Addressing Health-System Sustainability in Ontario

The views expressed in the evidence brief are the views of the authors and should not be taken to represent the views of the Ontario Medical Association. [...] There are many demand-side factors that drive change and create sustainability challenges for the health system Some of the most pressing challenges to sustainability relate to the ways in which the specific characteristics of citizens, patients, caregivers and communities in Ontario affect the use of the health system. [...] Given the body of literature that was identified that speaks to each of the demand-side factors, we present a summary of each in Table 2. In contrast to the factors outlined in the previous section on the demand side, many of the drivers of change on the supply side are those that health-system policymakers and stakeholders can exert some control over through the decisions that they make. [...] First, as demographics, the burden of disease/disability and patient/public expectations continue to shift in the province and create the impetus for reforms that veer away from the traditional focus of the health system in Ontario (acute episodic care) towards a system that centres on a strong primary-care sector with the aim of preventing disease and promoting health, and on supporting patients [...] Due to the extensive scope of each of the elements and the large number of systematic reviews relevant to them, we have restricted the evidence presented in the brief to only include high-quality (AMSTAR scores of 8 or high out of a possible eleven) and recent reviews (i.e., conducted since 2011).