Health Services Research Priorities for New Brunswick

New Brunswick Priorities

• Alternative Primary Care Delivery Models
  • What interdisciplinary models are available and what is the evidence of their effectiveness?
  • What models are particularly relevant in different environments (i.e., urban and rural)?
  • What is the appropriate mix of health human resources within primary care delivery?
• Health Human Resources
  • What models are available to assist in using health professionals differently i.e. changing the roles and mix of professionals and expanding scope of practice within and between professions (e.g. nurses, RNAs )?
  • Under what circumstances are the different models most effective? (e.g. pilot projects on nurses in family practice)?
  • What forms of remuneration would provide an incentive for primary care physicians to promote health enhancing behaviours and achieve improved access to health care services?
• Technology
  • What is the impact of new devices and therapeutic opportunities on the cost and outcome of health services?
  • How can Telehealth be implemented so as to ensure continuity of care with secondary and tertiary care centres?
  • What is the impact of the electronic health record and integrated information systems on the cost and effectiveness of health services delivery?
• Wellness
  • What interventions in health promotion and disease prevention are effective and not effective?
  • What evidence is available to demonstrate that investment in this area is worthwhile?
  • What is the best approach to implementation of wellness programs (i.e. should programs be targeted to specific populations vs. population at large; what is the appropriate setting and who should administer them)?
• Impact of Changing Demographics on Health Care
  • How will demographic changes (e.g., aging of baby boomers) impact the cost of health services delivery? Is this population in better health resulting in potentially lower costs?
  • What impact will immigration and globalization have on the cost of health services?

Conference of Deputy Ministers

The Conference of Deputy Ministers has similar research requirements as identified in section (i) related to:

• Alternative Models for Primary Care
• Health Human Resources
• Health Technology
• Wellness

The following additional issues are specific to the Conference of Deputy Ministers:

• Pharmacare
  • How can jurisdictions sustain the increasing cost of drug therapy within disease management?
  • What is the impact of the differences among provinces in eligibility for drug benefit coverage and how can these differences be sustained?
• Accountability
  • What indicators are available to support the requirements for reporting to the public on the performance of the health system?
  • What are the benchmarks and standards of good performance?

Top Three Priorities

The top three health services research priorities for both New Brunswick and the Conference of Deputy Ministers are:

• Alternative models for primary care delivery
• Health human resources
• Health technology

Anticipated Locus of Research Implementation

As the Department has no internal research capacity, all research initiatives are expected to be implemented by external research organizations. Whether the lead is taken at the national or provincial level depends on the topic. For example, in health human resources, different jurisdictions are at different stages of developing databases and consequently forecasting is likely best done within the province. However, best practices on the scope and mix of health professionals requires external research. Research in primary care models, technology and pharmaceuticals is expected to be external to the province.