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Searching for wisest ways to spend health care dollars
Medicine runs on money. How to get more bang for the
health care buck is the research focus of Dr. Walter
Wodchis, a Research Scientist at Toronto Rehab.
As a health economist, he is concerned with economics
and economic incentives. "I look at health care
from a policy standpoint. Right now, I'm particularly
interested in government payment systems for long-term
care and how they affect residents' access to rehabilitation."
Dr. Wodchis' research has focused on funding of complex
continuing care facilities. These facilities treat people
who need medical help over extended periods. In particular,
he is interested in the relationships between financial
allocations and quality of care.
"My research shows that rehabilitation can be
very effective for individuals who do not seem to have
rehabilitation potential at first glance," he says.
"When we increase the amount of therapy to people
we know are going home, it doesn't get them there any
faster. But when we increase therapy to people we did
not expect to go home, that extra therapy has a considerable
impact. The more we give them, the more likely they
are to go home and the faster they get there."
This unexpected finding is especially significant in
light of Dr. Wodchis' research into how complex continuing
care facilities function under different funding models.
"Facilities in the U.S. use a patient-based funding
model," he explains. "How much money the facility
gets depends on the kind of care they give individual
patients."
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Quick
Biography
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Dr. Wodchis is a Research Scientist at Toronto
Rehab. He is an Adjunct Scientist at the Institute
for Clinical Evaluative Sciences and Lecturer
in the Department of Health Policy, Management
and Evaluation, University of Toronto. His main
research interests are health economics, policy
evaluation, and long-term care. Recent publications
focus on economic incentives and government payment
for long-term care. Dr. Wodchis is currently supported
by a CIHR post-doctoral award and is investigating
the relationship between quality of care and financial
performance in Ontario Complex Continuing Care.
He earned his doctorate in Health Services Organization
and Policy (Health Economics) at the University
of Michigan.
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"In Canada, we use a more global, 'spread-the-wealth'
model. How much money a facility gets doesn't depend
on what it does for particular people. The Ontario system
works well because clinicians do not have financial
incentives to limit therapy for particular individuals-
and they are more likely to allocate extra therapy to
patients who we thought were marginal. On the other
hand, global budgets still restrict the amount of therapy
that is available."
Dr. Wodchis came to his research specialty via an unusual
route. "As an undergraduate, I studied actuarial
science and pension funding because I believed financial
security was important to older people. Then I switched
to gerontology because I started thinking health was
an even more significant concern for older people than
money.
"I like to take on research that hasn't been attempted
before. The challenge is to come up with a new approach
to try and answer the research question - in my case
mostly, 'what's the optimum way to finance health care
under such-and-such circumstances?'"
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