Toronto Central LHIN Equity Initiatives in 2010-2013 IHSP

Delivering High-Value Local Health Care Through Collaborative Action

• Go to Toronto Central LHIN website
• See the Toronto Central LHIN 2010-2013 IHSP
• See a snapshot from Toronto Central LHIN’s previous IHSP

Inequities in access to care persist in the TC LHIN, and patients and their families are not always well-served by the system, which can feel disorganized, impersonal and fragmented.

• The TC LHIN launched a project to create Hospital Health Equity Plans which was part of the LHIN’s commitment to ensuring that everyone in the local area has access to timely and quality care
• Achieving health equity in the TC LHIN is an objective that guides and cuts across all the priorities in IHSP-2 (p.36)

A Shared Vision for a Health System that All Ontarians Can Count On

• TC LHIN envisions an equitable and value-rich system that makes the best use of health care dollars — regardless of race, income, age, education, sexual orientation and language, every person in the Toronto Central LHIN will have timely access to the high-quality health care options they require, leading to more equitable health outcomes. (p.8)
• At the same time, those with the most serious and complex conditions will receive the extra support that they need

Translating the Vision into Strategy

• There are 4 overall dimensions of value that the TC LHIN must deliver to the people it serves:
  1. improved health
  2. timely access to care and service
  3. trust and confidence in the system
  4. equity in access and outcomes
• Changes required to reduce ER wait times and ALC (Alternate Level of Care) days will promote equitable access to care by targeting improvements so that those who are most vulnerable and sick get timely access to the care that they need

Making Diabetes a Strategic Priority

• Making diabetes a strategic priority will enhance health equity because diabetes disproportionately affects: visible minorities, low-income groups and marginalized populations in the TC LHIN
• So far, TC LHIN has identified service gaps and inequities in access by creating a map of diabetes services and diabetes rates in the LHIN

Mental Health and Addictions

• Addressing mental health and addictions will also improve health equity by ensuring that at-risk clients get the help that they need

The IHSP-2 Priorities are Enabled by two key factors: Health Equity and eHealth

Health Equity

• Evidence shows that, on average, individuals who are poor, have language barriers and are newcomers to Canada do not receive the same access to health care as the general population; more vulnerable populations experience poorer health than the average
• Health equity is of particular concern to the Toronto Central LHIN, where the range and diversity of incomes, languages, education and other cultural and socio-economic factors have led to disparities in access to service and in health outcomes (p.23)
• Each of the 5 priorities in the plan – reducing ER wait times; reducing ALC days; improving the prevention, management and treatment of diabetes; improving the prevention, management and treatment of mental illness and addiction and improving the value and affordability of health services – is intended to ensure that everyone has the same access to services and community-based options

Equity Initiatives

4 overall initiatives have been prioritized to improve health equity over the next 3 years (pp. 23-24)

1. Develop and implement a LHIN-wide language and interpretation model to set standards, achieve consistency and improve access to supports for non-English-speaking patients
2. Build obligations to promote health equity into accountability agreements starting with Hospital Service Accountability Agreements and extending to other sectors in future years
3. Identify a common set of hospital and system-level data critical to developing and evaluating strategies to address health inequities (the LHIN will also begin to collect health equity data and information related to the 5 IHSP priorities)
4. Introduce the Health Equity  Impact Assessment Tool – developed by MOHLTC and the TC LHIN – into health service provider and LHIN planning and decision-making, starting with Aging-at-Home in 2011/12

Enablers and other Supporting Action

2010/11

• Launch interpretation project
• Incorporate health equity obligations in hospital accountability agreements
• Confirm what equity indicators should be tracked to inform progress on IHSP-2 priorities

2011/12

• Expand reach of interpretation project
• Begin to track and report on health equity indicators
• Initiate use of Health Equity Impact Assessment Tool for decision-making

2012/13

• Shared service for LHIN-wide interpretation fully in place
• Health equity plans in place for community agencies and health equity obligations incorporated into all accountability agreements
• Information available to gauge the impact of IHSP-2 priorities on vulnerable populations