Janet M Lum

University of Toronto, Toronto, Ontario, Canada

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Publications (6)0 Total impact

  • A Paul Williams, Janet M Lum
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    ABSTRACT: If the healthcare sky is falling, it is because we have not yet grasped the opportunity to do better. Here we comment on three points in Chappell and Hollander's lead article. First, rather than looking to new federal-provincial mechanisms, which do not currently appear on the political agenda, we propose that federal and provincial governments honour their current commitments, including an extension of the 2004 First Ministers' agreement, set to expire in 2013-2014, that flows federal healthcare dollars to the provinces. Second, we concur that small things (e.g., transportation and medication management) matter in big health systems. Access to a full range of services in integrated systems of care permits cost-effective "downward substitution" instead of more costly, and often inappropriate "upward substitution" to hospital and institutional care. Finally, given the current political climate of fiscal constraint, it is helpful to consider the lessons of successful local initiatives such as supportive housing, which can integrate care "from the ground up" including essential primary and preventive care. Rather than seeing an aging population as the harbinger of healthcare doom, we suggest seeing it as a motivator to rethink, refresh and innovate.
    HealthcarePapers 01/2011; 11(1):52-8; discussion 86-91.
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    ABSTRACT: Integrating community-based health and social care has grabbed international attention as a way of addressing the needs of aging populations while contributing to health systems' sustainability. However, integrating initiatives in different jurisdictions work (or do not work) within very various institutional and structural dynamics. The question is, what transferable lessons can we learn to guide policy makers and policy innovators at the local level? In this paper, we consider "aging at home" as a policy option in Ontario, and beyond. In the first section, we focus on the problem, in effect, what not to do. Here, we briefly review findings from national and international research literature and from our own research in Ontario that identify the costs and consequences of non-systems of care for older persons. In the second part, we turn to solutions, in effect, what to do. Drawing on our recent scoping review of the international literature, we identify three guiding principles, as well as a number of recommendations, for integrating care for older persons, knowing that important details of how to put such initiatives "on the ground" will be provided by other contributors to this journal edition.
    HealthcarePapers 01/2009; 10(1):8-21.
  • Janet M Lum, Ann Aikens
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    ABSTRACT: Integrating community-based health and social care for older persons is said to help individuals maintain high levels of independence, well-being and quality of life and contribute to health systems sustainability by moderating the demand for costly emergency services and inappropriate hospital care. Rural settings, however, pose challenges distinct from those in urban areas. Using North Renfrew Long-Term Care Services as a case study, this paper discusses the principles and practices of a small, rural community service agency located in Renfrew County, Ontario, that provides to its scattered populations a range of services across the care continuum. Services include community support programs, supportive housing and long-term care beds as well as an innovative 24-Hour Flexible In-Home Support Pilot program adapted from the ground breaking "night patrol" system in Denmark.
    HealthcarePapers 01/2009; 10(1):50-7; discussion 79-83.
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    ABSTRACT: We are very grateful to the editors of HealthcarePapers for making this timely journal edition possible, and to our distinguished contributors for sharing their valuable insights on aging at home from local, national and international perspectives. While starting from different points and using different approaches, each contributor has articulated a common message: not only is it desirable to support the quality of life, independence and well-being of older persons and their caregivers in home and community, it is possible to do so while contributing to health system sustainability. If people are the top line of aging at home, cost-effectiveness and system sustainability are the bottom line.
    HealthcarePapers 01/2009; 10(1):79-83.
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    ABSTRACT: Why can many older persons with relatively high needs age successfully at home, while others with similar needs require residential long-term care (LTC)? How can healthcare investments best be balanced to ensure that older persons have access to the most appropriate, cost-effective care?
    Healthcare quarterly (Toronto, Ont.) 02/2008; 12(2):95-105.
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