the average age was 63

The proportion of patients who died and who did not have C. difficile was 5.8 per cent compared with 22 .1 per cent of the patients who had C. difficile.

They concluded the impact of hospital-acquired C. diff infections on length of stay is less than previous estimates but "remains large."

In a journal commentary accompanying the study, Dr. David Enoch, Peterborough and Stamford Hospitals, United Kingdom and Dr. Sani Aliyu of the U.K.'s Health Protection Agency stressed that prevention and strict control measures such as prudent prescribing of antibiotics, correct hand hygiene and use of personal protective equipment by hospital staff are important for controlling the spread of the disease.

doctors are reportedly earning 25 per cent more under capitation than they were under fee-for-service

total annual funding to family physicians went up by 32 per cent between 2006-07 and 2009-10

The path out of a $16-billion deficit, more or less endorsed by all three provincial parties in the recent election, revolves largely around flattening health spending increases

allow people to buy health insurance from a choice of up to 180 private insurers

Though there is a shortage of empirical evidence in any of the countries on what works, evidence suggests that such a system encourages patients and doctors to better manage their health, curbing the likelihood people will end up in an emergency ward or pricey acute-care hospital bed, the report said.

In addition to founding a cancer centre in the Bahamas in which he is still involved, Porter (a radiation oncologist by profession) had been appointed to at least three corporate boards.

On Nov. 10, Porter resigned as chairman of Canada’s Security and Intelligence Review Committee – the country’s spy watchdog – after The National Post reported that he wired $200,000 last year to a Montreal-based international arms dealer for an infrastructure deal in his native Sierra Leone that ultimately fell through.

Similarly, a robust systematic review of studies comparing health outcomes in Canada and the U.S. noted that while the Canadian model “has many well-publicized limitations. . . Canada’s single-payer system, which relies on not-for-profit delivery, achieves health outcomes that are at least equal to those in the United States at two-thirds the cost.”

Science-ish can only vouch for the best-available evidence on quality of care and cost. It suggests not-for-profit settings win.

health care isn’t like any other market

People who already have dementia or are particularly frail are at higher risk of acquiring the condition.

Once in hospital, delirium can be caused by a combination of numerous factors, including surgery, infection, isolation, dehydration, poor nutrition and medications such as painkillers, sedatives and sleeping pills.

The primary symptoms are shifting attention, poor orientation, incoherence and poor cognition. Most patients who acquire it must subsequently spend extended periods of time in expensive acute care settings. Some who suffer from the condition experience hallucinations and become aggressive and belligerent. Others, however, become sleepy and lethargic, their silence making the delirium more difficult to detect.

Treating delirium involves providing good basic care, such as ensuring patients are getting enough fluids and nutrients. It also includes reorienting them to their surroundings. Family members should ensure elderly patients have their hearing aids, dentures, glasses or whatever else they need to engage their senses. Other things that can help include daily exercise, removing medications if possible and surrounding patients with familiar objects.

It also leads to complications, such as pneumonia or blood clots

Alagiakrishnan is the lead author of a study that concluded health care professionals are not doing enough to identify the predisposing and precipitating factors that lead to delirium, a sentiment echoed by many in the field of geriatric medicine (Can Fam Physician 2009;55:e41-6). The study assessed 132 patients ages 65 and older who were admitted to medical teaching units at the University of Alberta Hospital over a seven-month period and found that 20 of those patients, or 15.2%, developed hospital-acquired delirium.

In Vancouver, British Columbia and Edmonton, Alberta, for example, hospitals have created “acute care for the elderly” units based on a model of elderly care which features multidisciplinary teams of specialists; elderly-friendly surroundings, including comfortable chairs and furnishings such as clocks with large faces and numbers; and policies designed to promote independence and cognitive stimulation, such as requirements that patients use bathrooms rather than bedpans and that they have their meals at central locations rather than in bed. In an effort to be elderly-friendly, other hospitals have introduced such measures as emergency room teams dedicated to detecting delirium or hired staff such as geriatric emergency nurses.

“In pockets, this is happening, but we need a more concerted movement,” says Wong.

delirium can cause permanent damage to cognitive ability and is associated with an increase in long-term care admissions

“We need to change how we are caring for patients in hospitals and get back to focusing on basic health care needs,” says Dr. Jayna Holroyd-Leduc, an associate professor of geriatrics at the University of Calgary in Alberta.

In a recent paper, Holroyd-Leduc and colleagues found that most interventions for hospital-induced delirium involve strategies to optimize sensory input, improve orientation, provide familiar objects and encourage family visits (www.cmaj.ca/lookup/doi/10.1503/cmaj.080519).

Almost anyone can find a way to die in peace at home, and pain can be managed better than ever.

a life of quality, not just quantity

the OFT said it found three key issues that needed further investigation: There is a lack of easily comparable information available to patients, GPs or health insurance providers on the quality and costs of private healthcare services; There are only a limited number of significant private healthcare providers and of larger health insurance providers at a national level; A number of features of the private healthcare market combine to create significant barriers to new competitors entering and being able to offer private patients greater choice.

Suppliers have broadly welcomed the review.

The initial evaluation is done by one of three “non-physician experts,” which is the clinic’s name for the trained, certified athletic therapists

The 208 patients who required an orthopedic surgeon were operated on within four months of diagnosis, five months earlier than patients outside of the clinic

reduction in the need for MRIs since the program began to 7.5 per cent from 30 per cent

the Bone and Joint Clinical Network, which is overseeing the project on behalf of AHS

This clinic has the ability to provide timely diagnosis and treatment for up to 200 patients a month

it’s only being used by an average of 95 patients a month

sees it being applied effectively to other types of musculoskeletal injuries

However, care must be taken to prevent the for-profit clinics from using their access to patients in the public system as an opportunity to recruit for other services

There must also be regulations in place to ensure that initial commitments do not erode over time to allow for the queue-jumping, creamskimming (only treating the healthiest patients), extra billing and worse clinical outcomes that have characterized for-profit facilities in other provinces.

The last criteria, planning and integration, will be the most challenging to attain.

The government insists that using private clinics is a temporary measure to address current waiting lists. Our group is concerned that this action will lead to a long-term strategy of using private delivery.

The better solution would be to investigate means of strengthening the long-term capacity of the public system, both in and out of hospitals.

the ministry could not provide the auditor with a cost-benefit analysis or a description of the criteria used in the selection

we did not see any evidence why (the ministry) did not follow its normal process for entering into an agreement with a health care provider or seek broader consultation on partnering with other organizations

The ministry also directed SHR to begin paying Amicus the rate of $185 per bed daily for 100 beds from the day that the facility opens - which is expected to be next month - notwithstanding how many are occupied, the report says, calling that a "significant departure" from the norm.

the capital portion of the daily rate - which is almost $48 of the $185

neither (the ministry) nor (SHR) could provide us any written analysis to support that funding longterm beds in this new way is cost-effective for the province

the proponent approached the government with the idea for the "pilot project"

McMorris pointed to a "huge need" for long-term care beds in the Saskatoon Health Region