Long-term care funding in Canada: a policy mosaic

When Canada was founded, health care was delegated as a provincial responsibility. Although the federal government shares a portion of health care costs, it is not directly responsible for the planning, delivery, and governance of health services. The 1984 Canada Health Act set national standards for the provision of physician and hospital services, but it does not apply to home care and long-term care facilities. Consequently, each province has established a unique approach to long-term care, resulting in a health policy mosaic. This paper examines different approaches to funding long-term care with a particular emphasis on the impacts of regionalization and of the implementation of case-mix-based funding systems.     

A Cross-Sectional Examination of the Association Between Dyspnea and Distress as Experienced by Palliative Home Care Clients and Their Informal Caregivers

This study examined the association between dyspnea and distress as experienced by both palliative home care clients and their informal caregivers as a unit of care. Cross-sectional analysis was conducted using the interRAI Palliative Care Assessment database. Responses from 6,655 individual palliative home care clients across six regional jurisdictions in Ontario, Canada were included. This study found that clients experiencing dyspnea were more likely to show overall signs of distress; report one or more signs of self-reported distress; and be at risk for depression when compared to clients who do not experience dyspnea. Caregivers of clients experiencing dyspnea were more likely to exhibit distress than caregivers of clients not reporting dyspnea. When indicators of caregiver distress and client distress were combined, 53% of the caregiver-client units exhibited distress. Social work practitioners should include a focus on distress within the care unit as a priority when care planning to meet the needs of persons nearing the end of life. Members of the care team should consider available treatment and management options tailored to meet both the client and their informal caregiver’s needs.     

Firm-specific human capital, job matching, and turnover: evidence from major league baseball, 1900–1992

The two dominant labor market turnover hypotheses, the firm-specific human capital model (FSHCM) and the job-matching model, suggest different patterns of player mobility in major league baseball. The matching hypothesis predicts greater mobility of players in positions that require substantial team production. A better match may offer large productivity gains. Alternately, the FSHCM predicts players in positions requiring the greatest amount of teamwork will benefit from specific knowledge, making them less likely to change teams. We examine the frequency distribution of trades by player position from 1900–1992 and find the FSHCM provides the best explanation for turnover in this industry.     

Short happiness and affect research protocol (sharp)

Issues in the measurement of subjective well-being (SWB) include the relative balance between scale brevity and measurement accuracy. Because accuracy is expected to vary negatively with the length of a scale, the brevity/accuracy trade-off has pragmatic implications for survey research. This article begins by examining minimal psychometric criteria to evaluate short measures of SWB. These criteria include content validity (i.e., four basic categories are cited), criterion validity, internal consistency, and test-retest reliability. Several measures frequently used in large-scale surveys are shown to fail against one or more of these criteria. Consequently, a new brief measure was developed and shown to satisfy all the criteria. It is termed the Short Happiness and Affect Research Protocol (SHARP). This measure contains 12-items derived from the Memorial University of Newfoundland Scale of Happiness (MUNSH), with the content balanced over positive and negative, and short-term (affective) and long-term (dispositional) components. The internal consistency, temporal stability, and criterion validity coefficients for the SHARP are comparable to those of the MUNSH, which is among the most accurate measures of self-reported SWB.