Guest Blogger Lauren Heinken, Student Occupational Therapist
Recently we reviewed the book Better Now: Six Big Ideas to Improve Healthcare for All Canadians, written by Dr. Danielle Martin. While the book is excellent, it did omit to include how Occupational Therapy (OT) services may impact Canada’s Healthcare system, and this blog will fill this gap. I believe that an increase in OHIP funded OT services has the potential to have a positive economic impact on the healthcare system as a whole. This is mainly due to OT being a proactive form of therapy that may help in preventing individuals from requiring more reactive forms of care following an acute bout of illness/injury.
An aging population has the potential to place strain on our healthcare system; however, this can be minimized through strategies that: decrease the number of episodes of acute illness/injury experienced by this population, and improve the management of the chronic conditions they face. These strategies require that a proactive approach to healthcare be undertaken. OTs are well positioned to provide preventative care due to their focus on helping individuals find ways to safely engage in their daily occupations despite limitations that they may have. The OT focus on helping clients to maintain independence and through empowering clients to be accountable for the management of their own health aligns well with a preventative approach. So why does OHIP coverage (and even private coverage) for OT services remain so limited? By limiting the number of individuals who can access these services, aren’t we missing out on an opportunity to reduce costs to the healthcare system in the future?
The answers to these questions lie in the fact that our healthcare system remains highly focused on reactive care. It is no secret that Canada’s healthcare system is much more effective in providing urgent and acute medical services than it is in providing services to those with health conditions that cause functional decline, but not to the point of being imminently life-threatening. Although having these acute services is essential, making cutbacks to services that have the potential to reduce these acute events, is shortsighted. Because acute medical services are necessary, increasing funding for preventative services will initially result in an increased cost to the system. However, as these preventative services become utilized it can be expected that acute costs will decrease to a greater extent than the cost of preventative services in the first place. This is especially true if these services can be administered in a group setting, and OTs are trained to provide educational self-management interventions in this manner.
OTs are also well positioned to provide transitional services that can help to bridge the gaps between care settings, for example when transitioning from acute hospital care to the care received afterwards in the community. Problems can arise during this transition especially if information is not communicated effectively between care sources. This can lead to hospital readmissions and complications in the recovery process, which lead to further healthcare costs. OTs can be effective coordinators and can help to arrange the necessary community care following the acute phase of recovery in the hospital. OT’s understand the demands required for someone to perform their daily living activities at home and are uniquely positioned to assess if returning to these activities is possible, or what assistance might be needed. If patients are given the appropriate assistance during their recovery process, their health outcomes will naturally be more positive. Additionally, since occupational therapists are trained to address all factors that can influence a person’s well being, they are more likely to pick up on additional challenges an individual may face when returning home post hospitalization. Maybe their home environment is poorly suited to their current needs, or maybe they have little social support available to them; whatever the situation, OTs know how best to solve these problems.
Considering the role OT’s can play in improving the lives of Canadians, and in reducing long term costs, as a profession they need to continue to advocate for their services, particularly those that may be considered preventative in nature. Outcome studies do exist that showcase how OT reduces costs and prevents re-institutionalization. This is the data we need, combined with qualitative case studies and stories of client experiences, to promote change. But in the end, it is a paradigm shift that is required in the minds of all Canadians – the “it won’t happen to me” needs to become “it is happening to me and I need help” before people will be able to reshape their activities and get the support and answers required to result in more positive health outcomes.