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Biomedical subjects

S E Shortt

Publications and source records attributed to S E Shortt.

At least 19 recordsLinked to original sources
PubMed2000

Dying in Canada: is it an institutionalized, technologically supported experience?

Although preliminary evidence shows that people generally prefer to die at home, very little is known about where Canadians die. Understanding the epidemiology of dying in Canada may illuminate opportunities to improve quality of end-of-life care and related health policy. We conducted a cross-sectional analysis of death records in Canada to determine the proportions of deaths occurring in hospitals and special care units. Our analysis found that deaths in Canada occur in hospitals with provincial and territorial proportions ranging from 87% in Quebec to 52% in the Northwest Territories. In hospitals recording deaths in special care units, 18.64% of all deaths occurred in special care units. The proportion of deaths in special care units ranged from 25% in Manitoba to 7% in the Northwest Territories. The proportion of deaths in special care units varied by size and nature (teaching vs. non-teaching) of hospitals. It increased with the size of the hospital from 8% in hospitals with 1-49 beds, to 23% for hospitals with 400 or more beds. In teaching hospitals, 27% of deaths occurred in special care units, and in non-teaching hospitals the proportion was 15%. In conclusion, the majority of deaths in Canada occur in hospitals and a substantial proportion occur in special care units, raising questions about the appropriateness and quality of current end-of-life care practices in Canada.

Canada↗
PubMed1997

A curriculum for the times: an experiment in teaching health policy to residents in family medicine.

The Department of Family Medicine at Queen's University in Kingston, Ont., recently undertook a pilot project to familiarize residents in family medicine with physician-related health policy issues. The objective of the project was to ease the residents' transition into practice and to equip them to participate effectively in future policy debates. All first-year residents assigned to a 4-month clinical rotation in the Department of Family Medicine took part in the program, which consisted of 5 weekly 1-hour lecture and discussion sessions. The program was offered as one component of the 130-hour core curriculum for first-year residents. Participants evaluated the program as highly informative and extremely relevant to their career plans. The authors conclude that health policy is a subject that can be incorporated into the core curriculum of residency training programs.

Curriculum↗
PubMed1996

Is unemployment pathogenic? A review of current concepts with lessons for policy planners.

This review of current literature on the relationship between unemployment and health covers time-series studies and critiques of this approach; micro-level studies of plant closures, which have yet to provide convincing data; and various studies dealing with mortality rates, physical health, mental health, women, children and families, and youth. At particular risk are youth, the economically marginal, and middle-age men. The most common disorders documented are emotional and cardiopulmonary disease. The key to the relationship between ill-health and unemployment may lie in the emerging epidemiological literature relating health status to social hierarchy. The article concludes with suggestions as to how current knowledge on the pathogenicity of unemployment may be of use to health policy planners on issues such as guaranteed annual incomes.

Female↗
PubMed1994

Reconciling two solitudes: the example of physicians and managers in Ontario's hospitals.

This paper describes five aspects of the traditional relationship of physicians to hospitals and their administrators which fail to facilitate cost control or quality assurance. Several significant obstacles to changing this relationship are described, including the inertia of tradition, the fallacy of costless care and the chasm between medical and management cultures. It argues that to achieve care which is both cost-efficient and of high quality, physicians and hospital managers must unite to pursue common goals in a well-integrated management structure. Five suggestions for developing an effective new relationship are made, including the adoption of a "social contract" for all hospitals, the integration of physicians into hospital management and quality assurance programs, improved patient-level data collection and obligatory cost-awareness programs for hospital physicians.

Cost Control↗