Comparing health system performance assessment and management approaches in the Netherlands and Ontario, Canada

BACKGROUND: Given the proliferation and the growing complexity of performance measurement initiatives in many health systems, the Netherlands and Ontario, Canada expressed interests in cross-national comparisons in an effort to promote knowledge transfer and best practise. To support this cross-national learning, a study was undertaken to compare health system performance approaches in The Netherlands with Ontario, Canada. METHODS: We explored the performance assessment framework and system of each constituency, the embeddedness of performance data in management and policy processes, and the interrelationships between the frameworks. Methods used included analysing governmental strategic planning and policy documents, literature and internet searches, comparative descriptive tables, and schematics. Data collection and analysis took place in Ontario and The Netherlands. A workshop to validate and discuss the findings was conducted in Toronto, adding important insights to the study. RESULTS: Both Ontario and The Netherlands conceive health system performance within supportive frameworks. However they differ in their assessment approaches. Ontario's Scorecard links performance measurement with strategy, aimed at health system integration. The Dutch Health Care Performance Report (Zorgbalans) does not explicitly link performance with strategy, and focuses on the technical quality of healthcare by measuring dimensions of quality, access, and cost against healthcare needs. A backbone 'five diamond' framework maps both frameworks and articulates the interrelations and overlap between their goals, themes, dimensions and indicators. The workshop yielded more contextual insights and further validated the comparative values of each constituency's performance assessment system. CONCLUSION: To compare the health system performance approaches between The Netherlands and Ontario, Canada, several important conceptual and contextual issues must be addressed, before even attempting any future content comparisons and benchmarking. Such issues would lend relevant interpretational credibility to international comparative assessments of the two health systems

Perceptions on Captive Malayan Porcupine (Hystrix brachyura) Meat by Malaysian Urban Consumers

ABSTRACT: The objective of this study is to investigate the acceptance and purchasing behaviours of Malaysian consumers for captive bred Malayan porcupine (Hystrix brachyura) meat as an alternative meat product in the domestic market. Result showed that 53.5% of the respondents acknowledged that porcupine meat can be eaten and is according to Muslim law (Halal). However, only 20% of the respondents had tried the meat. More than half (55.8%) of the respondents indicated that porcupine meat is delicious while 11.6% stated differently. Respondents preferred to try porcupine meat if it possesses high nutritional values, is of reasonable price and is good for health (62.4%). From the evaluation, 53.8% of the respondents are willing to pay if the price is higher than beef's price. Suggested price is between RM20.00 to RM25.00 / kg. Our data also indicated meat preference for wild porcupine meat is slightly greater than captive with percentages of respectively 54.7% and 45.3%. The reason of the choice is quality. Marketing strategy was suggested to promote porcupine meat in restaurants with ready cooked food. Packaging method was also introduced with pre-cooked food in packed form

Preliminary report: April 2009 - August 2010 National Inflammatory Arthritis Registry (NIAR)

Rheumatoid Arthritis (RA) is the most common form of infl ammatory arthritis. It is estimated to affect about 1% of the population. Of unknown aetiology, it typically affects many joints, causing acute inflammation, in most cases leading to joint erosions and joint damage (1). The NIAR, initiated in 2008, was set up with the aim of obtaining information about patients with Rheumatoid Arthritis. Information about patients with the other inflammatory arthritides will be collected in the future