Wrong Care in the Wrong Place: Time to Fix Canada’s Failing Approach to Chronic Disease

CFHI Shows Care Closer to Home Can Cut Hospitalizations and Improve Outcomes

Ottawa, Ontario – June 21, 2016 – Unnecessary hospitalizations due to chronic disease are reaching the tipping point of seriously harming this country’s healthcare system and do not meet the needs of patients and their families, according to a report by the Canadian Foundation for Healthcare Improvement (CFHI).

“Across Canada, patients end up seeking care in emergency departments to manage their chronic illnesses because more appropriate care isn’t available in the community,” says Maureen O’Neil, O.C., President of CFHI. “These patients are getting the wrong care in the wrong place.”

According to CFHI, diseases such as chronic obstructive pulmonary disease (COPD) are placing a growing strain on Canada’s healthcare system. COPD is a chronic and progressive lung disease that includes bronchitis and emphysema, and is characterized by debilitating breathlessness. It is primarily caused by smoking. Of all chronic diseases, COPD is the number one reason for hospitalizations in Canada, accounting for the largest number of return visits to emergency departments. COPD also generates the highest volume of hospital readmissions.

CFHI today announced new results from a national initiative that shows hospitalizations due to COPD can be decreased by up to 80 percent when healthcare is provided to patients and their families at home. This transformational approach not only improves quality of care, but would also avoid 68,500 emergency department visits, 44,100 hospitalizations and 400,000 bed days - saving $688 million in hospital costs over the next five years.

A conservative estimate finds that about 800,000 Canadians live with COPD, yet people with advanced COPD are among the highest users of Canada’s hospital resources. One in four Canadians (25 percent) over age 35 are expected to develop the disease in their lifetime, meaning the situation is forecast to worsen in coming years.

To demonstrate how care at home can transform the way chronic illnesses are treated and managed, CFHI spread across Canada an innovative community-outreach program to better manage COPD first developed in Halifax.

COPD Impact

“We knew this was coming,” says CFHI Vice-President, Programs, Stephen Samis. “Rising rates of chronic disease are straining our healthcare resources and staying the course is not an option. Canada continues to operate a healthcare system designed in the 1960s that focuses on expensive acute care rather than helping people manage their chronic diseases in the community.”

The Solution: Care Closer to Home

CFHI, in collaboration with Boehringer Ingelheim (Canada) Ltd. (BICL), supported 19 hospitals from every Canadian province to provide more effective, efficient and coordinated care to patients living with advanced COPD and their families.

Healthcare teams identified patients who visited emergency departments or were hospitalized with advanced COPD, and then invited them into a supportive program that provided them with written action plans for managing their disease. This included a phone call after they were discharged home; at-home self-management education and psychosocial support; and advance care planning when needed. Patients in the program were also given a telephone number to call for support.

The program, known as the INSPIRED collaboration, has enrolled 885 patients across Canada. For 146 of those patients who had participated in the program for a three- month period, their hospitalizations decreased by 80 percent. Patients also reported greater self-confidence, improved symptom management and a return to daily activities such as climbing stairs, exercising, travelling and returning to work. Family members and healthcare providers say that this program has improved care for patients – providing them with the support they need as they transition from hospital to home, and the information they need to manage their illness. Patients say this program gave them their lives back.

“The INSPIRED collaboration has demonstrated that we can transform the way chronic illnesses are treated and managed,” says Richard Mole, President and CEO, Boehringer Ingelheim (Canada) Ltd. “Patients need access to the best and most streamlined care possible, and that means finding ways to apply this model to other disease areas so that more Canadians can benefit.”

Significant Cost Savings

An independent analysis carried out by RiskAnalytica concluded that further expanding the CFHI/BICL INSPIRED collaboration would benefit 14,000 Canadians a year and save $688 million in hospital costs over the coming five years. For every $1 invested in the program, $21 in hospital-based costs could be prevented.

“These impressive results are for one chronic disease – COPD. If the same approach were taken for other chronic illnesses such as congestive heart failure, it could save Canada`s healthcare system billions of dollars each year,” says CFHI’s Mr. Samis. “The proof is in the results – with patients, providers of care and hospital budgets seeing real benefits from this program.”


CFHI is calling on governments and healthcare providers to work with them to scale-up the COPD collaboration, and move towards community-based healthcare for other diseases so that every Canadian can benefit from a person-centred approach to care. Materials are freely available on the CFHI website for organizations that want to deliver an INSPIRED Approach to COPD care.

For more information, or to get involved, please visit:

Regional Backgrounders:

About CFHI
The Canadian Foundation for Healthcare Improvement identifies proven innovations and accelerates their spread across Canada, improving patient care, the health of Canadians and value-for-money. These innovations could save healthcare budgets over $1 billion per year. CFHI is a not-for-profit organization funded by Health Canada. Visit cfhi-fcass.ca for more information.

The views expressed herein do not necessarily represent the views of Health Canada.

About Boehringer Ingelheim
The Boehringer Ingelheim group is one of the world’s 20 leading pharmaceutical companies. Headquartered in Ingelheim, Germany, Boehringer Ingelheim operates globally with 145 affiliates and a total of more than 47,500 employees. The focus of the family-owned company, founded in 1885, is researching, developing, manufacturing and marketing new medications of high therapeutic value for human and veterinary medicine. Social responsibility is an important element of the corporate culture at Boehringer Ingelheim. This includes worldwide involvement in social projects, such as the initiative “Making More Health” and caring for employees. Respect, equal opportunities and reconciling career and family form the foundation of the mutual cooperation. In everything it does, the company focuses on environmental protection and sustainability. In 2015, Boehringer Ingelheim achieved net sales of about 14.8 billion euros. R&D expenditure corresponds to 20.3 percent of its net sales. The Canadian headquarters of Boehringer Ingelheim was established in 1972 in Montreal, Quebec and is now located in Burlington, Ontario. Boehringer Ingelheim employs approximately 600 people across Canada. For more information, please visit www.boehringer-ingelheim.ca.

For more information, or to arrange media interviews, please contact:

  • Elissa Freeman – 416-565-5605
  • Robyn McIsaac (Atlantic Canada) – 902-440-1551
  • Brigitte Filiatrault (Quebec) – 514-521-8216
  • Holly Roy (Western Canada) – 780-991-2323

Joel Baglole
Senior Communications Specialist
Canadian Foundation for Healthcare Improvement
C: 613-797-6481
E: joel.baglole@cfhi-fcass.ca