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HSM330 nov 29 lecture

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Health Services Management
HSM 330
Daolun Chen

November 29, 2010 HumanHealthandAgingLecture#10 • its not enough to offer surgery and medication to older people, you must also look at their environment and the modifications of one’s immediate environment that can be made to make them more self sufficient • government wants “aging in place” which means people age at home • social support is important to provide people over the age of 65 and is linked to healthy aging • in canada, many immigrants are part of the older age 65+ group • when assessing these people, english may not be the first language • aside from language barriers, there are also cultural barriers where traditions and beliefs of other people are not factored in biomedical model in use today in canada • biomedical model has one approach and rarely looks at who the person is, where they’re from and what their traditions and beliefs are • doctors should include family in any decision they make • as we age, we lose functional ability and dignity if agist views persist • first physician assistants are graduating in ontario • new program “physician assistance” two year program offered at McMaster university • 21 physician assistants have graduated; 60 are currently enrolled in two university programs • two universities offer: McMaster and U of T • 80 physician assistants employed in ontario • etobicoke general hospital had bed bugs problem • 1950-1990 there were no reports of bed bugs in canada • between 1990-2000, a few reports but nothing to worry about as of yet • in last decade, we’ve had a problem that has approached infestation proportions and we know that land lords are facing a big challenge because tenants are complaining • some people think bed bugs happen because people are poor..this is a misconception • poverty strucken people do not have a higher risk • only an issue with poverty if they can’t hire exterminators • people think you are prone to bed bugs if house is dirty: this is also a misconception • bed bugs feed on human blood; doesn’t matter if house is clean or dirty • bed bugs have been found in most clean hospitals and most luxurious hotels • bed bugs donotjump from one person to another; if it happens it is rare • bed bugs hide in cracks and crevices and at night when its dark, they feed on their host then go back to hiding • not known to carry disease, no ability to fly or jump, small creatures about size of apple seed • they begin life as an egg and go through 5 nymph stages before becoming an adult bed bug; 4-6 weeks from baby bed bug to adult bed bug • bed bug females can lay 500-600 eggs; can have massive infestation within a couple of months November 29, 2010 • bed bugs spread because problem goes undetected and main thing that people can do is treat problem and seek help when they see bed bugs; problem is stigma associated with bed bugs • people are embarrassed or people will think they don’t live in a clean place • toronto has become epi-centre of bed bug war in • first 9 months of 2010, toronto public health responded to 1500 requests to help them deal with bed bug cases • toronto public health inspected 3500 apartments • in order to direct funding to help rid the province of ontario, there must be a health reason • since bed bugs do not carry disease, it is not a priority to get rid of them • paula fletcher is pushing for 3 million dollars from city of toronto because she thinks it should be a priority • they use heat and seal the cracks and crevices where they hide to combat the problem • they also need money to solve the problem • after age of 50, government is initiating screening processes for preventative care for colorectal cancer • screening is cost effective program and we learned that having colorectal screening has reduced mortality rates by 55-83% • doctors in rural areas in ontario are open to accepting new patients • more than 35% of rural based physicians reported they were accepting new patients • compared to 18% in urban areas in main city areas • published in report in summer called “what do we know about family physicians who accept new patients” • person in canada suffered from lip necrosis (tissue has died, gangreen sets in and tissue dies) • person suffered from lip necrosis after having a dermal filler injected in her lips • health canada has learned about 32 adverse reactions to dermal fillers • people can injectables to fill in wrinkle lines to • over 30 products have been licensed in canada for dermatologists and cosmeticians to use • people needed surgery, anti-histamines or corticosteroids to help • people suffering were people of ages 30-75 with median age of 50 • federal government has been under pressure to reform health insurance • criticism of canada health act which has barred private care • they hope that federal government will alter administration of health act in order to allow for more private care November 29, 2010 • bribes have been happening in places like quebec (montreal) which likely means it is happening in other places --> people are giving money to surgeons and specialists to get them higher up in line for any procedure • obstitricians have been known to accept bribes of 2000-10 000 dollars • issue relates to moral dilemma and becomes unfair for people without money • when it
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