Research Themes and Lead Organizations

Primary Research Themes Lead
Health Human Resources CHSRF
Financing and Public Expectations CIHR-IHSPR
Governance and Accountability CPRN
Driving and Managing System Change  
Improving Quality CIHR-IHSPR
Healthcare Evaluation and Technology Assessment CCOHTA
Public Advice Seeking in the Era of E-Health  
Improved Access for Marginalized Groups CIHR-IHSPR

Secondary Research Themes Lead
Primary Healthcare CHSRF
Globalization CPHI (CIHI)
Regionalization  
Population Health *
Continuum of Care and Delivery Models CHSRF
Performance Indicators, Benchmarks and Outcomes CIHI
Evolving Role of Informal and Voluntary Care CIHR-IHSPR

* This theme is now being undertaken by another group of partners to which CIHR-IPPH and CPHI (CIHI) belong.

Introduction

Following the identification of 15 themes emerging from the Listening for Direction: A national consultation on health services and policy issues, each partner organization has begun the process of incorporating the guidance provided by the report into their planning processes and determining how it may guide their future activities.

In addition, the partners have made progress in identifying potential partnerships and collaborations arising from the consultation. While this is a long-term process, it is clear there are opportunities for the organizations to work together to ensure that the needs of users throughout the health system are best met.

Significantly, the partners involved in the commissioning and performance of research have reached agreement regarding which agencies will take the lead on 10 of the 15 research themes. Further discussions and planning will occur in the coming months, regarding the research themes where no lead agency has yet been identified.

The remainder of this document identifies the progress to date in identifying research themes and lead agencies. It should be noted that the linkage of an agency with a research theme does not mean the theme is the exclusive responsibility of the agency identified. Rather, it means that the organization has determined it has a special interest or ability in that theme, and this is supported by the partnership.

Primary Themes

Health Human Resources

The Canadian Health Services Research Foundation (CHSRF) has been identified as the lead agency on this research theme. The Foundation sees this theme as being THE major priority area for decision makers of the health system. The Foundation is making a long-term commitment to fund research projects and programs in this theme through its Open Grants Competition. Also, because health human resources issues are such a pressing priority, some elements of this theme may also be addressed through the Foundation's Commissioned Research Program, by commissioning policy synthesis and specific research projects.

In addition, the Canadian Institute for Health Information (CIHI) has a program and a number of projects in support of this research theme.

Financing and Public Expectations

The Canadian Institutes of Health Research (CIHR), through the Institute of Health Services and Policy Research (IHSPR) has identified this as a major research theme. IHSPR will devote immediate attention to this theme in its Request for Applications (RFA) process this year. IHSPR will focus on research projects which address such issues as:

  • What are the implications for overall costs, distribution of costs (including indirect and voluntary), access, equity, quality and patient outcomes of different mixes of public and private financing for rapidly expanding sectors such as pharmaceuticals and long-term care (including home care) where financing is currently mixed?
  • How are public attitudes, expectations and values shaped and influenced? What are the (relative) roles of media, public, professional groups, culture and research evidence?

In recognition of the importance of this theme, CHSRF will be complementing the institute's commitment to this area through its own support of a program of research focusing on one aspect of the theme - defining the overall basket of publicly funded health care services.

Governance and Accountability

At this time, no organization has been identified as the lead on this research theme.

Driving and Managing System Change

At this time, no organization has been identified as the lead on this research theme.

Improving Quality

IHSPR is taking the lead on this research theme. With CIHI, a Request for Applications entitled "Improving the Quality of Health Care in Canadian Hospitals: A Research Study" has been released (application deadline: August 10, 2001). In addition, CIHI is currently leading a major project to develop and implement systems for monitoring and reporting on the quality of the health care system, particularly on preventable adverse effects of care.

Healthcare Evaluation and Technology Assessment

The Canadian Coordinating Office for Health Technology Assessment (CCOHTA) has been identified as the lead organization on this major theme. This is in keeping with CCOHTA's mandate, approved by the Conference of Deputy Ministers at the end of 1999. Within that five-year mandate CCOHTA carries out health technology assessments, coordinates health technology assessment (HTA) priorities across jurisdictions, fosters and undertakes collaborative assessment activities and functions as a clearinghouse for technology assessment results, while increasing health care system stakeholder awareness of HTA findings.

Technology assessment has a major role to play in the conversion of health research into health policy, and CCOHTA brings that component into play in its role as the national coordinator of HTA activities and as a clearinghouse for HTA results.

The participation of a number of organizations, including those involved in technology assessment, will help facilitate the full application of the research investment in organizations such as CIHR and CHRSF. This will ensure the appropriate decision-making tools are provided to health policy-makers at the federal, provincial and territorial levels, helping to create a more cost-effective health care system.

Public Advice Seeking in the Era of E-Health

At this time, no organization has been identified as the lead on this research theme.

Improved Access for Marginalized Groups

Three institutes of CIHR (Institute of Health Services and Policy Research, Institute of Gender and Health, Institute of Aboriginal People's Health) will be focusing on research projects in his area, which address such questions as:

  • What are the existing barriers to access to services for marginalized groups such as those with mental health problems or addictions; First Nations, Metis, Inuit or urban Aboriginal communities; women from visible minorities or with particular diseases or disabilities; groups with particular sexual orientation; incarcerated populations; the poor; and what are the effects of these barriers on the health and quality of life of people in these groups?
  • Through comparative/evaluative studies, what types of interventions/programs effectively identify marginalized groups and improve their access to appropriate health services?
  • What has the impact of recent health care system reforms been on access to particular types of health services for particular groups (e.g. by gender, socio-economic status, ethnicity, education); have such reforms created new jurisdictional gaps in service coverage that differentially affect certain groups?
  • What factors influence the help-seeking approaches of marginalized groups?

In recognition of the importance of this theme, CHSRF will be complementing the institute's commitment to this area through its own support of a program of research focusing on the small, rural and remote communities aspect of the theme.

Secondary Themes

Primary Healthcare

CHSRF will take the lead on this research theme. The Foundation appreciates the pressing concerns of decision makers, especially federal, provincial and territorial policy makers, about the design, implementation and evaluation of primary healthcare models. The Foundation will concentrate on commissioning primary healthcare policy synthesis and specific research projects, through its Commissioned Research Program.

In addition, CIHI has initiated work to identify and develop performance indicators for primary health care services delivered by physicians and other health professionals in a variety of practice settings.

Globalization

No lead agency has been identified on this research theme. However, the CIHR's Institute of Population and Public Health (IPPH) has identified this as a strategic research priority. Also CIHI, through the Canadian Population Health Initiative (CPHI) Research Program, has identified the question "What is Canada's relationship to population health from a global perspective?"

Regionalization

At this time, no organization has been identified as the lead on this research theme.

Population Health

Agencies focusing specifically on population health rather than health services per se are taking charge of this substantive theme. Indeed, the Institute of Population and Public Health (IPPH), of CIHR, and its partners are presently in the process of consulting constituencies on research priorities for this theme.

CIHR-IPPH will be releasing a RFA on Needs, Gaps, Opportunity Assessments relating to 2 strategic research areas:

  • The Influence of Various Contexts on Health
  • The Design and Evaluation of the Health Impact of Population Interventions

The RFA is designed to focus on the development of refined research agendas in these areas.

The Canadian Population Health Initiative (CPHI), coordinated by CIHI, also plays an important role under this theme. CPHI provides support to research advancing an understanding of the determinants of the health of the Canadian population and enhancing the articulation of policy options to improve population health and reduce health inequities.

The primary aim of the CPHI is to mobilize intellectual leadership and promote collaborative strategies for population health. The CPHI has identified five Strategic Themes for which it will provide funding to researchers. These themes are stated as questions:

  • Why are some communities healthy and others not?
  • To what extent do Canada's major policies and programs improve population health?
  • How do social roles at work, in the family and in the community affect health status over the life course?
  • What are the population health effects of broad factors in social organization in Canada and other wealthy countries?
  • What is Canada's relationship to population health from a global perspective?

CIHI is also supporting innovative approaches and methods in population health Knowledge Exchange, and dissemination.

Continuum of Care and Delivery Models

CHSRF has decided to maintain its previous commitment to fund research projects and programs addressing issues relative to the management of continuity, through its Open Grants Competition. The Foundation intends to build on the network of researchers and the pool of research it has developed since 1998 to undertake further activities under this theme.

In addition, CIHI has a major role in elements of this theme. CIHI is currently engaged in a number of projects to develop and/or enhance existing information required to answer fundamental questions about Canadians' health and health system and how individuals move through the system and with what results.

Performance Indicators, Benchmarks and Outcomes

CIHI is taking the lead on this research theme and the Health Indicators Project, a collaborative undertaking between CIHI and Statistics Canada, is a key initiative in this area. The goal of this project is to provide comparable national health indicators based on a conceptual framework, describing four interrelated areas: health status, the non-medical determinants of health, health system performance and other community and health system contextual indicators.

A set of health system performance indicators has been developed for all health regions over 100,000 population, comprising over 90 percent of the total population are currently available. Over time, this set of indicators will be refined and expanded. Increasingly, these will focus on the development of outcome indicators, such as AMI 30-day in-hospital mortality, unplanned readmissions and complication rates. The scope and utility of the core set of indicators will also increase as new data are developed and benchmarks are established.

Other CIHI projects (e.g. Home Care, Continuing Care) will contribute to filling important gaps in available indicators in the future.

Evolving Role of Informal and Voluntary Care

At this time, no organization has been identified as the lead on this research theme. However, the Institute of Health Services and Policy Research of the CIHR has incorporated some parts of this theme into its RFA on "Financing and Public Expectations".