Edson College of Nursing and Health Innovation, Arizona State University, 550 North 3(rd) St, Phoenix, Arizona, 85004, USA; North American Observatory on Health Systems and Policies, 155 College St, Suite 425, Toronto, Ontario M5T 3M6, Canada; Center for Innovation in Healthy and Resilient Aging, Arizona State University, 550 North 3(rd) St, Phoenix, Arizona, 85004, USA.
Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St, Suite 425, Toronto, Ontario M5T 3M6, Canada.
Health Policy. 2021 Dec;125(12):1536-1542. doi: 10.1016/j.healthpol.2021.09.014. Epub 2021 Oct 3.
Outpatient technologies are important for maintaining health and overall quality of life, yet the degree of access and coverage of these technologies remains variable within and across jurisdictions. In Canada, assistive technologies are not included in universal health coverage, and are not subject to the Canada Health Act's criteria and conditions that provinces and territories must fulfill to receive the full federal cash contribution under the Canada Health Transfer. As such, the thirteen Canadian provincial and territorial governments make separate decisions on programs and coverage. Drawing on the WHO Universal Coverage Cube we compare who gets access, the types of technologies that can be accessed, and the level of coverage (total costs covered) in Canada. Overall, each Canadian jurisdiction had at least one publicly supported program. All relied on a 'health assessment' of an individual's need to determine eligibility. Income and eligibility for social assistance was used as eligibility criteria in 6 of the 13 jurisdictions. Mobility aids as well as audio, visual, and communication aids were included in all jurisdictions. While some programs offered full financial support for some technologies, forms of cost sharing were common. The results are discussed in the context of international experiences, demographic changes, and health system trends to highlight areas for policy learning.
门诊技术对于维护健康和整体生活质量至关重要，但这些技术的可及性和覆盖范围在各司法管辖区内和之间存在差异。在加拿大，辅助技术不包括在全民健康覆盖范围内，也不受《加拿大健康法案》的标准和条件的约束，这些标准和条件是各省和地区必须满足的，才能根据《加拿大健康转移支付》获得全部联邦现金捐款。因此，加拿大十三个省级和地区政府各自对项目和覆盖范围做出决定。我们利用世界卫生组织的全民覆盖魔方来比较谁能获得服务、可获得的技术类型以及加拿大的覆盖水平（总费用覆盖）。总体而言，每个加拿大司法管辖区都至少有一个公共支持的项目。所有项目都依赖于对个人需求的“健康评估”来确定资格。在 13 个司法管辖区中有 6 个使用收入和社会援助资格作为资格标准。所有司法管辖区都包括助行器以及视听和通信辅助设备。虽然一些项目为某些技术提供全额资金支持，但常见的是各种形式的费用分担。结果将在国际经验、人口变化和卫生系统趋势的背景下进行讨论，以突出政策学习的领域。
