The recent Romanow and Kirby reports have focused attention once again on Canada’s health care system. Unfortunately, these reports have overlooked the changing profile of health care that is the result of tremendous advances in treatment.
There is a growing category of care that we, at Bridgepoint Health, are calling Specialized Complex Care. In fact, until recently, there was no accepted definition of the complex continuing care patient, and therefore, little understanding of the needs of this patient group. Now, however, with technological and pharmaceutical advances saving and extending the lives of more and more people, we have a rapidly growing patient population that is living a long time with chronic illness – often several chronic illnesses or disabilities at the same time. Complex illness is among the fastest growing health care categories in the country.
It is a surprising fact that in the last half of the 20th century there have been no new cures for illness (the last “cure” was for smallpox in 1954). The good news, however, is that new treatments have changed illnesses that used to be a death sentence into illnesses we can live with. Also, as we age, the likelihood of contracting more than one chronic illness or some kind of complicating disability increases. And, chronic diseases have a way of progressing over time. If you add the aging “Baby Boomers” to this mix you can easily see why the population with complex conditions is growing. Clearly this has not ended the need for treatment – it has changed the kind of treatment we need.
Today, there are 2100 complex care beds in Metropolitan Toronto, which can help no more than 3000 people per year. In shocking contrast, there are 365,000 people with severe chronic illness, including 60,000 who have complex disorders and disabilities. Already we calculate that complex care accounts for about 55 per cent of all health-care spending.
What is also surprising is that until the announcement of the Bridgepoint Health Research Institute in the fall of 2002 there was almost no research dedicated to the needs of complex continuing care patients in Canada. Research has tended to follow disease paths and, as a result, has missed the patient who has several chronic diseases or disabilities interacting on his or her system at one time. This situation of multiple complexities is no longer a rare occurrence.
The Bridgepoint Health Research Institute is committed to conducting applied research in complex rehabilitation, complex continuing care and high-level long-term care. It will evaluate the inter-relationships of multiple illnesses or disabilities and their impact on the patient’s overall health and quality-of-life. Clinical applications of effective and efficient interventions will be undertaken. The Institute will, for the first time, provide economic models for different approaches to the cost of care.Clinical studies will focus, for example, on:
- the impact of the patient’s living environment on health
- methods of increasing independence when living with disability
- enhancing mental health and coping
- illness prevention
- crisis management
Some of the studies currently being planned include:
- ways of enhancing oral health in patients with dementia
- preventing osteoporosis in non weight bearing people
The Institute is the outcome of a national survey conducted by Bridgepoint Health to determine the current status of knowledge and research into complex rehabilitation and complex continuing care. The study revealed that complex care has not been treated as a distinct category in research. It also revealed that there is no standard platform of research criteria, nor are there researchers dedicated to the field. Among the key contributions the Institute will make in its early days will be to evaluate and determine processes and procedures for managing the transition between different levels of care at different stages of illness. It will facilitate the creation of a national database of best practices, benchmarks and standards, and attract clinicians and researchers to become the first generation to specialize in complex continuing care.
Bridgepoint Health is among the first facilities in Canada to recognize that Specialized Complex Care is a distinct category requiring a new definition, a new model of care and ultimately new models for care facilities. Specialized Complex Care is unlike any other kind of care in that it is ongoing – it lasts the patient’s entire life and, it changes over the person’s lifetime. The best results for the patient and for the health-care system are those that provide maximum wellness and independence for patients with even the most severely compromised conditions – at all stages of their lives. That is the purpose of Bridgepoint Health.
For more information about Bridgepoint Health please visit us at www.bridgepointhealth.ca