintaining a healthy life style. Primary health care works with system partners to support adopting healthy behaviors including, but not limited to:
• Eating nutritious foods
• Being physically active
• Avoiding tobacco use (Nova Scotia Department of Health and Wellness, n.d.)
There are two different programs to help individuals’ transition into becoming in charge of managing their own health care. They include:
• You’re in Charge - Focused on teens 13-15 years of age living with chronic disease and their families. This program helps guide teens before they enter the adult healthcare system.
• Your Way to Wellness - Available to the public living with chronic disease.
Now let’s explore the Ontario side of management of chronic diseases. Unfortunately, “chronic diseases are the leading cause of death and disability in Ontario.” Almost 80 % of Ontarians over the age of 45 possess a chronic condition while approximately 70 % suffer from multiple chronic conditions.” Chronic diseases put a massive strain on the economy of Ontario and include an approximate 55 % of health costs. (Ministry of Health, n.d.)
In Ontario, the management of chronic diseases is organized by the Ontario Chronic Disease Prevention and Management Framework who play a vital role in taking initiatives to minimize these chronic diseases. The following are the components of Ontario’s Chronic Disease Prevention and Management Framework that are being used to reduce the occurrence of chronic diseases:
• Healthcare organizations take methodical efforts to assist in prevention and management of chronic diseases.
• Delivery System Design is used to expand access of services, deliver continuity of care throughout the system with a primary focus on prevention of chronic diseases.
• Provider Decision Supports assimilate evidence-based guidelines into everyday practice.
• Information Systems impart improved information for providers and combine healthcare services across the system so that high quality care can be delivered to support people in the management of their disease.
• Personal skills and Self-Management Support allow individuals to enhance skills for handling the disease and work towards a healthy life style.
• Healthy Public Policies enhance individual and population health along with attempting solving health inequity issues.
• Supportive Environments eliminate obstacles for an individual’s healthy living and help them provide a healthy working and living environment.
• Community Action attempt to control issues that impact the health of people dwelling within a certain community. (Ministry of Health, n.d.)
There is also Chronic Disease Prevention and Management i.e. CDPM Logic Model besides the Ontario Chronic Disease Prevention and Management Program that is valuable in managing chronic diseases and yields improved health outcomes. This logic model provides a visual demonstration of the precise activities that lead to better health and system results. The Priority Setting Decision Tool is used to offer methods to compare the burden of illness of various chronic disease which in turn aids to set priorities of chronic diseases. (Ministry of Health, n.d.)
Hence, to manage and prevent chronic diseases in Ontario the various components of the Ontario Chronic Disease Prevention and Management Framework well as the CDPM logic model are being used by the Ministry of Health and Long-Term Care, Ministry of Health Promotion, Local Health Integration Networks, health organizations and providers. (Ministry of Health, n.d.)
Funding of Chronic Disease Prevention in Nova Scotia & Ontario Funding for chronic disease in Nova Scotia is varied. The Nova Scotia Chronic Disease Innovation Fund supports new programs or enhance existing programs that help Nova Scotians live healthier lives and reduce the effects of chronic disease. Each year there is $300,000 that can be given to community-based organizations and non-profit community groups (registered or non-registered) that have been functioning for at least 6 months and managing funds. Each organization must submit an application for review and those that meet the criteria are eligible for funding. (Nova Scotia Health Authority, n.d.) In addition to this funding, prescription drug assistance is available to Nova Scotians living with the certain chronic diseases, provided they meet the eligibility criteria. These chronic diseases include but are not limited to: • Cancer • COPD
• Rheumatoid Arthritis
• Cardiovascular disease • Alzheimer’s disease
• Diabetes
• HIV
• Hepatitis C
(Nova Scotia Department of Health and Wellness, n.d.)
Chronic diseases have a substantial impact on healthcare funding in Ontario. Based on the data from 2008 on health, the Ministry of Health and Long-Term Care estimated that almost 31% of health care funds go towards major chronic diseases. Considering that Ontario’s health care expenditures in the last 10 years from 2007-2017 have increased by 47 % from $ 38.1 to $ 56.0 billion. (Health, n.d.)
Using data from 2008, the Ministry estimated that major chronic diseases and injuries accounted for about 31% of direct, attributable health-care costs in Ontario. This is a significant cost to focus on given that Ontario’s health-care expenditures have been increasing—by about 47% in the last 10 years between 2007/08 and 2016/17 from $38.1 billion to $56.0 billion. (Health, n.d.)
The figure below shows how the provincial funding was distributed in Ontario on chronic disease prevention management between the year 2016-2017. 📷
After research about the chronic diseases in both provinces, it is evident that Ontario has a lot more programs and organizations that assist in managing these diseases as opposed to Nova Scotia. Another key observation made by Amanda and me was that Nova Scotia’s funding was more towards community-based programs and non-profit organizations whereas in Ontario the provincial funding is majorly distributed to public health units.
Thus, in conclusion, it can be extremely challenging to manage chronic diseases. However, preventing it can minimize the burden on healthcare expenditures. Understanding the determinants, life style factors, risk factors can help one understand the prevalence of these chronic diseases. The efforts taken by the governments in each province through various support programs and healthcare initiatives play a huge in managing these chronic diseases and improving our healthcare system.
REFERENCES
Government of Canada. (2019, March 14). Canadian Chronic Disease Surveillance System: Summary of Methods. Retrieved June 30, 2019, from https://health-infobase.canada.ca/ccdss/data-tool/Methods
Health. (n.d.). Retrieved from http://www.auditor.on.ca/en/content/annualreports/reportsbytopic/bytopic_health.html
Jr, W. C. (n.d.). Definition of Chronic disease. Retrieved from https://www.medicinenet.com/script/main/art.asp?articlekey=33490
Ministry of Health. (n.d.). Retrieved from http://www.health.gov.on.ca/en/pro/programs/cdpm/
Nova Scotia Department of Health and Wellness. (n.d.-a). Chronic Disease Prevention and Management. Retrieved June 30, 2019 from https://novascotia.ca/dhw/primaryhealthcare/chronic-disease-management.asp
Nova Scotia Department of Health and Wellness. (n.d.-b). Nova Scotia Pharmacare. Retrieved June 30, 2019 from https://novascotia.ca/dhw/pharmacare/exception-status-drugs.asp
Nova Scotia Health Authority. (n.d.). The Nova Scotia Chronic Disease Innovation Fund Guidelines, Criteria & Application Form. Retrieved June 30, 2019 from https://novascotia.ca/dhw/primaryhealthcare/documents/Chronic-Disease-Innovation-Fund-Guidelines-and-Application.pdf
Public Services and Procurement Canada, Integrated Services Branch, & Government Information Services, Publishing and Depository Services. (2013, April 03). Preventing chronic disease strategic plan 2013-2016: HP35-39/2013E-PDF. Retrieved from http://publications.gc.ca/site/eng/443516/publication.html
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