Following the February 2003 First Ministers Health Accord, the Canadian Government created a five-year $16 billion Health Reform Fund targeted to primary health care, home care and catastrophic drug coverage. The drug coverage is intended to ensure that Canadians with serious health conditions have reasonable access to necessary drug therapy. Standards for catastrophic coverage will be determined in the coming years, yet there is little evidence to guide the choice of standards. Dr. Steven Morgan is evaluating two possible options for basing standards: mixed pharmacare and income-based pharmacare. Dr. Morgan is studying the change in BC from a mixed program, which covered drug costs for low income seniors and social assistance recipients and charged a $1,000 deductible to all other residents, to an income-based system that enables people to pay a sliding scale based on income levels. Dr. Morgan is comparing data from both systems to results in Manitoba, which also has an income-based program. He is assessing the impact of both systems on cost, access and equity for people across the spectrum of socio-economic status, age and health status. The results could help guide the development of provincial and national policies for drug coverage programs.
Year: 2004
Community, culture and health
Dr. Cindy Patton has conducted a series of studies on knowledge transfer from medical experts to clinicians, media, policymakers and the public. In dramatic and exceptional cases, this exchange happens almost directly. The media’s extensive reporting on health emergencies involving SARS (Severe Acute Respiratory Syndrome) and BSE (Bovine Spongiform Encephalopathy or Mad Cow Disease) created demand from health consumers for more medical research, changes in public health policy, and reassurance about their risk for these conditions. But more often medical research filters down through clinicians and advocacy groups, who translate complex information for consumers and advocate for their medical needs. In addition, government policy makers must sort through information from researchers and citizens to adapt health policies and resources to changing medical needs. Dr. Patton is examining existing methods and systems for exchanging information in various settings—clinics, research centres and global information networks. The research could be used to create better channels for transferring specialized medical information. Dr. Patton is also developing training programs for researchers and the public to help improve their understanding of how to efficiently transfer knowledge from medical experts to people affected by health issues.
Behaviour of the newborn infant in response to pain, distress and caregiving influences
Recent evidence suggests newborn infants are more sensitive to pain and stress than older children and adults. The level of sensitivity may be especially acute for newborns who are at-risk for developmental problems due to prenatal exposure to pain, antidepressants or illicit drugs. Studies suggest that early exposure to pain and stress leads to changes in the newborn’s brain circuitry, and may increase vulnerability to abnormal behaviour and development. This has led to a search for better ways to understand and recognize infant pain and measure the effects of pain treatment. Dr. Fay Warnock is investigating the actions and interactions of healthy and at-risk infants. The research involves confirming a comprehensive list of behaviour associated with newborn distress, and comparing the actions of healthy and at-risk newborns during and after routine diaper change and heel lancing, a common procedure for obtaining a blood sample to screen infants for metabolic errors. She is also linking newborn behaviour with changes in facial action and heart rate. The research will further develop measures of newborn pain, improve understanding of how caregivers can help alleviate pain, and lead to protocols for preventing, assessing and treating newborn pain.