HCIC 2018 Master Slide Deck - McGill University...2019/07/12 · Pollara Strategic Insights has...

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Results of the 2018 Health Care in Canada SurveyA National Survey of Health Care Providers, Managers and the Public

August 22, 2018

https://www.mcgill.ca/hcic-sssc/

Disclaimer

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The information herein being shared is for educational purposes and is not

intended for publication without the prior consent of the Health Care in Canada

Knowledge Translation Committee. Contact coordinate: [email protected]

Pollara Strategic Insights has provided this master slide deck of 2018 HCIC results

which includes section summaries with their interpretations of key 2018 findings.

www.pollara.com

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• Canadian Cancer Society (CCS)• Canadian Home Care Association (CHCA)• Canadian Hospice Palliative Care Association (CHPCA) • Canadian Medical Association (CMA)• Canadian Nurses Association (CNA)• Canadian Pharmacists Association (CPhA)• Constance Lethbridge Rehabilitation Center (McGill University) • Health Charities Coalition of Canada (HCCC)• HealthCareCAN• Innovative Medicines Canada• Institute of Health Economics (IHE)• Merck Canada • Studer Group Canada• POLLARA• CareNet / Strive Health

HCIC Members 2018

https://www.mcgill.ca/hcic-sssc/about-us

• Results derived from online survey questionnaires (POLLARA)• Conducted April to May 2018• With nationally representative samples of:

• Canadian adult public, doctors, nurses, pharmacists, administrators, other health care providers (including nutritionists/dieticians, occupational therapists, physical therapists, psychologists and social workers.)

• As a guideline, margins of error for comparable probability samples for each sample group are illustrated below:

Groups Sample Size ComparableMargin of Error

Public 1500 + 2.5%Doctors 100 + 9.8%Nurses 100 + 9.8% Pharmacists 100 + 9.8% Administrators 100 + 9.8%Other Providers 100 n/a

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Methodology

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5

Key Sections Public Professionals

Trends in quality of and access to care Trends in quality of and access to careHealth status Health status / workplace engagement

Chronic disease Prevalence Management

PharmacarePatient-centred care

Chronic disease Management

PharmacarePatient-centred care

End of Life Options End of Life Options

eHealth eHealth

Caregiving Opioids

Future innovations Future Innovations

TrendsWhere Were We?

Where Are We Now?

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61%

58%

58%

57%

55%

58%

53%

36%

37%

38%

37%

37%

38%

42%

2018

2016

2013

2007

2006

2003

2002

Receiving Quality Health Care Not Receiving Quality Health Care

7QB1: Overall, would you say that Canadians are or are not receiving quality health care services right now? (n=1500)

Quality of Care – In General Public Perceptions

8QB1: Overall, would you say that Canadians are or are not receiving quality health care services right now? (n=1500)

Quality of Care – By RegionPublic Perceptions

59%

61%

52%

65%

64%

52%

38%

38%

40%

32%

32%

43%

BC

Alberta

Prairies

Ontario

Quebec

Atlantic

Receiving Quality Health Care Not Receiving Quality Health Care

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9*NOTE: Name changed in 2018 previously Allied ProfessionalsQB1: Overall, would you say that Canadians are or are not receiving quality health care services right now? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers* (n=100)

Quality of Care – In GeneralProfessional Perceptions

72%

58%

67%

74%

56%

Doctors

Nurses

Pharmacists

Administrators

Other Provider*

2016 2013 2007 2006 2003 2002

77% 76% 72% 78% 70% 72%

46% 62% 66% 66% 58% 64%

75% 75% 76% 80% 74% 81%

69% 73% 91% 86% 88% 74%

52% NA NA NA NA NA

2018

NOTE: Responses less than 3% in 2018 not shownQB2: What is the most important health care issue facing Canada today? (n=1500)

Most Important Care IssuesPublic Perceptions

10

43%

14%

13%

8%

8%

4%

4%

3%

Wait times

Availability/Accessibility

Shortage of doctors

Aging population

High cost of care

Shortage of staff

Quality of care

Health coverage

2016 2013 2007 2000 1999 1998

36% 31% 20% 7% 6% 4%

11% 5% n/a n/a n/a n/a

13% 16% 19% 5% 5% 3%

10% 8% 8% 5% 5% 5%

7% 8% n/a n/a n/a n/a

3% 3% 3% 10% 4% 2%

6% 1% n/a n/a n/a n/a

n/a n/a n/a n/a n/a n/a

2018

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NOTE: Responses less than 3% not shownQB2: What is the most important health care issue facing Canada today? (n=1500)

Most Important Care Issue – By Region Public Perceptions

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BC AB Prairies ON PQ Atl

43% 49% 46% 40% 47% 34%

10% 10% 15% 14% 23% 11%

21% 4% 7% 12% 11% 25%

9% 8% 6% 13% 3% 8%

9% 11% 9% 9% 3% 6%

2% 1% 1% 3% 8% 4%

1% 4% 9% 5% 2% 2%

3% 6% 1% 2% 0% 7%

2018 Overall

43%

14%

13%

8%

8%

4%

4%

3%

Wait times


Shortage of doctors

Aging population

High cost of care

Shortage of staff

Quality of care

Health coverage

Wait times


Lack of funding

Shortage of doctors

Aging population/ Seniors

Health coverage

High cost of care

Shortage of staff

Quality of care

QB2: What is the most important health care issue facing Canada today? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)

Most Important Care Issue Professional Perceptions

12

31%

30%

14%

14%

15%

7%

6%

2%

3%

37%

27%

5%

6%

9%

5%

3%

10%

9%

34%

18%

12%

11%

9%

16%

10%

6%

1%

31%

13%

6%

7%

0%

3%

9%

6%

6%

Doctors Nurses Pharmacists Administrators

41%

27%

11%

3%

6%

4%

1%

1%

4%

Other Providers

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QB5: Which of the following do you use regularly to get health care information? (n=1500)

Sources of Health Care InformationPublic Perceptions

13

61%

48%

37%

27%

19%

16%

16%

15%

15%

12%

5%

6%

My primary care provider

Google or other online search engine

Family members or friends

Web MD (Website)

Other health care providers (not primary)

Print media like books, journals, newspapers or magazines

Other website

Fellow patients or others with similar health conditions

Broadcast media like radio and TV

Wikipedia

Other

I do not access health care information

Source of Information about Health Care

66%HCP

62%Internet

19%Media

Wait times continue to negatively impact the perception of the quality of health care in Canada

• Six in ten Canadians believe they are receiving quality health care, which has been a consistent finding for the past 15 years. Wait times continues to be the biggest challenge our health care system faces, with perceptions of this problem getting worse year over year.

• Regionally, those in Canada’s most populous provinces, Quebec and Ontario, have the most optimistic view, with almost two thirds saying they are receiving quality care. This compares to only half of those living in Atlantic and Prairie provinces holding this view.

• Doctors and administrators remain more optimistic about the quality of Canadians’ health care than the general public. While pharmacists are also slightly more optimistic than the general population, they are less optimistic than they have been since tracking began. Both nurses and other providers are slightly less optimistic than the general population this year; however, their opinions have shifted somewhat more positive compared to 2016.

• While wait times are also thought to be an issue to the professional groups, they also think access and availability affects the quality of health care in Canada.

• The main sources of information about health care for Canadians are health care providers and the Internet, with health care providers being used slightly more often.

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AccessWhat Care Is All About

QE1. For each of the following, please indicate whether timely access over the past five years has improved, worsened or remained the same. (n=1500)

Timely Access to CarePublic Perceptions

16

10%38%

19%15%13%13%13%12%12%

10%9%8%6%6%

37%35%

27%32%

20%24%

34%35%

33%23%

30%25%28%

21%

47%15%

21%48%

39%22%

25%34%

45%31%

53%59%

50%43%

6%12%

33%6%

27%40%

28%19%

10%37%

8%8%

16%30%

Health Care system in general

Pharmacists primary care services

Nurse practitioner

Family doctors

Mental health services

Hospice palliative and end-of-life care

New medicines

Treatments

Diagnostic procedures

Home care services

Emergency dept care

Specialists

Non-urgent surgery

Long term care

Improved Remained the same Worsened Don't know

Timely access to... 2018 2016 2013

-37% -35% -39%23% 21% NA-3% -4% NA

-33% -35% -41%-26% -29% -32%-9% -13% -19%

-12% -11% -14%-23% -22% NA-33% -28% -34%-21% -26% -24%-44% -39% NA-51% -49% -45%-43% -37% -40%-37% -36% -37%

Net Momentum

NOTE: Net Momentum equals Total Improve minus Total Worsen

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NOTE: Net Momentum equals Improve minus WorsenQE1. For each of the following, please indicate whether timely access over the past five years has improved, worsened or remained the same. (n=1500)

Timely Access to Health Care System in GeneralPublic Perceptions – By Region

17

Negative Net Momentum

-37%Overall

-40%

-42%

-26%

-34%

-34%

-51%

BC

Alberta

Prairies

Ontario

Quebec

Atlantic

QE1. For each of the following, please indicate whether timely access over the past five years has improved, worsened or remained the same. Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)

Timely Access to Health Care System in GeneralProfessional Perceptions

18

10%

16%

11%

39%

7%

19%

25%

29%

18%

28%

70%

59%

58%

43%

59% 6%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

Improved Remained the same Worsened Don't know

Negative Net Momentum2018 2016 2013

-60% -25% -28%

-43% -36% -27%

-47% -32% -30%

-4% -19% -19%

-52% -37% NA

Net Momentum

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Timely Access to Care - Health Care ProfessionalsProfessional Perceptions

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Improved Remained the same Worsened Don’t knowImproved Remained the same Worsened Don’t know

Family doctor

14%

18%

14%

35%

15%

24%

17%

30%

32%

17%

60%

65%

53%

30%

66%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

NetMomentum

-46%

-47%

-39%

5%

-51%

Nurse practitioner

31%

43%

45%

30%

45%

24%

27%

21%

34%

14%

17%

20%

11%

32%

12%

28%

10%

23%

4%

29%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

NetMomentum

+14%

+23%

+34%

-2%

+33%

Primary care by pharmacists

51%

44%

65%

32%

53%

22%

24%

21%

36%

24%

15%

21%

10%

29%

14%

12%

11%

3%

9%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

NetMomentum

+36%

+23%

+55%

+3%

+39%

Specialists

8%

10%

6%

25%

6%

15%

18%

32%

34%

23%

74%

70%

57%

40%

68%

3%

5%

3%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

NetMomentum

-66%

-60%

-51%

-15%

-62%


Timely Access to Care - Facilities for CareProfessional Perceptions

20

Care in emergency departments

11%

11%

17%

37%

11%

27%

24%

26%

36%

24%

58%

63%

52%

25%

51%

4%

5%

14%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

NetMomentum

-47%

-52%

-35%

+12%

-40%

Hospice palliative and end-of-life care

24%

22%

23%

36%

25%

26%

23%

36%

27%

25%

34%

30%

30%

32%

24%

16%

25%

11%

5%

26%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

NetMomentum

-10%

-8%

-7%

+4%

+1%

Home care services

13%

13%

19%

27%

12%

23%

26%

27%

35%

22%

50%

51%

39%

35%

48%

14%

10%

15%

3%

18%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

NetMomentum

-37%

-38%

-20%

-8%

-36%

Long term care

5%

10%

6%

32%

4%

19%

18%

22%

30%

16%

66%

62%

60%

35%

66%

10%

10%

12%

3%

14%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

NetMomentum

-61%

-52%

-54%

-3%

-62%


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Timely Access to Care - Care ServicesProfessional Perceptions

21

Mental health service

9%

15%

15%

41%

12%

15%

24%

16%

22%

13%

65%

51%

58%

34%

64%

11%

10%

11%

11%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

NetMomentum

-56%

-36%

-43%

+7%

-52%

Non-urgent surgery

9%

5%

32%

5%

21%

27%

30%

33%

22%

68%

58%

48%

34%

57%

9%

6%

17%

16%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

NetMomentum

-66%

-49%

-43%

-2%

-52%



Timely Access to Care - Test and TreatmentsProfessional Perceptions

22

New medicines

13%

29%

22%

33%

21%

35%

35%

41%

33%

23%

46%

30%

31%

32%

24%

6%

6%

6%

32%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

NetMomentum

-33%

-1%

-9%

+1%

-3%

Diagnostic procedures or screening tests

19%

20%

19%

35%

18%

28%

28%

35%

37%

22%

52%

50%

40%

27%

54%

6%

6%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

NetMomentum

-33%

-30%

-21%

+8%

-36%

Access to treatments

6%

15%

8%

33%

16%

31%

36%

35%

21%

28%

55%

44%

44%

44%

49%

8%

5%

13%

7%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

NetMomentum

-49%

-29%

-36%

-11%

-33%


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QF1: To what extent would you support or oppose each of the following policies to increase access to health professionals using a scale from one to 10, where one means you would ‘strongly oppose’ it and 10 means you would ‘strongly support’ it? (n=1500)

Access Improvement ProposalsPublic Perceptions

23

Mean

53%

46%

36%

36%

33%

29%

25%

16%

27%

27%

32%

30%

27%

29%

26%

21%

10%

15%

18%

17%

20%

21%

23%

21%

2%

5%

4%

8%

7%

8%

10%

15%

6%

7%

7%

19%

6%

6%

7%

5%

7%

6%

9%

7%

Encouraging health professionals to work in teams with other types of health care providers

Increasing medical and nursing school enrolment levels

Investing in formal training and development so health professionals are better equipped to coordinate patient …

Enabling health professionals (nurses and pharmacists) to expand roles re: diagnose, treat, prescribe medications, etc.

Recruiting health professionals back from the US

Making it easier for foreign trained doctors to practice in Canada

Mandating that designated health professionals work in underserviced rural and remote locations

Requiring patients to register with one family doctor or other primary health care professional

Strongly Support (9,10) Somewhat Support (7,8) Neutral (5,6)

Somewhat Oppose (3,4) Strongly Oppose (1,2) Don't know 2018 2016 2013 2007

8.4 7.7 7.5 7.7

8.0 7.8 7.9 8.4

7.7 7.5 NA NA

7.4 7.4 6.7 NA

7.2 7.2 7.3 7.3

6.9 7.0 6.9 7.5

6.7 7.0 6.8 6.2

5.5 5.8 6.2 6.0

QF2. Which three policies would you say are most important to increase access to health professionals? Please choose up to three options. (n=1500)

Most Important Access Improvement ProposalPublic Perceptions

24

54%

51%

47%

37%

28%

25%

23%

17%

4%


Enabling health professionals (nurses and pharmacists) to expand roles re: diagnose, treat, prescribe medications, etc

Increasing medical and nursing school enrolment levels


Investing in formal training and development so health professionals are better equipped to coordinate patient care




No other policies are important to me

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QF1: To what extent would you support or oppose each of the following policies to increase access to health professionals using a scale from one to 10, where ones means you would ‘strongly oppose’ it and 10 means you would ‘strongly support’ it? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)

Access Improvement ProposalsProfessional Perceptions

25

37%

49%

32%

28%

36%

35%

64%

69%

35%

62%

23%

28%

26%

48%

33%

29%

21%

22%

47%

24%

22%

12%

23%

19%

18%

23%

10%

6%

18%

8%

9%

8%

11%

5%

8%

3%

3%

6%

5%

9%

3%

3%

3%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

Doctors

Nurses

Pharmacists

Administrators

Other Providers


Somewhat Oppose (3,4) Strongly Oppose (1,2) Don't know

2018 2016 2013 2007 2006 2005

7.1 6.2 6.5 8.2 8.4 NA

7.9 7.5 7.7 9.1 8.8 NA

6.9 6.8 7.0 8.0 7.9 NA

7.5 7.3 7.3 8.7 8.2 NA

7.5 7.2 NA NA NA NA

7.3 6.2 6.3 6.3 6.1 6.0

8.7 8.3 8.5 8.6 8.7 8.3

8.8 7.6 8.0 8.1 8.4 8.3

7.8 7.9 8.3 8.8 8.9 8.6

8.7 8.0 NA NA NA NA

MeanIncreasing medical and nursing school enrolment levels


15%

22%

26%

27%

16%

14%

47%

54%

20%

27%

14%

27%

26%

44%

29%

16%

28%

20%

54%

37%

33%

19%

27%

25%

21%

18%

12%

12%

17%

17%

9%

17%

13%

13%

22%

4%

6%

7%

29%

13%

5%

18%

26%

3%

6%

3%

4%

7%

10%

5%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

Doctors

Nurses

Pharmacists

Administrators

Other Providers





26


Enabling health professionals such as nurses and pharmacists to expand their existing roles further in diagnosing patients, treating illnesses and prescribing medications, etc.

2018 2016 2013 2007 2006 2005

5.0 4.2 4.1 3.9 3.7 4.7

6.1 5.2 4.9 5.9 6.3 6.1

6.7 6.1 6.7 6.0 5.9 6.6

7.4 6.4 6.1 5.9 6.3 6.4

5.7 5.8 NA NA NA NA

4.8 4.4 3.8 NA NA NA

8.1 8.2 7.2 NA NA NA

8.4 8.3 8.4 NA NA NA

7.1 7.1 6.2 NA NA NA

7.1 7.0 NA NA NA NA

Mean

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18%

27%

15%

22%

29%

18%

21%

18%

26%

22%

24%

31%

23%

40%

19%

22%

32%

24%

41%

28%

29%

27%

40%

34%

17%

27%

28%

20%

25%

26%

8%

6%

8%

11%

11%

15%

19%

4%

13%

18%

6%

10%

17%

18%

17%

3%

9%

3%

4%

6%

4%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

Doctors

Nurses

Pharmacists

Administrators

Other Providers



*Wording change 2007=“Requiring health professionals to work in specific geographic areas”QF1: To what extent would you support or oppose each of the following policies to increase access to health professionals using a scale from one to 10, where ones means you would ‘strongly oppose’ it and 10 means you would ‘strongly support’ it? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)


27

Recruiting health professionals back from the U.S.


2018 2016 2013 2007 2006 2005

5.8 5.0 5.8 7.0 NA NA

6.9 6.1 6.6 7.8 NA NA

6.0 5.8 6.1 7.4 NA NA

7.2 6.7 6.9 7.3 NA NA

6.2 6.5 NA NA NA NA

5.6 4.3 5.4 6.4 6.4 NA

6.5 5.7 5.7 7.3 7.7 NA

5.6 5.3 5.2 6.8 7.0 NA

7.1 6.4 6.3 7.3 7.8 NA

6.4 6.4 NA NA NA NA

Mean

21%

26%

16%

27%

13%

26%

45%

33%

27%

38%

30%

27%

29%

38%

22%

33%

23%

38%

47%

28%

19%

22%

27%

26%

23%

23%

23%

18%

24%

18%

19%

16%

13%

4%

14%

12%

3%

8%

10%

10%

8%

14%

5%

24%

6%

4%

3%

3%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

Doctors

Nurses

Pharmacists

Administrators

Other Providers





28

Requiring patients to register with one family doctor orother primary health care professional (e.g. nurse practitioner)

Investing in formal leadership training and development so HCPs are better equipped to coordinate patient care among a team of health professionals

2018 2016 2013 2007 2006 2005

6.1 5.8 6.0 5.9 6.1 5.5

6.5 6.2 6.4 6.6 7.8 7.5

5.8 6.1 6.4 6.0 7.4 7.4

7.1 5.9 6.3 6.6 7.4 7.1

5.2 5.3 NA NA NA NA

6.7 6.3 NA NA NA NA

7.8 7.9 NA NA NA NA

7.5 7.1 NA NA NA NA

7.5 8.0 NA NA NA NA

7.4 7.7 NA NA NA NA

Mean

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Increase medical and nursing school enrolment levels





Enabling health professionals (nurses and pharmacists) to expand their roles re: diagnosing,

treating, prescribing medications, etc.


Investing in formal leadership training and development

No other policies are important to me

QF2. Which three policies would you say are most important to increase access to health professionals? Please choose up to three options.Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)

Most Important Access Improvement ProposalProfessional Perceptions

29

55%

67%

20%

28%

21%

21%

31%

35%

12%

Doctors Nurses Pharmacists Administrators Other Providers

43%

62%

17%

20%

21%

65%

23%

38%

3%

27%

69%

6%

12%

34%

86%

24%

26%

2%

36%

38%

32%

38%

25%

44%

34%

43%

2%

49%

70%

14%

28%

20%

56%

10%

37%

6%

1

2

1 1

12 2

2

2

1

NOTE: Net Momentum equals Total Improve minus Total WorsenQB3: Over the next five years, do you believe that Canadians’ access to the following will significantly improve, somewhat improve, somewhat worsen or significantly worsen? (n=1500)

Future of Health CarePublic Perceptions

30

4%

4%

29%

41%

38%

35%

18%

9%

10%

11%

Timely Health Care Services

Quality of Health Care Services

Significantly improve Somewhat Improve Somewhat Worsen Significantly worsen Don’t know

2018 2016 2013

-23% -21% -24%

0% 0% -4%

Net Momentum

Perceptions of Health Care over Next 5 Years

18-08-22

16

NOTE: Net Momentum equals Total Improve minus Total WorsenQB3: Over the next five years, do you believe that Canadians’ access to the following will significantly improve, somewhat improve, somewhat worsen or significantly worsen? (n=1500)

Future of Health Care Access – By Region Public Perceptions

31

Timely Health Care Services Quality Health Care Services

-31%

-30%

-21%

-26%

-8%

-24%

BC

Alberta

Prairies

Ontario

Quebec

Atlantic

-11%

-12%

-1%

0%

13%

11%

QB3: Over the next five years, do you believe that Canadians’ access to the following will significantly improve, somewhat improve, somewhat worsen or significantly worsen? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)

Future of Health Care Access Professional Perceptions

32

Tim

ely

Heal

th C

are

Serv

ices

Qual

ityHe

alth

Car

e Se

rvice

s

1%

6%

1%

20%

5%

6%

1%

24%

19%

28%

21%

38%

22%

27%

44%

37%

52%

43%

40%

45%

63%

31%

51%

41%

39%

49%

16%

38%

34%

18%

9%

9%

18%

19%

7%

6%

7%

9%

6%

3%

6%

2%

9%

8%

4%

7%

1%

10%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

Doctors

Nurses

Pharmacists

Administrators

Other Providers

Significantly improve Somewhat improve Somewhat worsen Significantly worsen Don't know 2018 2016 2013

-54% -42% -41%

-29% -53% -34%

-50% -54% -36%

+18% -28% -17%

-47% -50% NA

-28% -32% -7%

+4% -31% -19%

-17% -4% =

+53% +7% +17%

-4% -21% NA

Perceptions of Health Care over Next 5 Years

Net Momentum

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17

Timely access remains a concern to Canadians and providersand is thought to be getting worse

• Generally, Canadians feel that timely access to health care has gotten worse in the past five years. Results are similar to the 2016 and 2013 findings, showing at best stagnation in efforts, and at worst, a health care system that continues to fail to provide the timely care Canadians expect.

• Access to pharmacists and nurse practitioners is rated highest and most likely to have seen improvements.

• Timely access to hospice palliative / end-of-life care and to mental health services have seen some positive net momentum in the past five years, while timely access to other health care services and providers are either seen to have declined slightly more, or stayed the same.

• There is an apparent lack of access to many areas of health care, which is leading to general pessimism. Specific areas that have been on the steadiest decline in the minds of the general public and health care professionals are, in order of worse net momentum (most decline), the access to:

• Specialists• Emergency care• Non-urgent surgery• Long term care• Diagnostic procedures• Family doctors

33

Canadians are not optimistic about future access; team care seen as the most important factor to drive improvements

• When it comes to the future, the majority of Canadians feel that access to timely health care will get worse in the next 5 years. However, they are mixed on whether the quality of health care services will get better or worse.

• Health care professionals also agree that timely access to health care has declined in the past five years. While doctors areparticularly pessimistic about changes to the system, nurses, pharmacists and other providers are also seeing more negative momentum than they did in the past.

• Of all suggested policies that may help improve access to the system, the Canadian public most supports team care, attracting and training more health care professionals and expanding the roles and duties of nurses and pharmacists.

• The idea of health care teams is also gaining support among professionals, in particular among doctors and pharmacists. While a majority of nurses, pharmacists and other providers would like to see themselves take on more roles traditionally only doctors are allowed to do, such as diagnosing, treating and prescribing medications, this is not something most doctors find important.

34

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18

Personal Health /Engagement

Status / Impact

35

QG1: In general, how would you rate your health? (n=1500)

Personal HealthPublic Perceptions

36

3% 4% 6% 4%11% 10%

15%12%

34% 34%

39%

27%

39% 40%

34%

39%

14% 12%6%

18%

2018 2016 2013 2007

Excellent

Very Good

Good

Fair

Poor

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19

QG1: In general, how would you rate your health? (n=1500)

Personal HealthPublic Perceptions - By Region

37

3% 3% 3% 3%

12% 12% 12% 10% 10% 12%

30% 37% 35% 35% 36%28%

41% 35% 32% 40% 37%43%

14% 15% 19%12% 13% 15%

BC Alberta Prairies Ontario Quebec Atlantic

Excellent

Very Good

Good

Fair

Poor

QG1: In general, how would you rate your health? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers Professional (n=100)

Personal HealthProfessional Perceptions

38

8%2% 9% 4% 3%

35%

29%24% 30%

18%

29%48% 51%

42%49%

25% 20% 16%24% 28%

Doctor Nurse Pharmacist Administrator Other Providers

Excellent

Very Good

Good

Fair

Poor

18-08-22

20

QG2. In general, how would you rate your level of engagement in your current job using a scale from one to 10, where one means your level of engagement is “very poor” (i.e., with long-term exhaustion, cynicism and inefficiency) and 10 means your level of engagement is “excellent” (i.e., with high energy, involvement and performance efficacy)? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers Professional (n=100)

Level of Job EngagementProfessional Perceptions

39

11% 6% 6% 5%

10%12% 17%

8%12%

42% 47%

53%69%

44%

37% 35%24% 23%

39%


Very good (9-10)

Good (7-8)

Fair (5-6)

Poor (1-4)

Don't know

Increased stress in my workplace

Lack of meaningful voice within the organization

Decreased sense of empowerment in my work

Increased workload

Relentless change in my workplace

Functionally disorganized workplace

QG3. Please rate the following factors using a scale from one to 10, where one means it is “not a contributing factor” to lesser workplace engagement and 10 means it is a “major contributing factor.”Less Engaged: Doctor (n=86), Nurse (n=89), Pharmacist (n=91), Admin (n=98), Other Providers (n=85)

Factors Contributing to Work Place DisengagementProfessional Perceptions

40

38%

30%

29%

27%

27%

21%

33%

30%

22%

40%

33%

33%

40%

25%

21%

34%

40%

22%

23%

28%

15%

52%

45%

15%

25%

28%

19%

27%

27%

21%

Doctors Nurses Pharmacists Administrators Other ProvidersMajor Factor (9-10)

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21

My patients (NET impact)

Health in general

Quality of life

Mental health

I do not think I have impacted any patient outcomes through

my work in the past week

QG4. Thinking about your most recent week at work, what patient outcomes do you think you have impacted through your work? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)

Impact on Patient OutcomesProfessional Perceptions

41

89%

76%

58%

51%

11%

92%

72%

70%

54%

8%

85%

79%

59%

33%

15%

76%

58%

63%

42%

24%

93%

56%

77%

56%

7%


Have Impacted Patient Outcomes in the Past Week

42

Most Canadians, as well as health care providers, continue to rate their health as good to excellent, yet providers are feeling stressed, overworked.

• Just over half of Canadians describe their health as very good (four in ten) or excellent (one in seven), which is unchanged since 2016.

• Health care providers continue to view their overall health more positively than general Canadians, with around a quarter of doctors, administrators and other providers, and one in five nurses and pharmacists saying they are in excellent health. While this is higher than perceptions of the general public, it is lower than what they rated their health in 2016.

• Overall, health care providers continue to feel a high level of engagement, with their jobs with between nine-in-ten (administrators) and eight-in-ten (doctors and pharmacists) rating it at least good.

• Increased workload and increased stress are the most prominent reasons for a lack of engagement among most professionals.

• Most professionals feel they have a weekly impact on the general health and quality of life of their patients.

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22

Chronic DiseaseBurden / Management

43

Heart disease, high cholesterol,stroke or high blood pressure

Arthritis

Asthma, bronchitis or emphysema

A mental health condition

Diabetes

Cancer

Osteoporosis

A memory problem that interfereswith day-to-day function

Any other chronic health condition

None of the above

QG5. Have you or has anyone in your household, been diagnosed by a health care professional (e.g., physician, nurse practitioner) with any of the following? (n=1500)

Prevalence of Chronic DiseasesPublic Perceptions

44

22%

17%

14%

13%

8%

7%

5%

2%

10%

47%

26%

16%

12%

12%

14%

12%

8%

6%

7%

49%

58%

70%

75%

78%

79%

82%

87%

92%

84%

1%

Myself

OtherIn HH

NONEIn HH

18-08-22

23

QG6. Please consider the condition(s) that you personally have been diagnosed with. Do you work with a doctor or other health care professional(s) to manage your condition(s)?(Those with a chronic condition n=824)

Health Care Providers for Chronic ConditionsPublic Perceptions

45

89%

22%

11%

6%

5%

1%

16%

5%

Doctor

Pharmacist

HCP team that works together about your personal health care

Nurse practitioner

Registered nurse

A health navigator

Other health care professional(s)

None of the above

Health Care Providers Used for Chronic Conditions

Inadequate access to care

Poor patient adherence to treatment regimen

Non-diagnosis of disease

Inadequate prescribing of medications

Other

Don't know

QP1. It has been estimated that half of all Canadian adults have one or more chronic diseases. Many of these Canadians are experiencing care gaps, or gaps between recommended care and the care actually received. Which one of the following do you see as the primary cause of these care gaps?Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)

Improving Chronic Care - Identifying Care Gap Causes Professional Perceptions

46

46%

35%

6%

3%

6%

4%


53%

24%

9%

7%

6%

1%

46%

33%

7%

3%

5%

6%

42%

14%

11%

29%

2%

2%

Primary Cause of Gaps

62%

18%

4%

2%

12%

2%

18-08-22

24

QP2. Do you work with at least one other health care professional on a routine basis for the care of your patients? Work together means you communicate with and coordinate the care of your patients.Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)

CollaborationProfessional Realities

47

91%

99%

84%

93%

77%

Doctor

Nurse

Pharmacist

Administrator

Other Providers

Incidence of Working in Teams

QG10. As a direct result of your chronic condition(s), over the past 12 months, how many times were you…? n=821)

Part of the Burden - Acute Care Needs Public Perceptions

48

17% Admitted to ER

89%

7%

3%

0%

0%

None

Once

2 to 5 times

6 to 10 times

More than 10 times

83%

10%

6%

0%

0%

11% Hospitalized

Average Number of Hospitalizations – 0.21

Average Number of ER Visits – 0.29

18-08-22

25

QG7. Do you receive the support that you need from health professionals to help you manage your condition(s)? (Have been diagnosed with condition n=843)

Managing Chronic Care Public Perceptions of Professional Support

49

30%

30%

26%

7%

6%

Always

Often

Sometimes

Rarely

Never

Frequency of Receiving Needed Support for Chronic Condition

QG8. Do you have access to the treatments you need to manage your condition(s)? (Have been diagnosed with condition n=824)QG9. What are some of the reasons why you don’t always have access to the treatments you need to manage your condition(s)?(Do not always have access to treatments to manage condition(s) n=522)

Managing Chronic Care - Access to Treatments Public Perceptions

50

35%

31%

22%

6%

6%

Always

Often

Sometimes

Rarely

Never

36%

21%

19%

17%

16%

15%

11%

10%

7%

4%

3%

3%

2%

15%

Wait times were too long

Treatment was ineffectiveCan't afford the other forms of prescribed

treatment (other than medication)Can't afford the prescribed medication

Treatment was inadequate

Treatment not required

Did not get referred to the treatment in time

Treatment caused unbearable side effects

Can't get to or otherwise access the treatmentThe treatment is available in my province, but it is

too far or I have no way to access itThe prescribed treatment was refused

The treatment is not available in Canada

The treatment is not available in my province

Other

Reasons For Not Always Receiving Treatments

Frequency of Receiving Needed Treatments

18-08-22

26

QL4. After discharge?

QL1: How many times have you or someone in your household been hospitalized within the past year for any reason? (n=1500)QL2: And have you, or has someone in your household needed these types of health care within the past year? (n=1500)QL3: Was there a smooth transition from the primary care provider to the following other health care services? (Need specialty healthcare in past year (n=493)QL4: Upon discharge, do you feel that adequate support/care was provided when the following members of your household returned to the community? (Been in the hospital in past year n=330)

Managing Care TransitionsPublic Perceptions

51

23%23%QL1.Self or household

member has beenhospitalizedin past year

QL2. Self or householdmember

has neededspecialty health care

in past year

QL2. Self or householdmember

has neededspecialty health care

in past year

33%33%

66% 34%Adequate care/ support

67%

64%

55%

43%

17%

18%

35%

31%

16%

18%

11%

26%

Specialized care

Home care

Hospice Palliative Care

Long-term care

Home care 4%Long-term care 2%Hospice palliative care 1%

Yes No DK

QL3. Smooth transition from primary care provider?

52

Many Canadians live with or with someone who has a chronic health condition.

• Half of Canadians have one or more chronic health conditions and half live in a household where another family member (also) suffers from at least one.

• One in ten Canadians have been hospitalized in the past year as a results of their chronic condition(s), and one in six have been admitted to the ER. These proportions have been unchanged since 2016.

• Nine in ten patients work with a doctor to manage their condition(s). Those who feel they don’t always have access to the treatments they need in order to manage their condition(s), most often cite long wait times as the main cause for this. Providers also blame poor access to care as the main reason for a gap in care for those suffering from chronic conditions. They are less likely to blame patient adherence than they were two years ago. A vast majority of all providers say they work in teams to provide care to their patients.

• Hospital admittance stood at a quarter of households, which is a decrease from three in ten in 2016 and back to 2013 levels. Most (two-thirds) say they received adequate support when released from the hospital.

• One-third of households (steady since 2016) have (also) depended on specialty care in the past year, with most saying the transition to specialty from primary care was smooth. For most, the transition to home care and hospice palliative care was also smooth, while experiences with the transition to long-term care were more mixed. The likelihood of having a smooth transition has decreased since 2016.

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27

Prescription MedicationsUse and Adherence

53

WhichConditions?

QH1. Do you currently take any prescription medications on a regular (daily or weekly) basis? (n=1500)QH2. How many different types of prescription medications are you currently taking in total? (Take Rx regularly n=583)

Managing Chronic Care - MedicationsPublic Realities

54

81%

77%

59%

50%

42%

37%

34%

17%

67%

Diabetes

Heart disease, stroke or high bloodpressure

A mental health condition

Osteoporosis

Asthma, bronchitis or emphysema

A memory problem that interferes withday-to-day function

Arthritis

Cancer

Other

39%39%Take Rxregularly

Mean # of Rx’s

3.3Mean # of Rx’s

3.3

NB: 53% (n=795) of public respondents have been diagnosed by a health professional with at least one chronic condition.

18-08-22

28

QH1: Do you currently take any prescription medications on a regular (daily or weekly) basis? (n=1500)QH2: How many different types of prescription medications are you currently taking in total? (Take Rx regularly n=583)

Managing Chronic Care - MedicationsPublic Realities - By Region

55

39%39%OverallTake Rxregularly

OverallMean # of Rx’s currently taking

3.3

OverallMean # of Rx’s currently taking

3.3

BC44%4 Alberta

51%3

Prairies42%4 Ontario

47%4

Quebec38%4

Atlantic56%5

Take Rx regularlyMean # of RX currently taking

BC44%3.0 Alberta

47%3.7

Prairies36%3.0 Ontario

40%3.2

Quebec33%3.4

Atlantic33%3.0

Take Rx regularlyMean # of RX currently taking

QH3: Do you do any of the following when it comes to taking your prescribed medication? (Take Rx regularly n=583) 56

16%

14%

11%

11%

4%

3%

3%

1%

2%

22%

20%

16%

13%

12%

8%

6%

17%

16%

25%

15%

13%

9%

9%

33%

39%

54%

68%

72%

81%

81%

Spoke to your health care provider about how you take your medication (including when you do not follow

instructions)

Your health care provider has asked you about how you take your medication (including if you do not follow

instructions)

Take any of your medications less frequently than prescribed (e.g., twice daily instead of three times)

Stopped taking your medication for a short period of time (i.e., a medication holiday) or permanently

Take a lower dosage of any of your medications than prescribed (e.g., two pills per dosage instead of four)

Take a higher dosage of any of your medications than prescribed (e.g., two pills per dosage instead of one)

Take any of your medications more frequently than prescribed (e.g., twice daily instead of once)

Always Often Sometimes Rarely Never

Patterns of Non-Adherence

60% non-adherent, meaning not saying “never” to all five

behaviours

Chronic Medications - Adherence BehavioursPublic Perceptions

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29

I forget to take pills

Take depending onhow I feel

Side effects/reactions

Cost of medication/can't afford it

Does not work/not effective

Other

No Answer

Don't know

11%

46%

0%

16%

2%

14%

12%

52%

9%

9%

8%

9%

10%

2%

12%

21%

15%

13%

1%

14%

23%

2%

9%

40%

1%

10%

9%

21%

6%

TakeMore Frequently(n=97)

TakeLess Frequently(n=254)

TakeHigher Dosage(n=92)

TakeLower Dosage(n=152)

Reasons for Non-Adherence

QH4: Why do you at least occasionally do the following when it comes to taking your prescribed medication?

Chronic Medications – Reasons for Adherence BehavioursPublic Perceptions

12%

26%

13%

9%

3%

13%

16%

8%

Med Vacation(n=174)

57

QH5: How much would you say you understand about each of the following? (Take Rx regularly n=583)

Understanding MedicationsMedication Adherence - Public Perceptions

58

90%

86%

77%

64%

9%

12%

19%

29%

4%

7%

When and how to take medicine

The reasons why medication(s)were prescribed

What medication(s)are supposed to do

Potential side effects of medicine

Understand very well Understand a bit Do not understand

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30

QH1B. How often do you tell patients why the medication(s) was prescribed? Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99) 59

Clinicians Provide Reason For Prescription

72%

68%

68%

31%

11%

18%

22%

26%

41%

23%

7%

8%

6%

22%

26% 18%

3%

21%

Doctor

Nurse

Pharmacist

Administrator

Other Providers


Managing Chronic Care MedicationsProfessional Perceptions

QH1A. How often do you provide patients with instructions on how to take or use their prescribed medication properly? Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99) 60

43%

57%

73%

29%

5%

33%

31%

19%

34%

12%

15%

8%

7%

29%

19%

8%

4%

21% 42%

Doctor

Nurse

Pharmacist

Administrator

Other Providers


Clinicians Provide Instruction for Use


18-08-22

31

QH1C. How often do you tell patients what their medication(s) are supposed to do? Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99) 61

Clinicians Provide Information About How Medications Work

60%

68%

75%

34%

9%

29%

26%

19%

35%

21%

7%

5%

6%

22%

34%

3%

4%

16%

5%

19%

Doctor

Nurse

Pharmacist

Administrator

Other Providers



QH1D. How often do you tell patients about potential side effects to expect from their medications?Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99) 62

Clinicians Provide Information About Side Effects

54%

62%

72%

32%

5%

30%

26%

24%

36%

20%

12%

9%

4%

24%

22%

3%

5%

29% 23%

Doctor

Nurse

Pharmacist

Administrator

Other Providers



18-08-22

32

QH1E. How often do you Ask your patients’ about how they take their medication?Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99) 63

Clinicians Ask Patients About How They Take Medications

30%

49%

43%

35%

15%

41%

31%

40%

33%

29%

23%

15%

17%

23%

30%

5%

4%

11%

5%

14%

Doctor

Nurse

Pharmacist

Administrator

Other Providers



QH1F. How often do you Receive questions from patients about how they take their medication?Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)


64

Clinicians Receive Questions About How to Take Medications

33%

35%

41%

23%

4%

40%

42%

43%

37%

24%

18%

19%

15%

33%

35%

7%

17%

4%

19%

Doctor

Nurse

Pharmacist

Administrator

Other Providers


18-08-22

33

QH1G. How often do you Ask your patients if they have any drug coverage before prescribing a new medication or treatment?Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)


65

Clinicians Ask About Drug Coverage Before Prescribing

49%

34%

47%

28%

8%

30%

32%

29%

30%

7%

10%

16%

15%

31%

5%

5%

6%

7%

6%

9%

6%

11%

5%

71%

Doctor

Nurse

Pharmacist

Administrator

Other Providers


QH6. In the past six months, have you taken any medication that was prescribed to you for a condition that was not considered a chronic condition, such as an acute or short term illness such as antibiotics for an infection or medication for an injury? (n=1500) QH7. When it comes to taking medication you have been prescribed in the past six months for conditions that are not chronic (an acute or short term illnesses or injuries), do you do any of the following? (n=477)

Acute/Short Term Medications - Adherence BehavioursPublic Perceptions

66

Yes31%

No69% Acute

Rx

23%

9%

9%

9%

4%

4%

3%

21%

15%

17%

12%

12%

6%

6%

14%

16%

17%

15%

12%

9%

8%

33%

51%

62%

66%

72%

84%

85%

Spoke to your health care provider about how you take your medication (including when you do not follow

instructions)Your health care provider has asked you about how you

take your medication (including if you do not follow instructions)

Take any of your medications less frequently than prescribed (e.g., twice daily instead of three times)

Stopped taking your medication for a short period of time (i.e., a medication holiday) or permanently

Take a lower dosage of any of your medications than prescribed (e.g., two pills per dosage instead of four)

Take a higher dosage of any of your medications than prescribed (e.g., two pills per dosage instead of one)

Take any of your medications more frequently than prescribed (e.g., twice daily instead of once)


% Who Are Non-Compliant

51%% Who Are Non-Compliant

51%

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34

I forget to take pills

Take depending onhow I feel

Side effects/reactions

Cost of medication/can't afford it

Does not work/not effective

Other

Nothing

Don't know

12%

17%

0%

19%

7%

34%

11%

41%

21%

6%

3%

4%

16%

8%

9%

27%

13%

4%

1%

6%

26%

2%

12%

21%

0%

22%

4%

28%

12%

TakeMore Frequently(n=75)

TakeLess Frequently(n=177)

TakeHigher Dosage(n=73)

TakeLower Dosage(n=130)

Reasons for Non-Adherence

QH4: Why do you at least occasionally do the following when it comes to taking your prescribed medication?

Acute/Short Term Medications – Reasons for Adherence BehavioursPublic Perceptions

15%

23%

11%

5%

3%

12%

9%

8%

Med Vacation(n=152)

67

QH8. How much would you say you understand about each of the following for your acute illness or injury? (n=477)

Understanding Medications for Acute / Short Term IllnessPublic Perceptions

68

88%

83%

72%

62%

11%

14%

25%

32%

4%

7%

When and how to take your medicine

The reasons why your medication(s) wereprescribed

What your medication(s) are supposed to do

Potential side effects to be expected from yourmedications

Understand very well Understand a bit Do not understand

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35

69

Four in ten Canadians take regular meds; patients continue to be non-adherent

• As was seen in 2016, four in ten Canadians take prescription medication on a regular basis. Those who do, on average takemore than three. Three in ten have been prescribed medication for non-chronic illnesses or conditions in the past 6 months.

• Use of prescription medications for chronic conditions has remained stable overall, but is down in Atlantic Canada and up inAlberta compared to two years ago.

• Levels of non-adherence are high: 60% for those taking medication for chronic conditions and 51% of those takingmedications for acute conditions. Non-adherence is most likely to come in the form of taking too little medication ratherthan taking too much.

• Health care providers who deal with prescription drugs (doctors, pharmacists and nurses) also feel they are informing theirpatients about their medications, particularly why they are on it and what it should do for them. However, doctors are lesslikely to do so than they were in 2016.

• Despite this, non-adherence does not come from a lack of information, with most understanding their medications.

• Providers believe that care gaps for those with chronic conditions are more to blame on the health care system than onpatients. They say that the gap it mostly due to inadequate access, more so than the number two cause – poor patientadherence to their treatment regimen.

PharmacareSearching for the Best Direction

70

18-08-22

36

* Wording Change from 2016.QI1: Which one of the following three options would you choose as the best approach for ensuring that all Canadians have access to prescription medications? (n=1500)

Best Approach for Accessible Prescription MedicinePublic Perceptions

71

32%

29%

12%

26%

Have the federal government allocate funds to fill in the gaps for drug costs for those not currently covered by any public or

employer sponsored drug plan, those who have insufficient funding and those who can not afford their medications*.

A single national public Pharmacare plan operated by the federal government and funded by taxes collected by the federal

government.

Separate regional public Pharmacare plans in each province and territory, funded by taxes collected by both the federal

government and the provincial governments.

Don't know

QI1. Which one of the following three options would you choose as the best approach for ensuring that all Canadians have access to prescription medications?Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)

Best Approach for Accessible Prescription MedicineProfessional Perceptions

72

Have the federal government allocate funds to fill in the gaps for drug costs for those not

currently covered by any public or employerdrug plan, those who have insufficient funding

and those who can not afford their medications.

A single national public Pharmacare plan operated by the federal government and funded

by taxes collected by the federal government.

Separate regional public Pharmacare plans in each province and territory, funded by taxes

collected by both the federal government and the provincial governments.

Don't know

36%

35%

13%

16%


54%

29%

10%

7%

31%

46%

15%

8%

54%

20%

24%

2%

38%

32%

11%

18%

18-08-22

37

QI2. Please consider the following statements if that could be included in a Canadian national Pharmacare program. Please rank the statements from 1 to 5, with 1 being the attribute you feel is most important and 5 being the attribute you feel is least important. (n=1500)


73

39%

25%

17%

11%

7%

19%

27%

25%

16%

13%

16%

20%

25%

20%

19%

12%

15%

16%

31%

26%

14%

13%

18%

21%

35%

Access to prescription medications and treatments for allCanadians, regardless of the ability to pay

Lower overall prescription medication and treatment costs forCanadians

Coverage for medications and treatments not covered by otherplans (private, provincial or federal plans)

Access to a wide range of prescription medications and treatments

Access to newly approved prescription medications and treatments

Ranked #1 Ranked #2 Ranked #3 Ranked #4 Ranked #5

Access to prescription medications and treatments for all Canadians,

regardless of the ability to pay

Lower overall prescription medication and treatment costs for Canadians.

Access to a wide range of prescription medications and treatments.

Coverage for medications and treatments not covered by other plans

(private, provincial or federal plans).

Access to newly approved prescription medications and treatments.

QI2. Please consider the following statements if that could be included in a Canadian national Pharmacare program. Please rank the statements from 1 to 5, with 1 being the attribute you feel is most important and 5 being the attribute you feel is least important.Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)

Top 3 PrioritiesProfessional Perceptions

74

71%

69%

63%

59%

38%


68%

65%

52%

66%

46%

73%

58%

66%

51%

52%

59%

65%

54%

69%

53%

75%

70%

51%

60%

41%

Top 3 - Most Important

1 1

1

11

2

2

2

2 2

3

3

33

3

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38

QI3. When thinking of the development of a Pharmacare plan for Canada, who should lead this development? (n=1500)


75

50%

33%

17%

The leadership of the development of the Pharmacare plan in Canada should be shared between the

government (Federal and Provincial) and other organizations such as research hospitals, pharmaceutical

/ biotech companies, health authorities, etc

The government (Federal and Provincial) should lead the development of the Pharmacare plan in Canada

Don't know

The leadership of the development of the Pharmacare plan in Canada should be shared

between the government (Federal and Provincial) and other organizations such as

research hospitals, pharmaceutical / biotech companies, health authorities, etc.

The government (Federal and Provincial) should lead the development of the

Pharmacare plan in Canada.

Don't know

QI3. When thinking of the development of a Pharmacare plan for Canada, who should lead this development?Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)

Who Should LEAD Pharmacare Plan for Canada?Professional Perceptions

76

52%

35%

13%


68%

27%

5%

67%

23%

10%

55%

44%

1%

56%

34%

10%

18-08-22

39

77

Support for a national, universal Pharmacare plan has subsided, preference for gap-filling government initiatives

• The public and providers are split on whether a single federal universal Pharmacare plan, or a scenario where the federalgovernment ensures gaps are filled for those not covered/can’t afford their prescriptions, would be the best option toensure equal access to medications.

• Half of Canadians say that leadership of Pharmacare development should be shared across governments and otherorganizations, while a third believe it should be government-lead. Providers also prefer shared leadership.

• When it comes to prescription drugs, the most important attribute for Canadians and health care providers alike is toensure access to all, regardless of the ability to pay. Lowering the overall cost for Canadians is also ranked high.

Patient-Centred CareChallenges / Opportunities

78

18-08-22

40

QM1: Below is a list of attributes that have been proposed as elements that could help create a culture and practice of patient-centred care. Please indicate to what extent you oppose or support the widespread implementation of each attribute as an effective contribution to enhance patient-centred care using a scale from one to 10, where one means you would ‘strongly oppose’ it and 10 means you would ‘strongly support’ it. (n=1500)

Support for Enhancing Patient-Centred CarePublic Perceptions

79

66%

64%

65%

61%

60%

56%

53%

52%

19%

20%

16%

22%

23%

24%

26%

26%

6%

8%

7%

8%

9%

10%

10%

11%

4%

6%

4%

4%

4%

4%

4%

5%

5%

6%

5%

5%

6%

6%

7%

Care that is readily, and timely, accessed

Care that is provided in a caring, respectful context

Care that is based on need and not on the ability to pay

Care that is guided, and transparently communicated, by providers

Care decisions that are made in partnership between informed patients and their providers

Care that is supported by current research and expert opinion

Care policy that is shaped by interaction with, and learning from, patients

Care and system outcomes that are measured (evaluated) and presented in a manner meaningful to

most Canadians

Strongly Support (9,10) Somewhat Support (7,8) Neutral (5,6) Oppose (1-4) Don't know2018 2016 2013

8.8 8.8 8.6

8.7 8.7 8.6

8.7 8.6 NA

8.6 8.4 8.0

8.5 8.4 8.1

8.4 8.3 7.9

8.3 8.2 7.8

8.3 8.2 7.9

Mean

QM1. Below is a list of attributes that have been proposed as elements that could help create a culture and practice of patient-centred care. Please indicate to what extent you oppose or support the widespread implementation of each attribute as an effective contribution to enhance patient-centred care using a scale from one to 10, where one means you would “strongly oppose” and 10 means you would “strongly support”. Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99)

Support for Enhancing Patient-Centred CareProfessional Perceptions

80







Care and system outcomes that are measured (evaluated) and presented in a manner

meaningful to most Canadians


71%

69%

67%

65%

52%

47%

45%

38%

19%

18%

20%

21%

33%

41%

30%

37%

90%

87%

87%

86%

85%

88%

75%

75%


72%

75%

71%

69%

67%

77%

65%

62%

19%

14%

19%

19%

23%

13%

21%

25%

91%

89%

90%

88%

90%

90%

86%

87%

79%

64%

71%

61%

62%

59%

47%

40%

13%

26%

16%

26%

26%

28%

33%

31%

92%

90%

87%

87%

88%

87%

81%

72%

39%

32%

31%

29%

43%

28%

34%

30%

38%

46%

44%

47%

34%

45%

45%

44%

77%

78%

75%

76%

77%

73%

79%

74%

Strongly SupportSomewhat Support




84%

77%

81%

79%

78%

76%

62%

66%

10%

18%

12%

10%

16%

18%

25%

23%

94%

95%

93%

89%

94%

94%

87%

89%

Other Providers Strongly SupportSomewhat Support

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41

QM2: Which three attributes would you most strongly support? Choose only three. (n=1500)

Priorities for Enhancing Patient-Centred CarePublic Perceptions

81

75%

56%

37%

36%

35%

18%

16%

13%







Care and system outcomes that are measured (evaluated) and presented in a manner meaningful to most Canadians


2016 2013

76% 72%

60% NA

38% 55%

29% 32%

35% 46%

17% 25%

16% 24%

12% 26%

QM2: Which three attributes would you most strongly support? Choose up to three.Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99)

Priorities for Enhancing Patient-Centred CareProfessional Perceptions

82







meaningful to most CanadiansCare that is guided, and transparently

communicated, by providers


I do not support any other attribute


71%

57%

49%

36%

31%

25%

15%

9%

3%

60%

38%

48%

40%

43%

22%

23%

14%

3%

65%

55%

48%

28%

47%

22%

20%

10%

0%

47%

41%

33%

32%

33%

31%

44%

27%

1%

63%

64%

39%

33%

44%

16%

19%

17%

0%

3

2

1

3

2

1

3

2

1

3

2

1

3

2

1

18-08-22

42

QM3. Which ONE attribute is most lacking in order for you to feel you are receiving patient-centred care. Please choose only the MOST important attribute for you.. (n=1500)

Most Lacking Aspect When it Comes to Receiving Patient-Centered CarePublic Perceptions

83

38%

17%

8%

7%

5%

4%

4%

3%

14%



Care decisions that are made in partnership betweeninformed patients and their providers


Care that is supported by current research and expertopinion

Care policy that is shaped by interaction with, andlearning from, patients

Care that is guided, and transparently communicated, byproviders

Care and system outcomes that are measured(evaluated) and presented in a manner meaningful to…

I am not lacking any attribute. I am receiving patient-centred care

QM3. And which one aspect is most lacking when it comes to patients in Canada receiving patient-centred care?Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99)

Most Lacking Aspect When it Comes to Receiving Patient-Centered CareProfessional Perceptions

84







meaningful to most CanadiansCare that is guided, and transparently

communicated, by providers


Nothing is lacking


58%

10%

7%

6%

5%

5%

4%

1%

4%

40%

16%

7%

9%

6%

12%

3%

4%

2%

46%

17%

4%

8%

7%

7%

7%

3%

0%

21%

8%

12%

10%

13%

10%

7%

16%

3%

53%

6%

8%

8%

10%

7%

4%

3%

1%

18-08-22

43

85

Support for patient-centred care continues to be strong

• Support for patient-centred care continues to be strong, both among health care professionals and the general public,although support has waned somewhat in strength among administrators since 2016.

• Support for all factors of this care has increased marginally among the general public since the 2016 and 2013 studies.Support is especially strong for care that is readily, and timely accessed; care that is provided in a caring, respectfulcontext, and care that is needs-based, rather than based on ability to pay.

• To most health care providers, care that is readily and timely accessed also receives the highest support. Care that issupported by current research and expert opinion ranks in the top three for all providers but nurses. Care that is basedon need rather than wealth is important to doctors, nurses and pharmacists, while partnerships between patients andproviders are important to nurses and other providers.

• Not surprising in the context of what has been seen in other findings regarding access, health care providers are most likely to feel that the aspect most lacking in order for Canadians to receive patient-centred care is care that is readily, andtimely, accessed.

End of Life CareSupport of Options

86

18-08-22

44

QN1: Please consider each of the following options for end-of-life health care. Please indicate to what extent would you oppose or support each option using a scale from one to 10, where one means you would ‘strongly oppose’ it and 10 means you ‘strongly support it.’ (n=1500)

Support for End-of-Life OptionsPublic Perceptions

87

67%

66%

62%

56%

17%

18%

18%

17%

7%

8%

9%

9% 6%

5%

5%

6%

7%

Enhanced pain management practices and availability so that those reaching the end of their life can do so comfortably

Enhanced hospice and palliative care so that those reaching the end of their life can have easy access to the most

appropriate health care available

Enhanced home care supports for family and other non-professional caregivers so that those reaching the end of their

life can do so at home

Enhanced medically assisted death to enable those reaching the end of their life to have the option of ending it before it

gets worse, should they choose to do so

Strongly support Somewhat support Neutral Somewhat oppose Strongly oppose Don't know Prefer not to answer2018 2016

8.9 8.9

8.9 8.9

8.7 8.7

8.2 8.1

Mean

QN2. In your personal opinion, which one of the following should be the top priority for end-of-life care in Canada going forward? (n=1500)

Priorities for End-of-Life OptionsPublic Perceptions

88

32%

22%

21%

18%

8%

Enhanced medically assisted death to enable those reaching the end of their life to have the option of ending it before it gets worse, should

they choose to do so

Enhanced hospice and palliative care so that those reaching the end of their life can have easy access to the most appropriate health care

available.

Enhanced home care supports for family and other non-professional caregivers so that those reaching the end of their life can do so at

home.

Enhanced pain management practices and availability so that those reaching the end of their life can do so comfortably.

Prefer not to answer

Top Priority

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45

Enhanced hospice and palliative care so that those reaching the end of their life can have easy

access to the most appropriate health care available

Enhanced pain management practices and availability so that those reaching the end of

their life can do so comfortably

Enhanced home care supports for family and other non-professional caregivers so that those reaching the end of their life can do so at home


they choose to do so

QN1. Please consider each of the following options for end-of-life health care. Please indicate to what extent would you oppose or support each option using a scale from one to 10, where one means you would 'strongly oppose' it and 10 means you 'strongly support' it. - Enhanced hospice and palliative care so that those reaching the end of their life can have easy access to the most appropriate health care available

Support for End of Life OptionsProfessional Perceptions

89

71%

69%

65%

47%

21%

22%

22%

26%

92%

91%

88%

74%


80%

76%

74%

53%

11%

19%

16%

20%

91%

95%

90%

73%

80%

74%

75%

48%

14%

15%

18%

28%

94%

89%

93%

77%

38%

45%

29%

37%

40%

45%

47%

40%

78%

90%

76%

77%





79%

74%

78%

54%

11%

15%

12%

18%

90%

89%

90%

72%

Other Providers Strongly SupportSomewhat Support

Enhanced hospice and palliative care so that those reaching the end of their life can have

easy access to the most appropriate health care available.

Enhanced home care supports for family and other non-professional caregivers so that those

reaching the end of their life can do so at home.


they choose to do so.

Enhanced pain management practices and availability so that those reaching the end of

their life can do so comfortably.

Prefer not to answer

QN2. In your personal opinion, which one of the following should be the top priority for end-of-life care in Canada going forward?Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99)

Priority for End of Life CareProfessional Perceptions

90

42%

26%

19%

9%

4%


28%

35%

22%

14%

0%

Top Priority

33%

33%

13%

15%

5%

27%

22%

26%

23%

2%

35%

36%

14%

14%

0%

18-08-22

46

QN3. In the future, if you were ever to be personally involved in facilitating the provision of medically assisted death in your current role, to what extent would you fear legal or regulatory reprisals even if the federal government has passed legislation expressly allowing for the provision of such services? Please use a scale from one to 10, where one means “not at all” it and 10 means “a great deal” Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99)

Fear of Legal Reprisals for Medically Assisted Death Professional Perceptions

91

5% 9%6% 5% 3%

16%19% 15% 23%

4%

12%16%8%

18%

4%

12%13%

18%

10%

5%

12%

22%28%

22%

65%

23%

23% 23% 20% 19% 15%

Doctor Nurse Pharmacist Administrator OtherProviders

A great dealSomewhatNeutralNot muchNot at allDon't knowPrefer not to answer

QN5. If asked to facilitate the provision of medically assisted death in your current role, to what extent do you feel like you have the necessary system supports in place to easily implement these wishes?Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99)

Necessary System SupportsProfessional Perceptions

92

3% 4% 9%7% 4%

17%26% 29% 28%

4%

41%16% 11% 11%

3%

11%

19%12% 12%

10%

7%22%

24% 25%

54%

9%8%

16% 17%27%

5%


Strong supportSome supportNeutralNot much supportNo support at allDon't knowPrefer not to answer

18-08-22

47

93

Support for medically assisted death among the general public

• The general public continues to strongly support all scenarios to help those reaching the end of their life. Whilemedically assisted death receives somewhat less support than options which help to support and comfort those dyingand their families, almost three quarters of Canadians express support for medically assisted death, with a majoritysupporting this option strongly. However, when asked to choose only one option as the top priority, medically assisteddeath was chosen most often (by a third of respondents.)

• Among health care providers, medically assisted death also received support from the majority. However, at three-quarters, this support is not as strong as what is seen by the general public, nor is it as strong as other end of life careoptions, which received about the same levels of support, with around nine in ten showing support for enhancedhospice/palliative care, enhanced pain management and enhanced home care support.

• When asked to choose one priority for end-of-life care in Canada from a professional perspective, doctors emphasizedtraining and education for health care professionals around pain management the most, while for nurses, more trainingand research to use a harm reduction approach was ranked higher. Pharmacists and other providers ranked these twoaspects equally high.

• A plurality of health care providers also have some fear of reprisal, even if this service has been legalized by the federalgovernment. Moreover, this fear is felt somewhat stronger now than in 2016. Providers are also not all convinced that theappropriate system support is in place to facilitate medically assisted death.

eHealthAccess and Support

94

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48

QG2: As far as you know, do you have access to the following? – A) Your health record B) The information that you need that is important to manage your health Base: All (n=1500)

Access to Needed Health InformationPublic Perceptions

95

45%31%

15%

19%

24%

16%

18%24%

32%

9%11%

22%

8% 11% 15%

Electronic health record Paper health record Important informationto manage health

Always

Often

Sometimes

Rarely

Never

QG2. As far as you know, do you have access to the following? (n=1500)

Access to Needed Health InformationPublic Perceptions – By Region

96

Important information to manage health

Electronic health records8%

15%

6%

10%

9%

8%

9%

15%

9%

7%

12%

4%

9%

18%

21%

16%

20%

23%

11%

16%

19%

18%

24%

15%

16%

20%

20%

45%

31%

45%

49%

40%

61%

47%

TotalBCAB

PrairiesOntQue

Atlantic

Paper health records

Often Sometimes NeverAlways Rarely

11%

12%

9%

10%

11%

7%

17%

11%

15%

8%

9%

16%

5%

8%

24%

24%

23%

26%

26%

17%

27%

24%

26%

28%

19%

20%

30%

24%

31%

24%

32%

35%

28%

41%

23%

TotalBCAB

PrairiesOntQue

Atlantic

15%

22%

13%

17%

15%

6%

22%

22%

26%

25%

18%

26%

13%

21%

32%

29%

33%

35%

33%

32%

28%

16%

15%

16%

15%

14%

19%

16%

15%

7%

13%

15%

12%

30%

13%

TotalBCAB

PrairiesOntQue

Atlantic

18-08-22

49

QG3. To what extent do you support or oppose the use of an integrated eHealth system which allows your health records to be easily shared between your health care providers so you do not need to remember or continually repeat your medical history? (n=1500)

Support for eHealthPublic Perceptions

97

58%

33%

5%

1%

4%

Strongly support

Somewhat support

Somewhat oppose

Strongly oppose

Don't know

Support of the use of an integrated eHealth system which allows your health records to be easily shared between your health care providers so you do not

need to remember or continually repeat your medical history

QP3. To what extent do you support or oppose the use of an integrated eHealth system which allows patient health records to be easily shared across health care providers so patients do not need to remember or continually repeat their medical history.Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99) 98

Support For the use of Integrated eHealth System

64%

76%

82%

37%

75%

26%

20%

17%

56%

17%

4%

4%

7%

6%

4%Doctor

Nurse

Pharmacist

Administrator

Other Providers

Strongly support Somewhat support Somewhat oppose Strongly oppose Don't know 2018

90%

96%

99%

93%

92%

Total Support

Support for eHealthProfessional Perceptions

18-08-22

50

QG4. How concerned are you about the security of your information if it is shared online through the eHealth system? (n=1500)

Concern about eHealthPublic Perceptions

99

11%

28%

36%

23%

2%

Not concerned at all

Not very concerned

Somewhat concerned

Very concerned

Don't know

Concern about the Security of Information through Integrated eHealth System

QP4. How concerned are you about the security of your patients’ information if it is shared online through the eHealth system?Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99) 100

Concern about the Security of Information through Integrated eHealth System

11%

14%

15%

2%

14%

28%

22%

29%

7%

32%

28%

35%

30%

54%

37%

32%

26%

24%

35%

16%

Doctor

Nurse

Pharmacist

Administrator

Other Providers

Not concerned at all Not very concerned Somewhat concerned Very concerned Don't know 2018

60%

62%

55%

89%

54%

Total Concerned

Concern about eHealthProfessional Perceptions

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51

101

Both public and professionals support eHealth, yet are concerned

• While most Canadians support an integrated eHealth system, most are also concerned about security.

• Currently, access to EHRs is limited, with almost half saying they don’t have access to it. However, three in ten Canadiansalso say they don’t have access to their paper health record. EHR access is currently the highest is BC and by far lowest inQuebec; again, this trend is also seen with paper records.

• Health care professionals also express both support and concern, at about the same levels as the general population in fact.Administrators express the highest levels of concern.

Continuing Role –Caregivers

Challenges / Opportunities

102

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52

Actions Taken While Providing Care Health Care Professionals Worked With During Caregiving

QL5: Have you personally had to care for a family member or close friend with a serious health problem in the past 12 months? (n=1500)QL6: When caring for this person did you... (Provided care n=286)QL8: Did you work with a doctor or other health care professional(s) to help you manage the condition of the person under your care? (Provided care n=284)QL9: Do you receive the support that you need from health professionals to help you manage the condition of the person under your care? (Provided care n=284)QL10: Do you have access to the information you need to manage the condition of the person under your care? (Provided care n=284)

Care Burden of Family/FriendsPublic Realities

103

18%18%

Have cared for family/close friend in past 12 months

46%

29%

22%

17%

13%

12%

6%

5%

Used personal savings to manage

Cared for other family members at same time

Took one or more months off work

Accessed other benefits from employer

Quit work to care for this person

Took advantage of other government tax benefitsAccessed Federal Employment Insurance

Compassionate Care BenefitClaimed the Caregiver Tax Credit

20%

24%

30%

31%

30%

29%

12%

8%

8%

8%

Receive support from health professionals

Have access to information needed to manage condition


58%

22%

16%

15%

11%

8%

5%

22%

Doctor

HCP as a team

Registered nurse

Pharmacist

Other HCP

Nurse practitioner

Health navigator

None of the above

QL7. Why did you not take advantage of all the tax benefits that may have been available to you as a caregiver? (Base: Those who did not take advantage of tax credits n=282)

Tax Benefits – Reasons for not Taking AdvantagePublic Perceptions

104

41%

33%

13%

8%

5%

4%

21%

3%

Did not think I would qualify for them

Did not know about them

The application process was toodifficult/confusing

Knew about them, but just didn't accessthem

Applied, but did not qualify

Somebody else handles all my finances

Other reason(s)

Don't know

18-08-22

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QL5: Have you personally had to care for a family member or close friend with a serious health problem in the past 12 months? (n=1500)

Care Burden of Family/FriendsPublic Realities – By Region

105

BC21%

Alberta25% Prairies

15%

Ontario20%

Quebec12%

Atlantic15%

QL11: Do you have access to the treatments you need to manage the condition of the person under your care? (Provided care n=295)QL12: What are some of the reasons why you don’t always have access to the treatments you need to manage the condition of the person under your care? (Provided care and didn’t always have access to treatment n=209)Responses under 5% not shown.

Caregiver Obstacles: Knowledge / AccessPublic Perceptions

106

26%

30%

28%

8%

8%

Always

Often

Sometimes

Rarely

Never

37%

20%

17%

17%

14%

13%

12%

10%

6%

5%

Wait times were too long

Treatment was ineffective

Did not get referred to the treatment in time

Treatment was inadequate

Treatment not required

Treatment caused unbearable side effects

Can't afford the other forms of prescribed treatment

Can't afford the prescribed medication

The prescribed treatment was refused

Treatment is available in province, but it is too far or I am unable to access it

Reasons For Not AlwaysHaving Access to Treatments

Having Access to Treatments (Caregivers)

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107

Caregivers face challenges

• In the past year, 18% of people in Canada have been a caregiver to a family or friend with a serious health problem in thepast year (compared to 16% in 2016). This is still down from almost a quarter of respondents in 2007. These caregivers areoften juggling the care of multiple family members and they have to dip into savings to do so.

• Only small percentages of caregivers either accessed the EI Compassionate Care Benefit, claimed the Caregiver tax credit ortook advantage of other government tax benefits. Among those who did not take advantage of all three, the most commonreason for this was that they did not think they would qualify. Many also did not know about them.

• While they are most likely to rely on their ward’s doctor for care, they often also work with other health care providers.

• As was seen in 2016, only a quarter of caregivers say that access to treatment is always there, with wait times remaining themost common obstacle.

Opioid Crisis

108

18-08-22

55

QO1. How serious a problem would you say the opioid crisis is, in Canada? Would you say it is Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100) 109

Opioid Crisis Severity

5%

2%

2%

11%

5%

8%

5%

10%

37%

41%

42%

77%

38%

41%

51%

48%

16%

45%

6%

5%

Doctor

Nurse

Pharmacist

Administrator

Other Providers

Not at all serious Not very serious Neutral Serious Very serious Don't know 2018

78%

92%

90%

93%

83%

Total Serious

Opioid CrisisProfessional Perceptions

QO2. How important is each of the following option to addressing opioid issues in Canada?Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99) 110

Training and education for health care professionals around pain management (pharm

and non-pharm treatments)

Education of the general public of the dangers of opioid use and addiction

Training, education and resources for health care professionals around mental health and

addictions treatments.

More training and resources for health care professionals to use a harm reduction approach

in their facilities and practices.

Better integration of health and social services that improve treatment and patient outcomes.

The availability of safe injection sites for those who need them

Policy change such as decriminalization of personal use psychoactive substances.

58%

58%

54%

45%

43%

31%

19%

27%

21%

26%

35%

38%

33%

17%

85%

79%

80%

80%

81%

64%

36%


65%

61%

68%

58%

63%

46%

24%

22%

24%

25%

28%

29%

23%

24%

87%

85%

93%

86%

92%

70%

48%

63%

58%

55%

47%

58%

31%

18%

30%

32%

33%

37%

27%

30%

19%

93%

90%

88%

85%

85%

62%

37%

31%

34%

23%

34%

30%

27%

20%

40%

41%

49%

42%

45%

39%

44%

71%

75%

72%

76%

75%

66%

64%

Very ImportantSomewhat Important




67%

55%

70%

45%

65%

40%

21%

18%

20%

17%

26%

16%

21%

21%

85%

75%

87%

72%

81%

62%

42%

Other Providers Very ImportantSomewhat Important

Support for Addressing Opioid CrisisProfessional Perceptions

18-08-22

56

QO3. Which one option is MOST important to help with the opioid issues in Canada? Please select only one.Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99)

Top Priorities for Addressing Opioid CrisisProfessional Perceptions

111

Education of the general public of the dangers of opioiduse and addiction

Training, education and resources for health careprofessionals around mental health and addictions

treatments.

More training and resources for health care professionalsto use a harm reduction approach in their facilities and

practices.

Better integration of health and social services thatimprove treatment and patient outcomes.

Training and education for health care professionalsaround pain management (pharmacological and non-

pharmacological treatments).

Policy change such as decriminalization of personal usepsychoactive substances.

The availability of safe injection sites for those who needthem


25%

18%

16%

15%

14%

8%

4%

20%

20%

15%

25%

10%

3%

6%

20%

9%

11%

22%

30%

4%

3%

12%

18%

14%

27%

9%

10%

10%

11%

20%

14%

29%

22%

2%

1%

112

The Opioid Crisis is Real

• Health care providers agree that the opioid crisis in Canada is serious, with many saying it is very serious.

• Virtually all options to address the crisis tested are seen as important pieces to solve the puzzle, with the exception ofpolicy changes such as decriminalization of the use of opioids.

• While a majority believes safe injection sites are important, support for this is lower than for other options such astraining and education for health care professionals on pain management, harm reduction, mental health and addictiontreatments, and for public education.

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Looking ForwardInnovative Options /

Responsibilities

113

QB4. Which one of the following best describes what is needed to improve Canada’s health care system? (n=1500)

Approach Required to Improve Care Public Perceptions

114

16%

17%

17%

17%

14%

17%

13%

10%

21%

13%

12%

13%

12%

55%

55%

51%

41%

41%

54%

51%

51%

46%

50%

49%

42%

45%

23%

21%

25%

34%

38%

23%

30%

35%

29%

32%

34%

40%

37%

5%

4%

3%

4%

4%

2%

4%

3%

3%

4%

2018

2016

2013

2007

2006

Fall 2004

Spring 2004

2003

2002

2001

2000

1999

1998

Complete rebuild from ground up Some fairly major repairs Some minor tuning up Everything fine the way it is

18-08-22

58

QB4: Which one of the following best describes what is needed to improve Canada’s health care system? (n=1500)

Approach Required to Improve CarePublic Perceptions – By Region

115

12%

13%

16%

12%

32%

11%

49%

50%

55%

57%

58%

61%

33%

29%

23%

25%

8%

24%

BC

Alberta

Prairies

Ontario

Quebec

Atlantic

Complete rebuild from ground up Some fairly major repairs Some minor tuning up Everything fine the way it is

QB4: Which one of the following best describes what is needed to improve Canada’s health care system? Doctor (n=100), Nurse (n=100), Pharmacist (n=100), Admin (n=100), Other Providers (n=100)

Approach Required to Improve CareProfessional Perceptions

116

13%

18%

8%

40%

15%

59%

64%

70%

48%

70%

26%

16%

20%

10%

15%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

Complete rebuild from ground up Some fairly major repairsSome minor tuning up Everything fine the way it is 2018 2016 2013 2007 2006 2003

72% 79% 75% 62% 68% 69%

82% 84% 91% 69% 66% 72%

78% 73% 73% 52% 54% 56%

88% 78% 70% 66% 63% 72%

85% 74% n/a n/a n/a n/a

TotalComplete Rebuild/Major Repairs

18-08-22

59

QK3. Innovations in health care can include new treatments, use of best practices in providing care, approaches to the management and administration of the health care system and use of new technologies and medicines. To what extent do you agree or disagree with each of the following statements? (n=1500)

Support for InnovationPublic Perceptions

117

51%

48%

49%

42%

44%

39%

42%

33%

38%

40%

37%

44%

41%

44%

39%

46%

5%

4%

5%

5%

7%

8%

10%

10%

5%

7%

8%

9%

6%

8%

6%

9%

More disease prevention education and support

Increase access to home and community care services to help me stay independent

Accelerate shared leadership, that is, governments, health industry, universities, research hospitals and health authorities working more

closely together to address challenges in health care

An increased responsiveness of the health care system to the patient’s and family experience

More wellness promotion

Accelerate the use of personal electronic health records that patients can access

Increase the use of non-physician health care providers, meaning patients could see a nurse practitioner, pharmacist or other qualified

practitioner instead of a physician

Increase patient involvement in decision making about the health care system

Strongly support Somewhat support Somewhat oppose Strongly oppose Not sure2018 2016 2013 2007 2006 2005

89% 85% 83% 72% * *

88% 85% 85% 78% 80% 81%

86% NA NA NA NA NA

86% NA NA NA NA NA

85% 82% NA NA * *

83% NA NA NA NA NA

81% 82% 79% 58% 59% 55%

78% 79% 81% 72% NA NA

Total Support

*Before 2016: Combined as More Wellness promotion and Disease PreventionNA: Not asked in this year

QK4. Which three initiatives do you think are most important to lead to a better health care system? Please select up to three. (n=1500)

Top Supported Initiatives for InnovationPublic Perceptions

118

1st

Increase the use of non-physician health care providers, meaning patients could see a nurse practitioner, pharmacist or other

qualified practitioner instead of a physician

51%

2nd

Accelerate shared leadership, that is, governments, health industry, universities,

research hospitals and health authorities working more closely together to address

challenges in health care

44%

3rd

More disease prevention education and support (e.g., screening and early detection,

tele-health for patient coaching, etc.).

42%Increase access to home and community care services to help me stay independent 35%More wellness promotion 33%An increased responsiveness of the health care system to the patient’s and family experience 31%Accelerate the use of personal electronic health records that patients can access 25%Increase patient involvement in decision making about the health care system 19%No other initiatives are important to me 4%

18-08-22

60

QK3. Below is a list of initiatives that may lead to a better health care system. Thinking of how effective these might be, indicate the degree to which you support or oppose the implementation of these initiatives. Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)

Support for InnovationProfessional Perceptions

119

Strongly support Somewhat support Somewhat oppose Strongly oppose Not sure

14%

66%

73%

43%

57%

41%

60%

63%

34%

64%

30%

51%

57%

37%

49%

37%

26%

20%

34%

34%

48%

31%

34%

42%

32%

38%

36%

25%

45%

35%

28%

5%

4%

19%

6%

6%

7%

2%

21%

3%

15%

11%

11%

17%

9%

18%

3%

3%

2%

12%

4%

3%

5%

2%

4%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

Doctors

Nurses

Pharmacists

Administrators

Other Providers

Doctors

Nurses

Pharmacists

Administrators

Other Providers

2018 2016 2013 2007

51% 55% 62% 55%

92% 96% 94% 87%

93% 91% 95% 79%

77% 82% 83% 92%

91% 87% n/a n/a

89% n/a n/a n/a

91% n/a n/a n/a

97% n/a n/a n/a

76% n/a n/a n/a

96% n/a n/a n/a

68% 73% 77% 57%

87% 90% 83% 63%

82% 88% 83% 79%

82% 91% 85% 88%

85% 94% n/a n/a

Total SupportIncrease the use of non-physician health care providers, meaning patients could

see a nurse practitioner or other qualified individual instead of a physician

Accelerate shared leadership, health authorities working more closely together to address challenges in health care.*

* Indicates a new category in 2018

Accelerate the use of personal electronic health records that patients can access



120

58%

74%

65%

33%

78%

20%

56%

29%

43%

45%

35%

48%

49%

28%

60%

35%

18%

34%

33%

21%

46%

40%

57%

38%

44%

42%

46%

38%

45%

35%

6%

6%

32%

20%

4%

10%

15%

8%

14%

3%

11%

23%

11%

5%

3%

3%

3%

4%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

Doctors

Nurses

Pharmacists

Administrators

Other Providers

Doctors

Nurses

Pharmacists

Administrators

Other Providers

2018 2016 2013 2007

93% 94% 96% 81%

92% 99% 99% 91%

99% 96% 95% 87%

66% 95% 100% 93%

99% 99% n/a n/a

66% 73% 80% 63%

96% 96% 93% 85%

86% 92% 85% 72%

81% 85% 89% 81%

90% 93% n/a n/a

77% 81% n/a n/a

95% 97% n/a n/a

87% 89% n/a n/a

73% 93% n/a n/a

95% 94% n/a n/a

Total SupportIncrease access to home and community care

services to help me stay independent

Increase patient involvement in decision making about the health care system

An increased responsiveness of the health care system to the patient's and family experience


18-08-22

61



121

60%

63%

56%

43%

73%

60%

69%

65%

43%

67%

28%

32%

36%

34%

20%

31%

24%

30%

37%

26%

9%

4%

7%

18%

5%

7%

5%

3%

18%

3%

5%

4%

Doctors

Nurses

Pharmacists

Administrators

Other Providers

Doctors

Nurses

Pharmacists

Administrators

Other Providers

2018 2016 2013 2007

88% 92% n/a n/a

95% 96% n/a n/a

92% 97% n/a n/a

77% 96% n/a n/a

93% 95% n/a n/a

91% 89% n/a n/a

93% 98% n/a n/a

95% 97% n/a n/a

80% 96% n/a n/a

93% 97% n/a n/a

Total SupportMore wellness promotion

(e.g., nutrition counseling, exercise and healthy living education, etc.)

More disease prevention education and support (e.g., screening and early detection, tele-health for patient coaching, etc.)


QK4. Which three initiatives do you think are most important to lead to a better health care system? Please select up to three. Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)

Top Supported Initiatives for InnovationProfessional Perceptions

122

More disease prevention

Increase access to home and community care services to help me stay independent

More wellness promotion

Accelerate shared leadership, health authorities workingmore closely together to address challenges in health

care.*Increase patient involvement in decision making about

the health care system

Increase the use of non-physician health care providers,meaning patients could see a nurse practitioner or other

qualified individual instead of a physician

Accelerate the use of personal electronic health recordsthat patients can access

Increase patient involvement in decision making aboutthe health care system.

No other initiatives are important to me

55%

53%

53%

38%

21%

19%

18%

18%

4%


53%

39%

40%

42%

16%

57%

19%

24%

0%

47%

39%

40%

45%

14%

65%

26%

15%

0%

37%

32%

32%

41%

31%

39%

38%

35%

0%

Three Most Important Initiatives

44%

53%

48%

41%

24%

44%

21%

17%

0%

1

2

3

1

1

11

2

2

22

3

3

33

3

18-08-22

62

QK1: Which one health care stakeholder do you think is currently most responsible for introducing new innovation into the health care system in Canada? (n=1500)

Current Responsibility to Drive Innovation?Public Perceptions

123

22%

15%

13%

7%

7%

4%

3%

2%

1%

24%

Federal and provincial governments/funding agencies

Research hospitals

The pharmaceutical / biotech industry

Regional health authorities

Individual researchers, clinicians and health practitioners

Universities and colleges

Private corporations outside the pharmaceutical / biotech industry (e.g., Amazon, Google)

The general public

Foundations and not-for-profit organizations

Don't know

2016 2013/14

15% 21%

20% 18%

15% 14%

3% NA

10% 9%

7% 7%

NA NA

4% 4%

3% 3%

24% 23%

QK1: Which one health care stakeholder do you think is currently most responsible for introducing new innovation into the health care system in Canada?QK2. And which one health care stakeholder do you think should be most responsible for leading the implementation of diagnostic and treatment innovations into the health care system in Canada?(n=1500)

Who Is and Should Be Responsible to Drive Innovations?Public Perceptions

124

22%

15%

13%

7%

7%

4%

3%

2%

1%

24%

27%

18%

3%

10%

10%

5%

2%

3%

3%

19%


Research hospitals






The general public


Don't know

Currently responsible

Should be responsible

18-08-22

63

QK1. Which one health care stakeholder do you think is currently most responsible for leading the implementation of diagnostic and treatment innovations into the health care system in Canada?Doctor (n=100), Nurse (n=99), Pharmacist (n=99), Admin (n=100), Other Providers (n=99)

Who is Most Responsible to Drive Innovations?Professional Perceptions

125



Research hospitals




The general public



Don't know

25%

18%

14%

14%

12%

8%

1%

1%

0%

6%

12%

30%

11%

9%

16%

4%

1%

2%

11%

18%

26%

15%

10%

21%

2%

2%

1%

5%

14%

26%

10%

9%

15%

4%

1%

3%

12%

6%

19%

22%

14%

10%

9%

5%

4%

1%

11%


QK2. And which one health care stakeholder do you think should be most responsible for leading the implementation of diagnostic and treatment innovations into the health care system in Canada?Doctor (n=100), Nurse (n=99), Pharmacist (n=100), Admin (n=100), Other Providers (n=99)

Who SHOULD Be Most Responsible to Drive Innovations?Professional Perceptions

126



Research hospitals




The general public



Other

Don't know

27%

24%

16%

12%

9%

1%

1%

0%

0%

2%

8%

20%

21%

16%

12%

4%

9%

5%

1%

2%

2%

7%

19%

32%

22%

12%

4%

3%

1%

1%

1%

5%

6%

25%

12%

11%

7%

10%

5%

13%

8%

1%

2%


22%

24%

21%

12%

5%

3%

3%

1%

1%

5%

18-08-22

64

127

Most Canadians feel the current health care system is salvageable, however, in need of repair

• Canadians and providers agree that the health care system in Canada needs either a complete overhaul, some major work, or at least a tune-up. This sentiment is similar to that seen two years ago among the general population, with some minor fluctuationsamong health care providers.

• Quebecers in particular believe the system needs a serious re-do.

• As a possible improvement to the health care system, Canadians as well as health care providers strongly support all initiativestested. The top two, receiving the most support, are more disease prevention education and support, as well as increased access to home and community-based care services.

• When Canadians are asked to choose which initiatives are most important for a better system, the top three is made up of: increasing of the uses of non-physician health care providers; accelerating shared leadership of governments, health industry, research institutions and health authorities; and more disease prevention education and support (e.g., screening and early detection, tele-health for patient coaching, etc.).

• While more disease prevention is in the top three initiatives to help the health care system among doctors, nurses, pharmacists and other providers, this is less important to administrators. This group places the most value on accelerated shared leadership.Increased use of non-physician health care providers ranks in the top three for all providers except doctors, who place a higheremphasis on more wellness promotion and increased community and home care supports.

• There is some sense among providers that innovation is not always driven by the correct players: while they feel that pharmaceutical companies and governments currently are the most responsible, they feel that researchers and research hospitals should have a bigger role.

Help us help you!

128

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If you plan to use any HCIC results in any manner, please tell us so we can better understand what you/your organization find most interesting/useful by completing the Data Use Form found here:https://www.mcgill.ca/hcic-sssc/hcic-surveys/2018

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