central west lhin catchment consultation study wave 1 september 2006

Central West LHIN Central West LHIN Catchment Consultation Catchment Consultation StudyStudyWave 1Wave 1

September 2006 September 2006

Catchment Consultation Study, Wave 1: Central West LHINCentral West LHIN

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MethodologyMethodologyInterviewing Data collection for the study was conducted via CATI telephone

interviewing between August 17 to September 3, 2006.

Respondent Qualification

A randomly-selected, representative sample was achieved by inviting catchment residents aged 18 years of age and older to complete the survey. A total of 601 interviews are completed. The margin of error for a sample of this size is +/- 4.0%, 19 times out of 20.

Quota Regime and Weighting

In order to ensure the statistical reliability and comparability of regional results, a regional quota regime was employed as illustrated in the chart on the following slide.

However, the final data are statistically weighted using the most current Census and government data to ensure the results are representative of the actual population of the Central West LHIN catchment.


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Regional BreakdownRegional Breakdown

Sample Size

Margin of Error at the 95% confidence level

Total (Central West LHIN) 602 ±4.0% Brampton 135 ±8.4%

Caledon/Bolton 76 ±11.2%

Dufferin/Oville 105 ±9.6%

Etobicoke/Rexdale 120 ±8.9%

Mississauga/Malton 91 ±10.3%

Vaughn/Woodbridge 75 ±11.3%


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Table of ContentsTable of Contents

Executive Summary

Public Opinion Context

LHIN Awareness and Familiarity

Assessing LHIN Priorities

Public Engagement and Demands

Communications


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Executive SummaryExecutive SummaryHigh, Moderate Satisfaction with and Confidence in Local Health Care The majority of Central West LHIN residents are moderately satisfied with their local

health care system. No less than seven-in-ten are satisfied with the overall quality (77%), coordination (70%), efficiency (68%), and accessibility (68%) of the local health care system.

There is also high, moderate confidence in local health care. No less than six-in-ten are confident in the sustainability of the health care system (71%), that it will improve in the future (67%), that it is accessible (67%), and that there is a workable plan for the health care system (59%). Furthermore, 17% to 20% are very confident

Unaided Awareness of LHINs is Low. Half of Residents Say They are Aware Once Aided Over half of LHIN residents have seen, read, or heard about changes that are being

made or will be made to how health care services in their community and across the province are planned, managed, and funded (55%).

Among those that are aware of changes in the health care system, only 3% are aware of LHINs without prompting. With prompting, one in ten LHIN residents are aware of LHINS (12%). Three in ten LHIN residents say they aware of LHINS once they hear a description of them (29%). However, only one in five LHIN residents are somewhat to very familiar with the LHIN (17%).

LHIN residents who have have seen, read, or heard something about LHINs over the past two years report a number of things that they have heard, such as that this is new (13%), integrated (16%), team-based (24%) approach.


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Executive SummaryExecutive SummaryStrong Support for Key Priority Areas The majority of LHIN residents said that all priority areas are very important, and all

key priority areas are considered important by at least nine in ten LHIN residents. Ranking: The primary tier of support for key priority areas includes access (37%) and

improving the overall quality of health care (27%). This is followed by support for increasing the focus on health and wellness promotion and illness prevention (15%) as a secondary tier priority, and ensuring sustainability (12%) as a tertiary tier priority.

After discussing health care and the LHIN priorities, there was no consensus re: any missing priorities. Indeed 53% responded “No/Nothing” and the remainder issues mentioned are addressed by the LHIN’s key priorities tested.

Residents have High Expectations of Local Health Care When it comes to engaging the public, patients want a more active and empowered

role in making decisions about their own health care (95%). On a broader scale, the vast majority of residents say the Central West LHIN should collaborate with the public and with health care providers when making decisions (97%), and that the LHIN should communicate to them about health care integration plans (94%).

There is high, strong support for team-based health care provision (99%). More than nine in ten LHIN residents want to have access to all their needed health care services within their own region (96%). Yet, eight in ten LHIN residents are willing to travel to a neighbouring region for service (78%). As well, there is high, strong agreement that the health care system should help people manage their complicated health conditions (96%), and focus on wellness (91%).


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Executive SummaryExecutive Summary

LHIN Residents Like Tagline Four in five LHIN residents have a positive impression of the tagline, “IT’S ABOUT

YOU AND YOUR HEALTH” (85%).

Communications LIHN residents receive information about local health care from a variety of sources,

but primarily from their doctor (30%) or the newspaper (30%). Commonly preferred methods of communication for receiving health care information include by mail (39%), the local newspaper (23%), and brochures (20%).

Public Opinion Public Opinion ContextContext

Top-of-Mind Top-of-Mind Satisfaction and Satisfaction and Confidence RatingsConfidence Ratings


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High, Moderate Satisfaction with Local High, Moderate Satisfaction with Local Health Care System: Health Care System: No Less Than Seven-in-No Less Than Seven-in-Ten Satisfied withTen Satisfied with Overall Quality (77%) , Overall Quality (77%) , Coordination (70%), Efficiency (68%), & Access Coordination (70%), Efficiency (68%), & Access (68%) (68%) Nine in ten residents of Caledon and Bolton are satisfied with the overall quality

of health care (89%). In addition, three quarters of residents of Vaughn and Woodbridge are satisfied with the overall accessibility to health care services and providers (78%).

Four in five LIHN residents between 18 and 34 years old are satisfied with the coordination and integration of health care services (81%), as well four in five LIHN residents 65 years old and over are satisfied with the efficiency of health care in their area (82%).

QA51: Overall, are you very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied with the following aspects of health care in your area ? For each, please tell me if you are very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied. How about… [n=602]

15%

17%

19%

19% 58%

49%

53%

53%

14%

23%

22%

20%

8%

9%

7%

5%

The overall quality of healthcare

The overall coordinationand integration of health

care services and providers

The overall efficiency ofproviding health care

services

The overall accessibility tohealth care services and

providers

Very satisfied Somew hat satisfied Somew hat dissatisfied Very dissatisfied100%

Satisfied

68%

70%

77%

68%


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High, Moderate Confidence in Local Health High, Moderate Confidence in Local Health CareCareNo Less Than Six-in-Ten are Confident in No Less Than Six-in-Ten are Confident in Sustainability (71%), Future Improvement (67%), Sustainability (71%), Future Improvement (67%), Access (67%), and Existence of Plan (59%) - Access (67%), and Existence of Plan (59%) - 17% to 21% are 17% to 21% are VeryVery Confident Confident

Seven in ten residents of Dufferin and Orangeville are confident that there is a workable plan or vision for the future of health care in their area (72%).

Three quarters of LHIN residents between 18 and 34 years old are confident that the overall accessibility (77%) and quality (78%) of health care in their area will improve in the future.

QA51: QA3: Now, please tell me your overall level of confidence with the following aspects of health care in your area. Are you very confident, somewhat confident, not very confident, or not confident at all about each of these aspects? How about… [n=602]

20%

21%

17%

17% 54%

42%

47%

46%

18%

25%

24%

21%

10%

8%

6%

10%

The health care system in your area is sustainable.

The overall quality of health care in your area willimprove in the future.

The overall accessibility to health care services andproviders in your area will improve in the future

There is a workable plan or vision for the future of healthcare in your area.

Very confident Somew hat confident Not very confident Not confident at all

100%

Confident

67%

59%

71%

67%

LHIN LHIN Awareness Awareness and Familiarityand Familiarity


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General System Change Awareness: 55%General System Change Awareness: 55%

Two thirds of residents of Brampton have seen, read, or heard something about changes that are being made or will be made to how health care services in their community and across the province are planned, managed, and funded (64%).

Three in five residents of Caledon and Bolton are aware of changes to local and provincial health care (59%).

Yes55%

No45%

QB1: Over the past two years, have you seen, read, or heard anything about any changes that are being made or will be made to how health care services in your community and across the province are planned, managed, and funded? [n=602]


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Unaided LHIN Awareness (Among Unaided LHIN Awareness (Among Change Aware): Only 3%Change Aware): Only 3% LHIN residents report a number of changes that they have heard

about, such as…

Hospitals – building more (37%) Doctors – hiring/attracting more/higher numbers (10%) Cut backs on services/funding (10%) More private involvement/privatization/two tier (9%) Better facilities/services/accessibility/equipment (7%) Reducing wait times/lists (7%) Doctors – shortage/not enough/low numbers (5%) Hospitals – closing hospitals (4%) Primary health care (4%) New clinics opened (4%) Funding for health care to be increased (3%) Local health integration networks (3%) Nurses – hiring/attracting more/higher numbers (3%) Moving to a team approach (3%)

QB2A/QB2B: And, what is the main change that you have heard about? What other changes have you heard about? [n=309]


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Prompted LHIN Awareness: 12%Prompted LHIN Awareness: 12%

One quarter of residents of Dufferin and Orangeville have seen, read, or heard something about LHINs (24%).

QB3: Over the past two years, have you seen, read, or heard anything about Local Health Integration Networks – also known as LHINs (“LINS”)? [n=602]

Yes12%

No88%


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Low Knowledge of LHINs (Among LHIN Low Knowledge of LHINs (Among LHIN Aware):Aware):Primarily, New (13%), Integrated (16%), Team-Primarily, New (13%), Integrated (16%), Team-Based (24%) ApproachBased (24%) Approach LHIN residents report a number of things that they have heard about

LHINS, such as…

Moving to a team approach (24%)Amalgamate/integrate/coordinate health services/hospitals and

CCAC’s (16%)New approach to health care (13%) Improvement of the system/accessibility to health care/services

(9%)Local control of health care planning (9%)Nurses – hiring/attracting more/higher numbers (6%)Nurses – shortage/not enough/ low numbers (6%)

QB4A/QB4B: And, what is the main thing that you have heard about LHINs? What else have you heard about them? [n=82 *small sample]


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Aided Awareness: 29%Aided Awareness: 29%But Only 17% Very (1%) to Somewhat (16%) But Only 17% Very (1%) to Somewhat (16%) FamiliarFamiliar One in five LHIN residents are somewhat to very familiar with the LHIN (17%), and

one third voluntarily said that they are unaware of the LHIN (35%). One third of LIHN residents who are 65 years old and over are familiar with LHINs

in general and the Central West LHIN in particular (31%).

16%12%

36%

1%

35%

Very familiar Somewhatfamiliar

Not veryfamiliar

Not familiar atall

Unaware /Never seen,

read, or heardof them

29% Aware

QB5: …Thinking about this – overall – are you very familiar, somewhat familiar, not very familiar, or not familiar at all with Local Health Integration Networks and your Central West LHIN? If you are completely unaware, just say so. [n=602]

Assessing LHIN Assessing LHIN PrioritiesPriorities


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Top of Mind Health Care PrioritiesTop of Mind Health Care PrioritiesPrimarily, Availability of Family Doctors (24%) Primarily, Availability of Family Doctors (24%) Also, Wait Time/Lists (13%), Access (12%), & Also, Wait Time/Lists (13%), Access (12%), & Number of Doctors (12%)Number of Doctors (12%) In their own words at the start of the survey, LHIN residents named a

number of health care issues that they say the leaders in their community should make a priority…

Availability of family doctors – not enough (24%)Waiting time/lists – hospital emergency room (13%)Ease of access – low/not easy/too hard (12%)Number of doctors – not enough (12%)Waiting time/lists – non-emergency medical procedures (6%)Availability of hospital beds (6%)Wait times (non-specific, general) (6%)Chronic diseases – cancer, bronchitis, heart, diabetes, blood

pressure, asthma (5%)

QA1A/QA1B: Now, I am going to ask you some questions about health care in your area – that is, all aspects of the health care system in your area. To begin, what is the most important health care issue facing your community today – That is, what one health care issue should the leaders in your community make their top health care priority? Are there any other important health care issues in your area? [n=602]


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Widespread Support for Improvement Widespread Support for Improvement StrategiesStrategies The majority of LHIN residents say that all improvement strategies are very

important.

QC1A/QC1B: Overall improvement strategies - For each, I would like you to tell me how important it is to you and the members in your household – that is, is it very important, somewhat important, not very important, or not important at all. How important is…? And, of these overall improvement strategies, which ONE – if any – is the MOST important to you? [n=602]

80%

83%

77%

84%15%

21%

18%

16%

0%

2%

0%

1%

1%

0%

0%

0%

Improving the overall accessibility to healthcare services and providers

Improving the overall quality of health care

Ensuring the sustainability of the healthcare system

Increasing the focus on health andwellness promotion and illness prevention

Very important Somewhat important Not very important Not important at all 100%

Important

99%

99%

98%

97%


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Ranking of Key Priority AreasRanking of Key Priority AreasPrimary Tier: Access and Overall QualityPrimary Tier: Access and Overall QualitySecondary Tier: Wellness, Tertiary Tier: Secondary Tier: Wellness, Tertiary Tier: SustainabilitySustainability Half of residents in Dufferin and Ovile say that improving the overall accessibility

to health care services and providers in the most important strategy (46%). Two in five residents of Vaughn and Woodbridge say that improving the overall

quality of health care is the most important (38%), as do two in five LHIN residents who are between 18 and 34 years old (38%).

One in five LHIN residents who are 65 years old and over say that ensuring the sustainability of the health care system is key (22%).

27%

15%

12%

37%Improving the overall accessibility to healthcare services and providers

Improving the overall quality of health care

Increasing the focus on health and wellnesspromotion and illness prevention

Ensuring the sustainability of the health caresystem

QC1B: And, of the following 4 overall priority areas, which ONE – if any – is the MOST important to you? [n=602]


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Importance of Specific Health Care Importance of Specific Health Care Services HighServices High The majority of LHIN residents say that all health care services are very

important.

QC1C/QC1D: And now, I am going to read you some specific health care services. For each, I would like you to tell me how important it is to you and the members in your household – that is, is it very important, somewhat important, not very important, or not important at all. How important is …? And, of these specific health care services, which ONE – if any – is the MOST important to you? [n=602]

31%

6%

7%

12%

68%

80%

83%

60%

81%

70%

50%

22%

20%

17%

31%

17%

15%

2%

5%

3%

2%

5%

3%

1%

2%

0%

0%

1%

Primary health care services – that is, the first point-of-contact for your everyday health care needs

Health care for senior citizens

Rehabilitation services after an injury or surgery or anillness like a stroke

Palliative or end-of-life health care services and support

Health care for new mothers and their children

Health care for people with mental health issues

Health care for people with addictions

Very important Somew hat important Not very important Not important at all 100%

Important

81%

90%

91%

92%

97%

98%

98%


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No Missing Priority AreasNo Missing Priority Areas

After discussing health care and the LHIN priorities, there was no consensus re: any missing priorities. Indeed 53% responded “No/Nothing” and the remainder mentioned issues addressed by the LHIN’s key priorities tests. Interestingly, a small percentage of residents said that there was a lack of integration in the system.

Availability of family doctors – not enough (8%)Ease of access – low/not easy/too hard (5%)Waiting time/lists – hospital emergency room (4%)Number of doctors – not enough (3%)Public education/prevention/health promotion/ wellness initiatives

(3%)Waiting time/lists – non emergency medical procedures (3%)Affordability – high cost of health/medical care (3%) Inefficiency/lack of integration in the system (3%)No/Nothing (53%)

QC2A/QC2B. Thinking about all of these priority areas – both the improvement strategies and the services – is there any aspect or service of the health care system that is missing from these lists that your LHIN should focus on? If so, what one additional priority area – that has not been mentioned already – would be most important to you and your household? Is there anything else? [n=602]


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Indicators of Success In Line With Priority Indicators of Success In Line With Priority Areas Areas Top Indicators: More Family Doctors (13%), Top Indicators: More Family Doctors (13%), Better Access (13%), Health and Wellness Better Access (13%), Health and Wellness Promotion (13%)Promotion (13%) LHIN residents report a number of accomplishments and initiatives

that that they would have to hear about in order to consider the Central West LHIN to be on the right track to improving health care, such as…

More family doctors (13%)More public education/prevention/health promotion/wellness

initiatives (13%)Better access – general (13%)More information on health system to public (8%)More specialty care near my home/community – general (6%)More efficiency/integration in the system (6%)Better quality of health care (5%)

QC4A/QC4B: Ultimately, your LHIN’s vision is to foster a health care system in your area that will help keep people healthy, will get them good care when they are sick, and will be there for their children and grandchildren. Thinking about this, what would be the one LHIN accomplishment or initiative that you would have to hear about in order to consider your LHIN to be on the right track to improving health care in your area? Is there anything else? [n=602]

Public Public Engagement Engagement and Demandsand Demands


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Public EngagementPublic EngagementOver Nine in Ten Patients Want to be Involved in Over Nine in Ten Patients Want to be Involved in Health Care Planning & DecisionsHealth Care Planning & Decisions

QC3: Now, I am going to read you a few statements. For each, please tell me if you strongly agree, somewhat agree, somewhat disagree, or strongly disagree with it. How about… “Patients should have an active, empowered role in making decisions about their own health care.”, “My LHIN should communicate information to me about its health care integration plans for my community.”, “My LHIN should collaborate with the public and with health care providers about the decisions and plans it makes about health care services in my community.” [n=602]

100%

Agree

64%

66%

68% 29%

30%

29%

1%

4%

3%

0%

1%

2%

LHIN shouldcollaborate with

public andproviders

Patients shouldhave an active

role

LHIN shouldcommunicate

plans

Strongly agree Somewhat agree Somewhat disagree Strongly disagree

97%

95%

94%


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System Demands and ExpectationsSystem Demands and ExpectationsHigh, Strong Support for Integration of Health High, Strong Support for Integration of Health Care ServicesCare Services Weaker Support for Traveling to Receive Health Weaker Support for Traveling to Receive Health Care (78%)Care (78%)

QC3: Now, I am going to read you a few statements. For each, please tell me if you strongly agree, somewhat agree, somewhat disagree, or strongly disagree with it. How about… “I would prefer that it be possible for me to get all of the health care services that I need within my own region, rather than travelling to other regions of the province.”, “I approve of having to travel outside my region to get specialty health care services, but no further than to Toronto or Mississauga or a neighbouring Region.”, “The health care system should provide care through teams of primary health care providers – including doctors, nurses, nurse practitioners, dieticians, pharmacists, counselors and others – so that the most appropriate care is provided by the most appropriate provider.” [n=602]

100%

Agree

45%

77%

78%21%

33%

19%

1%

9%

2%

11%

0%

1%

Should provide care through teams

Get all health care services withingmy own region

Prefer to travle not further thanToronto, Mississauga, neighbouring

region

Strongly agree Somewhat agree Somewhat disagree Strongly disagree

99%

96%

78%


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System Demands and ExpectationsSystem Demands and ExpectationsSystem Should Help People Manage Complicated System Should Help People Manage Complicated Health Conditions (96%) with a Focus on Health Conditions (96%) with a Focus on Wellness (91%)Wellness (91%)

QC3: Now, I am going to read you a few statements. For each, please tell me if you strongly agree, somewhat agree, somewhat disagree, or strongly disagree with it. How about… “The health care system should shift its focus from illness to wellness, and put more emphasis on promoting healthier lifestyles and preventing illness and injury.”, “The health care system should help people manage their complicated health conditions like diabetes or heart disease, instead of just treating the effects of these health conditions.” [n=602]

59%

75%21%

32%

3%

6%

1%

3%

Managecomplicated

health conditions

Shift focus fromillness to wellness

Strongly agree Somewhat agree Somewhat disagree Strongly disagree 100%

Agree

96%

91%

CommunicationCommunicationss


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Positive Impression of Tagline: 85% Positive Impression of Tagline: 85%

Nine in ten LHIN residents between the ages of 18 to 34 years old have a positive impression of the tag line (93%).

QC5: Now, your LHIN – the Central West LHIN – will use a tagline or slogan in its documents, brochures, and other materials to quickly describe and explain its main goal as an organization. This tagline is “IT’S ABOUT YOU AND YOUR HEALTH”. Thinking about this, do you have a very positive, somewhat positive, somewhat negative, or very negative impression of this tagline or slogan? [n=602]

59%

7%4%

26%

Very positive Somewhatpositive

Somewhatnegative

Very negative

85% Positive


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Information Sources About Local Health Information Sources About Local Health CareCarePrimarily, Doctor (30%), Newspaper (30%)Primarily, Doctor (30%), Newspaper (30%) LHIN residents list a number of sources for information about health

care services or facilities in their community, such as…

Word-of-mouth – doctor (30%)Newspaper – general (30%)Television – general (16%) Internet/Web – general (12%)Newspaper – local (12%)Word-of-mouth – friends/family (8%)Word-of-mouth – health care professional (7%)Word-of-mouth – general (6%)Radio – general (5%)Television –news/discussion (5%)

QD1A/QD1B: What is your MAIN source for information about health care services or facilities in your community? Is there anything else? [n=602]


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Preferred Method of CommunicationPreferred Method of CommunicationPrimarily, Primarily, Mail (39%)Mail (39%)Also, Local Newspaper (23%), Brochures (20%)Also, Local Newspaper (23%), Brochures (20%)

Half of residents of Mississauga and Halton (54%), and of Vaughn and Woodbridge (52%) prefer to receive information about their LHIN in the mail.

One third of residents of Dufferin and Orangeville prefer to receive information via their local newspaper (36%).

One third of residents of Etobicoke and Rexdale prefer to receive information in brochures (30%).

QD2: And, of the following, what method would you MOST prefer that your LHIN use to communicate such information to you? Would it be … [n=602]

23%

20%

7%

5%

39%Information mailed directly to your home

Information or advertising in your localcommunity newspaper

Brochures available at local healthproviders, like your doctor, hospitals,

clinics, and pharmacies

On the LHIN website

Advertising on radio

central west lhin catchment consultation study wave 1 september 2006

Documents

catchment residents

local health care system

health care services

half of residents

aware of lhins

aware of changes

moderate confidence

regional quota regime