Skip to main content

Chronically sick to chronically well: a realistic and concrete way to do things differently with evidence in the canadian system!

Date and Location




Monday 23 September 2013 - 10:30 - 12:00


Presenting author and contact person

Presenting author

france laframboise

Contact person

france laframboise
Jean Mireault
Abstract text
TITLE: Chronically sick to chronically well: a realistic and concrete way to do things differently in the canadian system! CONTEXT: With only 5% of the population consuming 80% of the canadian health care, who are those persons at risk in the community & what are the evidence and effective actions to create a «chronically well» population? An international comparative study has looked at the Canadian health care system with 7 countries. It shows a strong and frequent emergency use amongst the population, especially in Québec and Ontario. These difficulties reflect a weak primary care organization in the community. OBJECTIVE: two regional Québec initiatives will be presented to demonstrate how to renew community care with a chronically sick population and high consumers of care while reducing preventable emergency visits and hospitalisations. METHOD: Simple actions working with the 5% of the population who’s consuming 80% of the care will be discussed and revisited : • Organisational portrait and origine of the greatest consumptions of care in the system know the difference between system induced consumptions and complex case management in the community • Significant evidence for an integrated and proactive approach with the «chronically sick» • Simple actions with great impact (ex : computarized nominative stratification, NHS complex case management, empowerment of families/patients,...) • Caracteristics of the «chronically sick » and the myths surrounding them • Relevent Performance indicators and documentiation on Return on investments RESULTS: Results indicate very significant decrease in preventable ER visits and hospitalisations, an increase in timely and quality community follow ups. With the SF- 12, an increased well-being was observed amongst the most vulnerable. CONCLUSION: Simple & high impact systemic multi-level strategies for creating a chronically well population exist. Let's share learned lessons to build a stronger primary care system for all PS either french or english.Thanks.