Choosing Wisely Canada ( CWC ) is a Canadian-based health education campaign launched on April 2, 2014 under the leadership of Wendy Levinson , in partnership with the Canadian Medical Association , and based at Unity Health Toronto and the University of Toronto . The campaign aims to help clinicians and patients engage in conversations about unnecessary tests, treatments and procedures , and to assist physicians and patients in making informed and effective choices to ensure high quality care.
172-604: The campaign is based on the notion that unnecessary tests, treatments, and procedures often do more harm than good, resulting in poor clinical outcomes and significant waste in the Canadian healthcare system . These unnecessary tests and procedures take away from care by potentially exposing patients to harm, leading to more testing to investigate false positive tests , and contributing to unnecessary anxiety and avoidable costs for patients. Choosing Wisely Canada aims to encourage and empower physicians to assimilate, evaluate, and implement
344-583: A Jesuit seminary, entered federation with the university in 1979. In contrast with the constituent colleges, the colleges of Knox, Massey, Regis, St. Michael's, Trinity, Victoria and Wycliffe continue to exist as legally distinct entities, each possessing a separate financial endowment . While St. Michael's, Trinity and Victoria continue to recognize their religious affiliations and heritage, they have since adopted secular policies of enrolment and teaching in non-divinity subjects. Some colleges have, or once had, collegiate structures of their own: Emmanuel College
516-527: A low church seminary, both encouraged their students to study for non-divinity degrees at University College. In 1885, they entered a formal affiliation with the University of Toronto, and became federated schools in 1890. The idea of federation initially met strong opposition at Victoria University , a Methodist school in Cobourg , but a financial incentive in 1890 convinced the school to join. Decades after
688-629: A "When you need them and when you don't" approach. These materials complement the lists of "Five Things Physicians and Patients Should Question" developed by specialty societies. The response to Choosing Wisely Canada has been positive, with clinicians across the country expressing support for the campaign and highlighting the need for more resource stewardship. Danielle Martin , family physician and Vice-President Medical Affairs and Health Systems Solutions at Women's College Hospital , lists Choosing Wisely Canada as one of three major ideas to improve Canadian healthcare, highlighting that "Choosing Wisely Canada
860-400: A "national seniors strategy to address needs along the full continuum of care." The government guarantees the quality of care through federal standards. The government does not participate in day-to-day care or collect any information about an individual's health, which remains confidential between a person and their physician. In each province, each doctor handles the insurance claim against
1032-952: A "think twice" attitude to avoid unnecessary and potentially harmful tests and procedures, and to foster discussions between patients and clinicians about inappropriate care. The campaign also uses patient-friendly education materials to complement these lists, as well as teaches medical trainees about resource stewardship. As of June 2, 2021, 400 clinician recommendations and 39 lay language patient educational materials have been released. Choosing Wisely Canada leads an international community, made up of nations who are implementing similar programs in their respective countries. At present, this community includes representation from Australia , Austria , Brazil , Denmark , England , France , Germany , India , Israel , Italy , Japan , Netherlands , New Zealand , South Korea , Switzerland , United States and Wales . Choosing Wisely Canada stems from worldwide concern around providing unnecessary treatment when
1204-460: A CBC report, some police forces "offer benefits plans that cover only a handful of sessions with community psychologists, forcing those seeking help to join lengthy waiting lists to seek free psychiatric assistance." Among the OECD countries, Canada ranks second to last in the public funding of oral healthcare . Those who need dental care are usually responsible for the finances and some may benefit from
1376-535: A college be established in York. On March 15, 1827, a royal charter was formally issued by King George IV , proclaiming "from this time one College, with the style and privileges of a University ... for the education of youth in the principles of the Christian Religion , and for their instruction in the various branches of Science and Literature ... to continue for ever, to be called King's College." The granting of
1548-600: A dramatic renaissance after the 2003 SARS crisis, and it is now Canada's largest public health school, with more than 750 faculty, 800 students, and research and training partnerships with institutions throughout Toronto and the world. With more than $ 39 million in research funding per year, the School supports discovery in global health, tobacco impacts on health , occupational disease and disability, air pollution, inner city health, circumpolar health, and many other pressing issues in population health. The Temerty Faculty of Medicine
1720-525: A hospital" by providing cash to provinces and territories through the Canada Health Transfer (CHT) based on their fulfilling certain "criteria and conditions related to insured health services and extended health care services." In his widely cited 1987 book, Malcolm G. Taylor traced the roots of Medicare and federal-provincial negotiations involving "issues of jurisdiction, cost allocations, revenue transfers, and taxing authorities" that resulted in
1892-565: A limited range of prescriptions. No premiums are charged. A deductible and out-of-pocket maximum for copayments are set as a percentage of taxable income of two years before. Pharmaceutical medications are covered by public funds in some provinces for the elderly or indigent, through employment-based private insurance or paid for out-of-pocket. In Ontario, eligible medications are provided at no cost for covered individuals aged 24 and under. Most drug prices are negotiated with suppliers by each provincial government to control costs but more recently,
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#17330858110172064-516: A model that resembles those of the University of Cambridge and the University of Oxford in Britain. The colleges hold substantial autonomy over admissions, scholarships, programs and other academic and financial affairs, in addition to the housing and social duties of typical residential colleges . The system emerged in the 19th century, as ecclesiastical colleges considered various forms of union with
2236-429: A national movement. The second and third waves of physician recommendation lists and patient education materials were launched on October 29, 2014, and June 2, 2015, respectively. As of June 2, 2015, more than 80 Canadian medical specialty societies are engaged and at various stages of recommendations development. In total, 400 clinician recommendations and 39 lay language patient educational materials have been released in
2408-525: A new hospital. Charities such as the Canadian Cancer Society provide assistance such as transportation for patients. There are no deductibles on basic health care and co-pays are extremely low or non-existent (supplemental insurance such as Fair Pharmacare may have deductibles, depending on income). In general, user fees are not permitted by the Canada Health Act , but physicians may charge
2580-745: A number of challenges which could potentially undermine the efforts of Choosing Wisely Canada. Since reducing unnecessary tests and procedures may result in lowering healthcare costs, the campaign may be viewed as a cost-cutting or rationing measure , which could in turn "undermine both physician engagement and patient trust." Consequently, the campaign is centered around patient safety with particular emphasis on quality of care. Furthermore, Choosing Wisely Canada recommendations do not determine payment for individual services. Some physicians report feeling pressure to engage in defensive medicine (e.g., ordering more tests than necessary) because they feel that it will help them avoid litigation. The Canadian healthcare system
2752-559: A passive privatization." University of Toronto The University of Toronto ( UToronto or U of T ) is a public research university in Toronto , Ontario , Canada, located on the grounds that surround Queen's Park . It was founded by royal charter in 1827 as King's College , the first institution of higher learning in Upper Canada . Originally controlled by the Church of England ,
2924-872: A population of approximately 34 million. This significantly influences Canada's healthcare services; by 2019, Canada's aging population represented a modest increase in healthcare costs of about 1% a year. Since the 2010s, Statistics Canada health research on aging has focused on "chronic diseases," "social isolation" and senior's mental health needs, and "transitions to institutional care" including long-term care. The eight chronic conditions that are prevalent in one out of ten seniors include high blood pressure, arthritis, back problems, eye problems, heart disease, osteoporosis, diabetes and urinary incontinence, with many seniors having multiple chronic conditions . Those with chronic conditions are "associated with higher use of home-care services and need for formal-care providers." Ninety percent of Canadians agree that Canada should have
3096-755: A range of services and facilities, including a library, restaurants, barbershops, an art gallery, a theatre, concerts, debates, study spaces, and a swimming pool. The confluence of assorted functions is the result of an effort to create a holistic educational experience, a goal summarized in the Founders' Prayer. The Hart House model was influential in the planning of student centres at other universities, notably Cornell University 's Willard Straight Hall . Hart House resembles some traditional aspects of student representation through its financial support of student clubs, and its standing committees and board of stewards that are composed mostly of undergraduate students. However,
3268-470: A set number of visits to the optometrist and dentist, with a limited amount of coverage for glasses, eye exams, fillings, root canals, etc. For the most part, First Nations people use normal hospitals and the federal government then fully compensates the provincial government for the expense. The federal government also covers any user fees the province charges. The federal government maintains a network of clinics and health centers on First Nations reserves . At
3440-577: A small fee to the patient for reasons such as missed appointments, doctor's notes, and prescription refills done over the phone. Some physicians charge "annual fees" as part of a comprehensive package of services they offer their patients and their families. Legally, such charges must be completely optional and can only be for non-essential health options, however, some clinics have allegedly broken these rules, and provincial agencies have pursued injunctions and investigations. Health cards are issued by provincial health ministries to individuals who enroll for
3612-401: A specialist or is counseled to see a specialist by their GP, a referral is made by a GP in the local community. Preventive care and early detection are considered critical. The Canada Health Act covers the services of psychiatrists , medical doctors with additional training in psychiatry . In Canada, psychiatrists tend to focus on the treatment of mental illness with medication. However,
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#17330858110173784-463: Is a ceremonial boulevard and arterial thoroughfare that runs through downtown between Queen's Park and Front Street . The Spadina , St. George , Museum , Queen's Park , and St. Patrick stations of the Toronto subway system are nearby. The architecture is epitomized by a combination of Romanesque and Gothic Revival buildings spread across the eastern and central portions of campus, most dating between 1858 and 1929. The traditional heart of
3956-564: Is a college of Victoria and St. Hilda's College is part of Trinity; St. Joseph's College had existed as a college within St. Michael's until it was dissolved in 2006. Ewart College existed as an affiliated college until 1991, when it was merged into Knox College. Postgraduate theology degrees are conferred by the colleges of Knox, Regis and Wycliffe, along with the divinity faculties within Emmanuel, St. Michael's and Trinity, including joint degrees with
4128-559: Is a core facet of the campaign, communication with patients presents another challenge. Some campaign recommendations may require clinical education for complete comprehension. Furthermore, many patients tend to follow physician recommendations without question, even if they have questions. As such, a major portion of the campaign focuses on encouraging patients to initiate conversations about unnecessary care. Additionally, Choosing Wisely Canada has developed patient-friendly materials with straightforward, lay language to explain common tests, with
4300-408: Is affiliated with a network of ten teaching hospitals , providing medical treatment, research and advisory services to patients and clients from Canada and abroad. A core member of the network is University Health Network , itself a specialized federation of Toronto General Hospital , Princess Margaret Cancer Centre , Toronto Western Hospital , and Toronto Rehabilitation Institute . Physicians in
4472-443: Is also set up so that specialty physicians get paid for tests and procedures conducted, and not for practicing conservative medicine. Such a system may create a pattern for physicians to recommend more treatment. This pattern may also contribute to unwilling of physicians to put recommendations on their lists pertaining specifically to their specialty, instead focusing their recommendations on overuse by other specialties. Evaluation of
4644-676: Is an early example of the North American student centre , simultaneously serving cultural, intellectual, and recreational interests within its large Gothic-revival complex. University of Toronto alumni include five Prime Ministers of Canada (including William Lyon Mackenzie King and Lester B. Pearson ), three Governors General of Canada , nine foreign leaders, and 17 justices of the Supreme Court of Canada . As of 2024 , 13 Nobel laureates , six Turing Award winners, 100 Rhodes Scholars , and one Fields Medalist have been affiliated with
4816-405: Is felt through numerous physician and patient awareness campaigns conducted at the hospital. Medical education efforts of CWC are currently centered at the University of Toronto , where Choosing Wisely principles are integrated into the undergraduate and postgraduate medical curricula through Problem-Based Learning seminars, lectures, resident research projects and academic half days. Following
4988-568: Is guided by the provisions of the Canada Health Act of 1984, and is universal . The 2002 Royal Commission , known as the Romanow Report, revealed that Canadians consider universal access to publicly funded health services as a "fundamental value that ensures national health care insurance for everyone wherever they live in the country". Canadian Medicare provides coverage for approximately 70 percent of Canadians' healthcare needs, and
5160-420: Is hosting the annual convocation ceremonies, the building is a venue for academic and social events throughout the year. The sandstone buildings of Knox College epitomizes the North American collegiate Gothic design, with its characteristic cloisters surrounding a secluded courtyard. A lawn at the northeast is anchored by Hart House , a Gothic-revival student centre complex. Among its many common rooms,
5332-548: Is household income, employment, as well as education. Those individuals who are in the middle class may be covered through the benefits of their employment whereas older individuals may not due to the fact of retirement. Under the government healthcare system in Canada, routine dental care is not covered. There are a couple of provinces that offer child prevention programs such as Nova Scotia and Quebec. Other provinces make patients pay for medical dental procedures that are performed in
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5504-752: Is modeled after the Choosing Wisely campaign launched by the ABIM Foundation of the American Board of Internal Medicine in the United States in 2012. Wendy Levinson , a Canadian physician and previous chair of the ABIM Board of Directors, was involved in launching the Choosing Wisely campaign in the United States. After its successful launch, she decided to bring the movement to Canada and partnered with
5676-473: Is not a rationing or cost-cutting exercising. It is about reorganizing healthcare services so we only do things for people that truly benefit their health." Chris Simpson , past president of the Canadian Medical Association, Professor of Medicine and Chief of Cardiology at Queen's University , Kingston , notes "Physicians are really embracing the principles behind Choosing Wisely. It's all about
5848-515: Is not affected by loss or change of jobs, cannot be denied due to unpaid premiums, and is not subject to lifetime limits or exclusions for pre-existing conditions. The Canada Health Act deems that essential physician and hospital care be covered by the publicly funded system, but each province has reasons to determine what is considered essential, and where, how and who should provide the services. There are some provinces that are moving towards private health care away from public health care. The result
6020-630: Is particularly complex, since "the definition of appropriateness often includes knowing about symptoms and physical exam findings often not included in electronic health records and administrative databases". Recognizing the complexity of evaluation efforts, Choosing Wisely Canada along with other international Choosing Wisely movements is working with the Organization for Economic Co-operation and Development to develop metrics that might be used to compare countries on specific measures of overuse, as well to develop cross-country metrics. Since patient education
6192-625: Is supported by different levels of government depending on the group insured." It is true that compared to primary care checkups, dental care checkups depend on the ability of people being able to pay those fees. Studies in Quebec and Ontario provide data on the extent of dental health care. For example, studies in Quebec showed that there was a strong relation among dental services and the socioeconomic factors of income and education whereas in Ontario older adults heavily relied on dental insurance with visits to
6364-441: Is that clinicians must lead such conversations, since they determine the appropriate or inappropriate use of resources. CWC has also developed complementary patient-friendly education materials, and has begun to embed lessons focusing on resource stewardship in undergraduate and postgraduate medical curricula. In order to unify grassroots projects occurring across Canada to implement clinician recommendations, CWC additionally developed
6536-507: Is that there is a wide variance in what is covered across the country by the public health system, particularly in more controversial or expensive areas, such as mental health, substance use treatment, in-vitro fertilization , gender-affirming surgery , or autism treatments. Canada (with the exception of the province of Quebec ) is one of the few countries with a universal healthcare system that does not include coverage of prescription medication (other such countries are Russia and some of
6708-502: Is the massive Robarts Library complex, built in 1972 and opened a year later in 1973. It features raised podia, extensive use of triangular geometric designs and a towering 14-storey concrete structure that cantilevers above a field of open space and mature trees. Sidney Smith Hall is the home to the Faculty of Arts and Science, as well as a few departments within the faculty. The Leslie L. Dan Pharmacy Building , completed in 2006, exhibits
6880-899: Is working with Canadian medical schools to introduce new content focussing on resource stewardship into the undergraduate, postgraduate and continuing medical education curricula. On the media front, the campaign includes partnerships with patient organizations and media outlets to develop and disseminate complementary content to increase patient awareness, and to support them in conversations surrounding inappropriate care. Choosing Wisely Canada recommendations range from avoiding overuse of broad practices such as unnecessary and potentially harmful screening, diagnostic and radiographic services, to specific tests which are not supported by evidence to improve patient outcomes. Examples of recommendations which advise against overuse of broad practices include: Examples of specific low-value tests to avoid in certain circumstances include: Campaign leaders have identified
7052-744: The Advisory Panel on Healthcare Innovation to Rona Ambrose , Minister of Health (Canada) , saluted Choosing Wisely Canada "as an innovative physician-led and patient-centered approach that has the potential to shift healthcare away from a culture of consumption to a focus on appropriateness and quality of care". Furthermore, the panel urged "governments to support the implementation of [Choosing Wisely Canada] in all jurisdictions and to carefully evaluate its impact". In addition to endorsements from eminent physician leaders and professional organizations, Choosing Wisely Canada received positive media coverage in national media sources, including The Globe and Mail ,
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7224-625: The Canada Health Act excludes care provided in a "hospital or institution primarily for the mentally disordered." Some institutional care is provided by provinces. The Canada Health Act does not cover treatment by a psychologist or psychotherapist unless the practitioner is also a medical doctor. Goods and Services Tax or Harmonized Sales Tax (depending on the province) applies to the services of psychotherapists. Some coverage for mental health care and substance abuse treatment may be available under other government programs. For example, in Alberta,
7396-764: The Canadian Broadcasting Corporation , and the Toronto Star , which heralded Choosing Wisely Canada as one of the top medical breakthroughs of the year. On the other hand, early criticism of Choosing Wisely in the United States highlighted that some specialty recommendations addressed overuse of resources by primary care specialties, instead of addressing unnecessary tests and procedures conducted by their own specialty colleagues. Choosing Wisely Canada responded to such criticisms by setting guidelines for its list development, which required recommendations put forward by specialty societies to pertain specifically to
7568-674: The Canadian Institute for Health Information (CIHI), by 2019, Canada's aging population represents an increase in healthcare costs of approximately one percent a year, which is a modest increase. In a 2020 Statistics Canada Canadian Perspectives Survey Series (CPSS), 69 percent of Canadians self-reported that they had excellent or very good physical health—an improvement from 60 percent in 2018. In 2019, 80 percent of Canadian adults self-reported having at least one major risk factor for chronic disease: smoking , physical inactivity, unhealthy eating or excessive alcohol use. Canada has one of
7740-416: The Canadian Institute for Health Information reported that healthcare spending is expected to reach $ 242 billion, or 11.5% of Canada's gross domestic product for that year. The provinces and territories health spending accounted for approximately "64.2% of total health expenditure" in 2018. Public sources of revenue for the public healthcare system include provincial financing which represented 64.2% of
7912-603: The Canadian Institutes of Health Research , the Natural Sciences and Engineering Research Council and the Social Sciences and Humanities Research Council amounting to about one-third of the research budget. About eight per cent of research funding came from corporations, mostly in the healthcare industry . The first practical electron microscope was built by the physics department in 1938. During World War II,
8084-614: The Canadian Medical Association and the University of Toronto to launch Choosing Wisely Canada on April 2, 2014. In the first wave of the campaign, nine national medical specialty societies released evidence-based lists of 41 tests, treatments and procedures that provided no benefit or potentially caused harm to patients. Under the leadership of Wendy Levinson and the Canadian Medical Association, Choosing Wisely Canada initially gained momentum in Ontario and subsequently became
8256-518: The Council of the Federation announced an initiative for select provinces to work together to create a larger buying block for more leverage to control costs of pharmaceutical drugs. More than 60 percent of prescription medications are paid for privately in Canada. Family physicians ("General Practitioners") are assigned to individuals using provincial waitlist registry systems. If a patient wishes to see
8428-554: The Faculty of Medicine from Toronto-based philanthropists James and Louise Temerty . This broke the previous record for the school set in 2019 when Gerry Schwartz and Heather Reisman jointly donated $ 100 million for the creation of a 70,000-square-metre (750,000 sq ft) innovation and artificial intelligence centre. The Faculty of Medicine has been renamed the Temerty Faculty of Medicine in their honour. In December 2021,
8600-804: The Greater Toronto Area , one of the early adopters of the campaign. A multi-faceted campaign was implemented particularly in the hospital Emergency Department in June, 2014. Test utilization in the Emergency Department was analyzed between September 15 and November 21, 2014, and compared to the same 10-week period in 2013 to account for any seasonal variances. The study found a 41% decline in the number of laboratory tests ordered pre- and post- CWC program implementation, without any observable change in outcomes. A preliminary cost analysis revealed annual departmental savings of approximately $ 215,000 while maintaining
8772-690: The Greco-Roman period, and the painting Adam and Eve by Lucas Cranach the Elder , dated from 1538. The University of Toronto Collection features Canadian contemporary art , while the University College Art Collection holds significant works by the Group of Seven and 19th century landscape artists . In the 2022 Academic Ranking of World Universities (also known as the Shanghai Ranking),
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#17330858110178944-700: The Group of Twenty , and the Citizen Lab , which conducts research on Internet censorship as a joint founder of the OpenNet Initiative . The university operates international offices in Berlin, Hong Kong and Siena . The Dalla Lana School of Public Health is a Faculty of the University of Toronto that began as one of the Schools of Hygiene begun by the Rockefeller Foundation in 1927. The School went through
9116-735: The Hart House Debates were suspended, although exhibition and interfaculty games were still held. The David Dunlap Observatory in Richmond Hill opened in 1935, followed by the University of Toronto Institute for Aerospace Studies in 1949. By the 1961–62 academic year, the university had a total enrolment of 14,302 students, including 1,531 graduate students. The university opened suburban campuses in Scarborough in 1964 and in Mississauga in 1967. The university's former affiliated schools at
9288-512: The Ontario Agricultural College and Glendon Hall became fully independent of the University of Toronto and became part of University of Guelph in 1964 and York University in 1965, respectively. Beginning in the 1980s, reductions in government funding prompted more rigorous fundraising efforts. In 2000, geophysicist Kin-Yip Chun was reinstated as a professor of the university, after he launched an unsuccessful lawsuit against
9460-517: The Rotman School of Management . The Faculty of Applied Science and Engineering is the other major direct-entry undergraduate faculty. The University of Toronto is the birthplace of an influential school of thought on communication theory and literary criticism known as the Toronto School . Described as "the theory of the primacy of communication in the structuring of human cultures and
9632-653: The Spanish Civil War , the history of science and medicine , Canadiana and the history of books . The Cheng Yu Tung East Asian Library has a rare 40,000-volume Chinese collection from the Song Dynasty (960–1279) to the Qing Dynasty (1644–1911) that was originally held by scholar Mu Xuexun (1880–1929). The Richard Charles Lee Canada-Hong Kong Library has the largest research collection for Hong Kong and Canada–Hong Kong studies outside of Hong Kong. The rest of
9804-444: The high-tech architectural style of glass and steel by British architect Norman Foster . The University of Toronto has traditionally been a decentralized institution, with governing authority shared among its central administration, academic faculties and colleges. The Governing Council is the unicameral legislative organ of the central administration, overseeing general academic, business and institutional affairs. Before 1971,
9976-599: The British colonial elite, known as the Family Compact . Reformist politicians opposed the clergy's control over colonial institutions and fought to have the college secularized . In 1849, after a lengthy and heated debate, the newly elected responsible government of the Province of Canada voted to rename King's College as the University of Toronto and severed the school's ties with the church. Having anticipated this decision,
10148-661: The British use of wit . Smaller debating societies at Trinity, University and Victoria College have served as initial training grounds for debaters who later progress to Hart House. The club won the World Universities Debating Championship in 1981 and 2006. The North American Model United Nations (NAMUN) hosts an annual Model United Nations conference on campus, while the United Nations Society participates in various North American and international conferences. The Toronto chess team has captured
10320-731: The CIHI has produced an annual detailed report updating "National Health Expenditure Trends" which includes data tables with the most recent report published in January 2021. Other CIHI research topics include hospital care, organ and joint replacements, health system performance, seniors and aging, health workforce, health inequality, quality and safety, mental health and addictions, pharmaceuticals, international comparisons, emergency care, patient experience, residential care, population health, community care, patient outcomes, access and wait times, children and youth, and First Nations, Inuit and Métis. In 2003, at
10492-650: The CWC campaign at provincial and local levels. Choosing Wisely Canada has regional campaigns in all provinces and territories. At the local level, hospitals, health regions and clinician groups across the country are working under their own initiative to find innovative ways to put the recommendations into practice. Such local implementation efforts are beginning to emerge across Canada, with activities ranging from clinician and patient education, to modifying clinical processes and information systems, to providing data back to providers about their practice patterns. Another major aspect of
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#173308581101710664-599: The Canadian healthcare system has been called a single payer system , Canada "does not have a single health care system" according to a 2018 Library of Parliament report. The provinces and territories provide "publicly funded health care" through provincial and territorial public health insurance systems. The total health expenditure in Canada includes expenditures for those health services not covered by either federal funds or these public insurance systems, that are paid by private insurance or by individuals out-of-pocket. In 2017,
10836-753: The Canadian system is for the most part publicly funded, yet most of the services are provided by private enterprises. In 2006, most doctors do not receive an annual salary, but receive a fee per visit or service. According to Dr. Albert Schumacher, former president of the Canadian Medical Association , an "estimated 75% of Canadian health care services are delivered privately but funded publicly." "Front line practitioners whether they're GP's or specialists, by and large, are not salaried. They're small hardware stores. Same thing with labs and radiology clinics ... The situation we are seeing now are more services around not being funded publicly but people having to pay for them, or their insurance companies. We have sort of
11008-646: The Choosing Wisely campaign published in the Journal of the American Medical Association by Clement and Charlton highlights a number of shortcomings in the overall movement. While the critique commends the campaign for succeeding in its goal of promoting conversations about low-value care, the authors of the critique believed that the process of list development were based on "quasi-systematic methods that focus on physician participation to increase support". The critique additionally called for increased evidence of
11180-650: The Early Adopters Collaborative, which serves as a "learning platform for sharing knowledge, tools and experiences among participating organizations". At the core of the campaign are lists of "Things Clinicians and Patients Should Question" developed by national specialty societies representing a broad spectrum of clinicians. These lists contain tests, treatments or procedures commonly used in their specialty, but which are not supported by evidence, and/or could expose patients to unnecessary harm. List items recommend practices to be avoided and typically begin with
11352-566: The Faculties of Medicine and Pharmacy at the Université de Montréal . The trial recruited more than 300 patients aged 65–95 years in the greater Montréal area who were long term users of benzodiazepines. Approximately half the patients were exposed to educational intervention, which included Choosing Wisely recommendations around excessive benzodiazepine therapy. The patients were then followed for 6 months. The study found that 62% of patients who received
11524-594: The First Ministers' Accord on Health Care Renewal, the Health Council of Canada (HCC)—an independent national agency—was established to monitor and report on Canada's healthcare system. For over a decade, until 2014, the HCC produced 60 reports on access and wait times, health promotion, seniors healthcare, aboriginal healthcare, home and community care, pharmaceuticals management, and primary health care. By February 2024,
11696-525: The Niagara border in 1866. The Corps was part of the Reserve Militia led by professor Henry Croft . Established in 1878, the School of Practical Science was the precursor to the Faculty of Applied Science and Engineering , which has been nicknamed Skule since its earliest days. While the Faculty of Medicine opened in 1843, medical teaching was conducted by proprietary schools from 1853 until 1887 when
11868-477: The OECD . Canada has performed close to the average on the majority of OECD health indicators since the early 2000s, and ranks above average for access to care , but the number of doctors and hospital beds are considerably below the OECD average. The Commonwealth Funds 2021 report comparing the healthcare systems of the 11 most developed countries ranked Canada second-to-last. Identified weaknesses of Canada's system were comparatively higher infant mortality rate,
12040-758: The University of Toronto announced the launch of the Defy Gravity campaign, the largest fundraising campaign in Canadian history, with a goal of raising $ 4 billion for the university. The university grounds lie about 2 kilometres (1.2 mi) north of the Financial District in Downtown Toronto , immediately north of Chinatown and the Discovery District , and immediately south of the neighbourhoods of Yorkville and The Annex . The site encompasses 55.8 hectares (138 acres) bounded mostly by Bay Street to
12212-457: The University of Toronto in 1921 is considered among the most significant events in the history of medicine . The stem cell was discovered at the university in 1963, forming the basis for bone marrow transplantation and all subsequent research on adult and embryonic stem cells . This was the first of many findings at Toronto relating to stem cells, including the identification of pancreatic and retinal stem cells. The cancer stem cell
12384-430: The University of Toronto is Hart House , a neo-Gothic student activity centre that was initiated and financed by alumnus-benefactor Vincent Massey and named for his grandfather Hart . Opened in 1919, the complex aimed to establish a communitarian student culture in the university and its students, who at the time kept largely within their own colleges under the decentralized collegiate system. The Hart House offers
12556-399: The University of Toronto to ensure their viability. The desire to preserve religious traditions in a secular institution resulted in the federative collegiate model that came to characterize the university. University College was the founding nondenominational college, created in 1853 after the university was secularized. Knox College , a Presbyterian institution, and Wycliffe College ,
12728-434: The University of Toronto was named the top research university in Canada by Research Infosource, with a sponsored research income (external sources of funding) of $ 1,234.278 million in 2020. In the same year, the university's faculty averaged a sponsored research income of $ 446,600, while graduate students averaged a sponsored research income of $ 61,000. The federal government was the largest source of funding, with grants from
12900-434: The age of 24 are covered by the Ontario health insurance plan if no private insurance plan is available. Competitive practices such as advertising are kept to a minimum, thus maximizing the percentage of revenues that go directly towards care. Costs are paid through funding from federal and provincial general tax revenues, which include income taxes, sales taxes, and corporate taxes. In British Columbia, taxation-based funding
13072-552: The amount of bed rest required to treat lower back pain, advising that staying in bed longer than 48 hours will not help, and in fact, may actually delay recovery. An editorial was written by Wendy Levinson in The Toronto Star as a part of the weekly feature titled "Doctor's Notes". The article highlighted the Choosing Wisely campaign and encouraged patients to engage in conversations with their physicians about unnecessary care. Healthcare stakeholder groups have mobilized around
13244-518: The building's Great Hall is noted for large stained-glass windows and a long quotation from John Milton 's Areopagitica inscribed around the walls. The adjacent Soldiers' Tower stands 143 feet (44 m) tall as the most prominent structure in the vicinity, its stone arches etched with the names of university members lost to the battlefields of the two World Wars. The tower houses a 51-bell carillon played on special occasions such as Remembrance Day and convocation. North of University College,
13416-552: The buried Taddle Creek , linking with Trinity College, Varsity Arena and the Faculty of Law . Victoria College is on the eastern side of Queen's Park, centred on a Romanesque main building made of contrasting red sandstone and grey limestone. Developed after the Second World War , the western section of the campus consists mainly of modernist and internationalist structures that house laboratories and faculty offices. The most significant example of Brutalist architecture
13588-422: The campaign has also been identified as a major challenge. Campaign leaders concede that measuring the impact of Choosing Wisely is complex and may require multiple approaches, including physician and patient awareness of the campaign, documented curriculum inclusion in medical curricula, and demonstrated reduction in unnecessary testing following campaign efforts. Measuring progress of reduction in inappropriate care
13760-481: The campaign include: The campaign is also endorsed by all the Canadian provincial and territorial medical associations: The national medical organizations endorsing CWC include: Choosing Wisely Canada has also partnered with a number of patient and community groups which include: Canadian healthcare system Healthcare in Canada is delivered through the provincial and territorial systems of publicly funded health care , informally called Medicare . It
13932-441: The campaign is engaging medical trainees at all levels. The Draft 2015 CanMEDS Framework identifies leadership as one of seven essential physician competencies, urging medical professionals to "engage in the stewardship of health care resources", particularly to "allocate health care resources for optimal patient care" and "to apply evidence and management processes to achieve cost-appropriate care". In order to embody these ideals, CWC
14104-408: The campaign that he believes are unique and have great potential. "The first", he states, "is that it's targeted to the public, and the second is that it's driven not only by scientists and medical journals, but by the professional organizations themselves. For radiologists to come forward and say you shouldn't order radiology tests under these circumstances, this is unprecedented". The final report of
14276-491: The care providers could reap great gains in efficiency. Additionally, the study suggested facilitating the exchange of information and interaction between health providers and government figures as well as flexible funding would also contribute to the improvement and solve the problem of differences in regional care by allowing regions to determine the needs of their general populace and meet those needs more efficiently by allowing target-specific allocation of funds. For 24 years,
14448-420: The charter was largely the result of intense lobbying by John Strachan , the influential future first Anglican Bishop of Toronto who took office as the college's first president. The original three-storey Greek Revival school building was built on the present site of Queen's Park . Under Strachan's stewardship, King's College was a religious institution closely aligned with the Church of England and
14620-649: The conditions with which provincial/territorial health insurance plans must comply if they wish to receive their full transfer payments from the federal government. The CHA does not allow charges to insured persons for insured services (defined as medically necessary care provided in hospitals or by physicians). Most provinces have responded through various prohibitions on such payments. Private-sector health care dollars, which has represented about 30% of total health expenditure, "consists primarily of health expenditures by households and private insurance firms". In 2018, private sector funding for health care, accounted for 31% of
14792-502: The country's legal education system away from the apprenticeship model that prevailed until the mid-20th century. The Ontario Institute for Studies in Education is the teachers college of the university, affiliated with its two laboratory schools , the Institute of Child Study and the University of Toronto Schools (a private high school run by the university). Autonomous institutes at
14964-498: The coverage available through employment, under provincial plans, or private dental care plans. "As opposed to its national system of public health insurance, dental care in Canada is almost wholly privately financed, with approximately 60% of dental care paid through employment-based insurance, and 35% through out-of-pocket expenditures. Of the approximately 5% of publicly financed care that remains, most has focused on socially marginalized groups (e.g., low-income children and adults), and
15136-511: The creation of New College in 1962, Innis College in 1964 and Woodsworth College in 1974, all of them nondenominational. Along with University College, they comprise the university's constituent colleges, which are established and funded by the central administration and are therefore financially dependent. Massey College was established in 1963 by the Massey Foundation as a college exclusively for graduate students. Regis College ,
15308-461: The current system that provides healthcare to "Canadians on the basis of need, irrespective of financial circumstances." Health Canada, under the direction of the Health Minister, is the ministry responsible for overseeing Canada's healthcare, including its public policies and implementations. This includes the maintenance and improvement of the health of the Canadian population, which is "among
15480-755: The death of John Strachan, the Anglican seminary Trinity College entered federation in 1904, followed in 1910 by St. Michael's College , a Roman Catholic college founded by the Basilian Fathers . Among the institutions that had considered federation but ultimately remained independent were McMaster University , a Baptist school that later moved to Hamilton , and Queen's College, a Presbyterian school in Kingston that later became Queen's University . Constituent colleges Theological colleges Federated colleges Postgraduate college The post-war era saw
15652-509: The dentist. "According to the National Public Health Service in 1996/1997, it showed a whopping difference of people who were in different classes. About half of Canadians aged 15 or older (53%) reported having dental insurance. Coverage tended to be highest among middle-aged people. At older ages, the rate dropped, and only one-fifth of the 65-or-older age group (21%) was covered." Attributes that can contribute to these outcomes
15824-488: The east, Bloor Street to the north, Spadina Avenue to the west and College Street to the south. An enclave surrounded by university grounds, Queen's Park , contains the Ontario Legislative Building and several historic monuments. With its green spaces and many interlocking courtyards, the university forms a distinct region of urban parkland in the city's downtown core. The namesake University Avenue
15996-437: The efficacy of the "Top Five" lists in terms of reduction in wasteful practices. Clement and Charlton furthermore warn of "Top Five List Burnout", noting that when faced with multiple guidelines on a single topic, physicians become confused regarding which protocol to follow. In spite of these criticisms, Clement and Charlton "strongly believe in the global spirit behind the Choosing Wisely campaigns and movement" and "advocate that
16168-582: The enraged Strachan had resigned a year earlier to open Trinity College as a private Anglican seminary. University College was created as the nondenominational teaching branch of the University of Toronto. During the American Civil War , the threat of Union blockade on British North America prompted the creation of the University Rifle Corps , which saw battle in resisting the Fenian raids on
16340-459: The evaluating and suggested improvements for the efficiency of healthcare services. Regions that were similar in factors such as education levels and immigration numbers were found to have different efficiency levels in health care provision. The study concluded if increased efficiency of the current system was set as a goal, the death rate could be decreased by 18%-35%. The study notes that supporting physician leadership and facilitating engagement of
16512-418: The ever-increasing amount of evidence on current best practice. The campaign also supports the equally important role of patient education and the need to dispel the false notion that "more care is better care". Central to the campaign are lists of "Things Clinicians and Patients Should Question" developed by more than eighty Canadian specialty societies. These lists are intended to encourage clinicians to adopt
16684-440: The example of Choosing Wisely in the United States and Choosing Wisely Canada, health leaders from Australia , Austria , Brazil , Denmark , England , France , Germany , India , Israel , Italy , Japan , Netherlands , New Zealand , South Korea , Switzerland , and Wales have committed to initiating similar campaigns revolving around medical stewardship and low-value care in their respective countries. Italy has integrated
16856-575: The faculty absorbed the Toronto School of Medicine. Meanwhile, the university continued to set examinations and confer medical degrees. The university opened the Faculty of Law in 1887, followed by the Faculty of Dentistry in 1888 when the Royal College of Dental Surgeons became an affiliate. Women were first admitted to the university in 1884. A devastating fire in 1890 gutted the interior of University College and destroyed 33,000 volumes from
17028-498: The federal government established the Canadian Health Services Research Foundation (CHRSF) in the 1996 federal budget to conduct research in collaboration with "provincial governments, health institutions, and the private sector" to identify the successes and failures in the health system. The Canadian Institute for Health Information (CIHI) is a not-for-profit, independent organization established by
17200-1049: The feet. In Ontario, as of 2019, Medicare covers between $ 7–16 of each visit to a registered podiatrist up to $ 135 per patient per year, plus $ 30 for x-rays. Although the elderly, as well as diabetic patients, may have needs that greatly exceed that limit, such costs would have to be covered by patients or private supplemental insurance. As of 2014, most, but not all provinces and territories provide some coverage for sex reassignment surgery (also known as gender confirming surgery) and other treatment for gender dysphoria . In Ontario, sex reassignment surgery requires prior approval before being covered. However, access to care does not meet WPATH guidelines in provinces covering 84% of Canada's population (excepting British Columbia, Prince Edward Island and Yukon Territory). Wait times are extensive for gender care in Canada, and can be as long as eight years. There are wide discrepancies in coverage for various assistive devices such as wheelchairs and respiratory equipment in Canada. Ontario, which has one of
17372-556: The former USSR republics ). Residents of Quebec who are covered by the province's public prescription drug plan pay an annual premium of $ 0 to $ 660 when they file their Quebec income tax return. Over the past two decades, at least some provinces have introduced some universal prescription drug insurance. Nova Scotia has Family Pharmacare, introduced in 2008 by Rodney MacDonald's Progressive Conservative government. However, residents do not automatically receive it through their health care as they must register separately for it, and it covers
17544-566: The government. Home care is an "extended" service, and is therefore not an insured service under the Canada Health Act. Home care is not considered to be a medically necessary service, like hospital and physician services, and provincial and territorial governments are under no obligation to provide home care services. In their 2009 report on home care in Canada, the Canadian Healthcare Association (CHA ) said that there
17716-484: The healthiest in the world as measured by longevity, lifestyle and effective use of the public health care system." Health Canada , a federal department , publishes a series of surveys of the healthcare system in Canada. Although life-threatening cases are dealt with immediately, some services needed are non-urgent and patients are seen at the next-available appointment in their local chosen facility. In 1996, in response to an interest in renewing its healthcare system,
17888-646: The highest rates of adult obesity among Organisation for Economic Co-operation and Development (OECD) countries attributing to approximately 2.7 million cases of diabetes (types 1 and 2 combined). Four chronic diseases— cancer (a leading cause of death), cardiovascular diseases , respiratory diseases and diabetes account for 65 percent of deaths in Canada. In 2021, the Canadian Institute for Health Information reported that healthcare spending reached $ 308 billion, or 12.7 percent of Canada's GDP for that year. In 2022 Canada's per-capita spending on health expenditures ranked 12th among healthcare systems in
18060-466: The hospital. Some dental services that are possibly not covered by Medicare may include cavity fillings, routine dental check-ups, restorative dental care, and preventive care, dentures, dental implants, bridges, crowns, veneers, and in-lays, X-rays, and orthodontic procedures. In 2022, however, the federal government announced the creation of a new Canada Dental Benefit which reimburses low- to middle-income parents up to $ 650 of dental fees per child. This
18232-484: The intervention initiated conversation regarding benzodiazepine therapy discontinuation with physicians and/or pharmacists. After six months, 27% of the intervention group had stopped taking benzodiazepines, compared with 5% of the patients who did not receive the educational intervention. The impact of Choosing Wisely Canada on test ordering and utilization was studied at the North York General Hospital in
18404-455: The last twenty years and despite health care being a guaranteed right for First Nations due to the many treaties the government of Canada signed for access to First Nations lands and resources, the amount of coverage provided by the Federal government's Non-Insured Health Benefits program has diminished drastically for optometry, dentistry, and medicines. Status First Nations individuals qualify for
18576-464: The libraries, Robarts Library , holds about five million bound volumes that form the main collection for humanities and social sciences . The Thomas Fisher Rare Book Library constitutes one of the largest repositories of publicly accessible rare books and manuscripts . Its collections range from ancient Egyptian papyri to incunabula and libretti ; the subjects of focus include British, Western and Canadian literature , Aristotle , Darwin ,
18748-687: The library collections are dispersed at departmental and faculty libraries in addition to about 1.3 million bound volumes the colleges hold. The university has collaborated with the Internet Archive since 2005 to digitize some of its library holdings. Housed within University College, the University of Toronto Art Centre contains three major art collections. The Malcove Collection is primarily represented by Early Christian and Byzantine sculptures, bronzeware, furniture, icons and liturgical items. It also includes glassware and stone reliefs from
18920-566: The library, but the university restored the building and replenished its library within two years. Over the next two decades, a collegiate system took shape as the university arranged federation with several ecclesiastical colleges, including Strachan's Trinity College in 1904. The university operated the Royal Conservatory of Music from 1896 to 1991 and the Royal Ontario Museum from 1912 to 1968; both still retain close ties with
19092-454: The lists are meant to spur conversation about what is appropriate and necessary treatment. As each patient situation is unique, Choosing Wisely Canada recommends that its materials be used as guidelines for clinicians and patients to determine an appropriate treatment plan together. In order to encourage patients to initiate conversations about unnecessary care, Choosing Wisely Canada uses patient-friendly materials with lay language to complement
19264-422: The lists of "Five Things Clinicians and Patients Should Question". These patient educational materials are meant to inform patients about the tests, treatments and procedures used within various medical specialties, when they may or may not be necessary, and what patients can do to improve their overall health. For example, one of the patient educational materials released on June 2, 2015, addressed concerns regarding
19436-521: The main students' unions on administrative and policy issues are the University of Toronto Students' Union , Association of Part-time Undergraduate Students and the Graduate Students' Union. Student representative bodies also exist at the various colleges, academic faculties and departments. The Hart House Debating Club employs a debating style that combines the American emphasis on analysis and
19608-477: The main building of Trinity College displays Jacobethan Tudor architecture , while its chapel was built in the Perpendicular Gothic style of Giles Gilbert Scott . The chapel features exterior walls of sandstone and interiors of Indiana Limestone and was built by Italian stonemasons using ancient building methods. Philosopher's Walk is a scenic footpath that follows a meandering, wooded ravine ,
19780-494: The median age in Canada was 40.6 years in 2023 compared to 39.5 in 2006. By July 2020, there were 6,835,866 individuals who were 65 years old and older and 11,517 centenarians . The same data reported that by July 2020, 16% of Canadians were 14-years-old or under, 66.5% were between the ages of 15 and 65, and 17.5% were 65 years and older. Canada's population is aging, like that of many other countries. By 2016, there were about six million seniors in Canada, which then had
19952-433: The medical institutes have cross-appointments to faculty and supervisory positions in university departments. The Rotman School of Management developed the discipline and methodology of integrative thinking , upon which the school used to base its curriculum. Founded in 1887, the Faculty of Law 's emphasis on formal teachings of liberal arts and legal theory was then considered unconventional, but gradually helped shift
20124-479: The most annual scientific research funding and endowment of any Canadian university. It is also one of two members of the Association of American Universities outside the United States, alongside McGill University . Academically, the University of Toronto is noted for influential movements and curricula in literary criticism and communication theory , known collectively as the Toronto School . The university
20296-574: The most generous programs, pays 75% of the cost for listed equipment and supplies for persons with a disability requiring such equipment or supplies for six months or longer. The program does not have age or income restrictions. As with other health coverage, veterans and others covered by federal programs are not eligible under the provincial program. Only certain types of equipment and supplies are covered, and within categories only approved models of equipment from approved vendors are covered, and vendors may not charge more than specified prices established by
20468-667: The past two years. Further studies highlighted the financial strain of medical overuse, such as the analysis conducted by the Institute of Medicine , which found that up to 30% of American health care spending is on unnecessary tests and procedures. In 2017, a joint report between Choosing Wisely Canada and the Canadian Institute for Health Information found up to 30% of tests and treatments were unnecessary based on eight campaign recommendations. In light of these concerns, Choosing Wisely Canada hopes to optimize value, reduce waste and improve patient outcomes by promoting patient-physician conversations about low-value care. Choosing Wisely Canada
20640-743: The prevalence of chronic conditions, long wait times, poor availability of after-hours care, and a lack of prescription drugs coverage. An increasing problem in Canada's health system is a shortage of healthcare professionals and hospital capacity. The primary objective of the Canadian healthcare policy, as set out in the 1984 Canada Health Act (CHA), is to "protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers." The federal government ensures compliance with its requirements that all Canadians have "reasonable access to medically necessary hospital, physician, and surgical-dental services that require
20812-655: The principles of Choosing Wisely in a campaign called "Doing more does not mean doing better", and the Netherlands has launched "Choosing Wisely Netherlands", both contributing to a growing international Choosing Wisely movement Choosing Wisely Canada is supported by the University of Toronto , Unity Health Toronto (Toronto) and the Canadian Medical Association . It receives funding from the Canadian Medical Association, along with grants from federal, provincial and territorial ministries of health, and other partner organizations and agencies. The specialty societies participating in
20984-471: The priority in 2015 should be thoughtful implementation and rigorous evaluation of existing top five lists". Choosing Wisely Canada has identified a multifaceted evaluation approach to measure its impact, which includes: Evaluation of campaign impact on patient education and receptiveness included a randomized control trial entitled EMPOWER (Eliminating Medications Through Patient Ownership of End Results), led by Cara Tannenbaum, geriatrician and professor in
21156-820: The program, though newcomers must wait up to three months after they arrive in the province, and everyone receives the same level of care once they receive one. Most essential basic care is covered, including maternity but excluding mental health and home care . Infertility costs are not covered in any province other than Quebec, though they are now partially covered in some other provinces. In some provinces, private supplemental plans are available for those who desire private rooms if they are hospitalized. Cosmetic surgery and some forms of elective surgery are not considered essential care and are generally not covered. For example, Canadian health insurance plans do not cover non-therapeutic circumcision . These can be paid out-of-pocket or through private insurers. Basic health coverage
21328-446: The province provides funding for mental health care through Alberta Health Services. Most or all provinces and territories offer government-funded drug and alcohol addiction rehabilitation, although waiting lists may exist. The cost of treatment by a psychologist or psychotherapist in Canada has been cited as a contributing factor in the high suicide rate among first responders such as police officers, EMTs and paramedics . According to
21500-454: The provincial health plan, OHIP, does cover physiotherapy following hospital discharge and occupational therapy but does not cover massage therapy. To be eligible for coverage for physiotherapy in Ontario, insured individuals must have been discharged as an inpatient of a hospital after an overnight stay and require physiotherapy for the condition, illness or injury, or be age 19 or younger or age 65 or older. Coverage varies for care related to
21672-476: The provincial insurer. There is no need for the person who accesses healthcare to be involved in billing and reclaim. Private health expenditure accounts for 30% of health care financing. The Canada Health Act does not cover prescription drugs, home care, or long-term care or dental care . Provinces provide partial coverage for children, those living in poverty, and seniors. Programs vary by province. In Ontario, for example, most prescriptions for youths under
21844-424: The provincial level, there are also several much smaller health programs alongside Medicare. The largest of these is the health care costs paid by the workers' compensation system. Regardless of federal efforts, healthcare for First Nations has generally not been considered effective. Despite being a provincial responsibility, the large health costs have long been partially funded by the federal government. While
22016-654: The provincial, territorial, and federal government to make healthcare information publicly available. The CIHI was established in 1994 to serve as a national "coordinating council and an independent institute for health information" in response to the 1991 report, "Health Information for Canada" produced by the National Task Force on Health Information. In 1994, the CIHI merged the Hospital Medical Records Institute (HMRI) and The Management Information Systems (MIS) Group. Reports include topics such as
22188-409: The public sector and 30% from the private sector. Public-sector funding, which has represented approximately 70% of total health expenditure since 1997, "includes payments by governments at the federal, provincial/territorial and municipal levels and by workers' compensation boards and other social security schemes". Private sector funding is regulated under the Canada Health Act , (CHA) which sets
22360-472: The publication of the first observational evidence proving the existence of black holes . Toronto astronomers have also discovered the Uranian moons of Caliban and Sycorax , the dwarf galaxies of Andromeda I , II and III , and the supernova SN 1987A . A pioneer in computing technology, the university designed and built UTEC , one of the world's first operational computers, and later purchased Ferut ,
22532-463: The publication placed the university 19th in the world. In the 2024–25 U.S. News & World Report Best Global University Ranking , the university ranked 17th in the world, and first in Canada. The Canadian-based Maclean's magazine ranked the University of Toronto second in their 2022–2023 Medical Doctoral university category. Maclean's 2023 university rankings also ranked the University of Toronto first in its reputation survey. The university
22704-663: The remaining 30 percent is paid for through the private sector. The 30 percent typically relates to services not covered or only partially covered by Medicare, such as prescription drugs , eye care, medical devices , gender care , psychotherapy , physical therapy and dentistry . About 65-75 percent of Canadians have some form of supplementary health insurance related to the aforementioned reasons; many receive it through their employers or use secondary social service programs related to extended coverage for families receiving social assistance or vulnerable demographics, such as seniors, minors, and those with disabilities. According to
22876-424: The right thing to do for patients and avoiding the harm that can come from unnecessary testing. Let's do more of what works and…and less of what is done 'just in case'. Society expects us to lead the way, and the physicians of Canada intend to do just that". Rick Glazier , senior scientist in primary care and population health at the Institute for Clinical Evaluative Sciences in Toronto , highlights two aspects of
23048-942: The risk of harm exceeds its potential benefit ("medical overuse"). A number of studies have highlighted the prevalence of medical overuse in Canada, which include findings that approximately 50% of prescriptions for respiratory infections in Saskatchewan are inappropriate, 28% of lumbar spine MRIs in Alberta and Ontario are unnecessary, and 28% of bone mineral density scans are inappropriate. These unnecessary invasive procedures and low-value care are major causes of preventable harm and increased waste of medical resources. Medical overuse has been associated with decreased patient satisfaction and poor clinical outcomes, including higher mortality. A systematic survey of patients in seven countries revealed that 10–20% of patients believed that their physicians had provided treatment of little or no value in
23220-418: The role of home care aids evolves, so does the need for more training and instruction. Nurses and HCAs are expected to think critically and execute real-time, and make evidence-based care decisions. The largest group the federal government is directly responsible for is First Nations . Native peoples are a federal responsibility and the federal government guarantees complete coverage of their health needs. For
23392-887: The same quality of care. A quality improvement initiative based on CWC principles was launched under the supervision of Danielle Martin at the Women's College Hospital (WCH) in Toronto. The American Thyroid Association and Choosing Wisely Canada recommends testing only Thyroid Stimulating Hormone (TSH) levels rather than testing both TSH and free thyroid hormones (such as T4) for assessment of suspected hypothyroidism , since majority of patients with hypothyroidism will present with abnormal TSH levels. A baseline audit at Women's College Hospital revealed that 60% of all free thyroid hormones tests were performed in patients who had normal TSH levels, amounting to approximately $ 50,000 annually in additional laboratory testing expenditure. A "Reflex T4" approach
23564-531: The second commercial computer after UNIVAC I . Multi-touch technology was developed at Toronto, with applications ranging from handheld devices to high-end drawing monitors to collaboration walls . The AeroVelo Atlas , which won the Igor I. Sikorsky Human Powered Helicopter Competition in 2013, was developed by the university's team of students and graduates and was tested in Vaughan . The discovery of insulin at
23736-427: The specialty's scope of practice. Many physician bloggers assert that most medical overuse is a result of practicing defensive medicine in an effort to avoid lawsuits. Others recognize the noble goal of reducing overuse and harm, but lament that the lists are too simplistic and do not necessarily advance the identification of low-value care, but merely synthesize "agreed-upon, well-established practices". A critique of
23908-543: The structuring of the human mind", the school is rooted in the works of Eric A. Havelock and Harold Innis and the subsequent contributions of Edmund Snow Carpenter , Northrop Frye and Marshall McLuhan . Since 1963, the McLuhan Program in Culture and Technology of the Faculty of Information has carried the mandate for teaching and advancing the Toronto School. Several notable works in arts and humanities are based at
24080-584: The supply of home care aids (HCA)s was not meeting the demand required to provide adequate nursing home care and home care in an increasingly complex care system. Home care aids face intense job precarity, inadequate staffing levels as well as increasingly complex needs including different types of routinized, assembly-lines types of work, and cost-cutting on equipment and supplies. They also work in situations where there are more occupational hazards , which can include aggressive pets, environmental tobacco smoke, oxygen equipment, unsafe neighborhoods, and pests. As
24252-782: The theory of NP-completeness . The University of Toronto is the recipient of both the single largest philanthropic gift in Canadian history, a $ 250 million donation from James and Louise Temerty in 2020, and the largest ever research grant in Canada, a $ 200 million grant from the Government of Canada in 2023. The Varsity Blues are the athletic teams that represent the university in intercollegiate league matches, primarily within U Sports , with ties to gridiron football , rowing and ice hockey. The earliest recorded instance of gridiron football occurred at University of Toronto's University College in November 1861. The university's Hart House
24424-423: The three waves from 2014–2015. Choosing Wisely Canada has adopted a multi-faceted campaign approach, engaging clinicians, patients, and medical trainees at all levels. The campaign has partnered with more than 80 Canadian medical specialty societies to develop evidence-supported lists of "Things Clinicians and Patients Should Question", hoping to promote conversation about inappropriate care. The underlying premise
24596-455: The time: "Until I reached Toronto," remarked Lord Dufferin during his visit in 1872, "I confess I was not aware that so magnificent a specimen of architecture existed upon the American continent ." The building was declared a National Historic Site of Canada in 1968. Built in 1907, Convocation Hall is recognizable for its domed roof and Ionic -pillared rotunda. Although its foremost function
24768-539: The total health expenditures. "includes primarily private insurance and household expenditures." The top categories of private sector expenditures account for 66% of this spending, and include pharmaceuticals, and professional services such as dental and vision care services. Only 10% of these services are paid for by the public sector. In 2017, 41% of private sector expenses were paid by private insurance companies. The amount of out-of-pocket spending represented 49% of private sector spending. A 2006 in-depth CBC report,
24940-529: The total in 2018. This includes funds transferred from the federal government to the provinces in the form of the CHT. Direct funding from the federal government, as well as funds from municipal governments and social security funds represented 4.8% in 2018. According to the CIHI 2019 report, since 1997, the 70–30 split between public and private sector healthcare spending has remained relatively consistent with approximately 70% of Canada's total health expenditures from
25112-457: The university alleging racial discrimination. In 2017, a human rights application was filed against the University by one of its students for allegedly delaying the investigation of sexual assault and being dismissive of their concerns. In 2018, the university cleared one of its professors of allegations of discrimination and antisemitism in an internal investigation, after a complaint was filed by one of its students. The University of Toronto
25284-559: The university as independent institutions. The University of Toronto Press was founded in 1901 as Canada's first academic publishing house . The Faculty of Forestry, founded in 1907 with Bernhard Fernow as dean, was Canada's first university faculty devoted to forest science. In 1910, the Faculty of Education opened its laboratory school , the University of Toronto Schools . The First and Second World Wars curtailed some university activities as undergraduate and graduate men eagerly enlisted. Intercollegiate athletic competitions and
25456-564: The university assumed its present name in 1850 upon becoming a secular institution. As a collegiate university , it comprises 11 colleges each with substantial autonomy on financial and institutional affairs and significant differences in character and history. The university maintains three campuses, the oldest of which is St. George, located in downtown Toronto . The other two satellite campuses are located in Scarborough and Mississauga . The University of Toronto offers over 700 undergraduate and 200 graduate programs. The university receives
25628-552: The university developed the G-suit , a life-saving garment worn by Allied fighter plane pilots, later adopted for use by astronauts. Development of the infrared chemiluminescence technique improved analyses of energy behaviours in chemical reactions. In 1963, the asteroid 2104 Toronto is discovered in the David Dunlap Observatory in Richmond Hill and is named after the university. In 1972, studies on Cygnus X-1 led to
25800-483: The university fourth in the world, and first in Canada. The University Ranking by Academic Performance 2019–2020 rankings placed the university second in the world, and first in Canada. Along with academic and research-based rankings, the university has also been ranked by publications that evaluate the employment prospects of its graduates. In the Times Higher Education's 2022 global employability ranking,
25972-481: The university grounds in Toronto's Discovery District , conducting $ 1 billion of medical research annually. MaRS Discovery District is a research park that serves commercial enterprises and the university's technology transfer ventures. In 2008, the university disclosed 159 inventions and had 114 active start-up companies. Its SciNet Consortium operates the most powerful supercomputer in Canada. A notable hub for social, cultural and recreational activities at
26144-847: The university include the Canadian Institute for Theoretical Astrophysics , the Pontifical Institute of Mediaeval Studies and the Fields Institute . Within the Faculty of Arts and Science, notable departments include the Department of Mathematics . The University of Toronto Libraries is the third-largest academic library system in North America, following those of Harvard and Yale , measured by number of volumes held. Its collections include more than 12 million print books, 1.9 million digital books, over 160,000 journal titles, and close to 30,000 metres of archival materials. The largest of
26316-538: The university operated the Connaught Medical Research Laboratories , now part of the pharmaceutical corporation Sanofi-Aventis . Among the research conducted at the laboratory was the development of gel electrophoresis . The University of Toronto is the primary research presence that supports one of the world's largest concentrations of biotechnology firms. More than 5,000 principal investigators reside within 2 kilometres (1.2 mi) from
26488-463: The university ranked 11th in the world, and first in Canada. In QS's 2022 graduate employability ranking, the university ranked 21st in the world, and first in Canada. In a 2013 employment survey conducted by the New York Times , the University of Toronto was ranked 14th in the world. In 2018, the University of Toronto Entrepreneurship was ranked the fourth best university-based incubator in
26660-483: The university ranked 22nd in the world and first in Canada. The 2023 QS World University Rankings ranked the university 21st in the world, and first in Canada. In 2019, it ranked 11th among the universities around the world by SCImago Institutions Rankings . The 2023 Times Higher Education World University Rankings ranked the university 18th in the world, and first in Canada. In the Times' 2020 reputational ranking,
26832-787: The university through the Toronto School of Theology . The Faculty of Arts and Science is the university's main undergraduate faculty, and administers most of the courses in the college system. While the colleges are not entirely responsible for teaching duties, most of them house specialized academic programs and lecture series. Among other subjects, Trinity College is associated with programs in international relations , as are University College with Canadian studies , Victoria College with Renaissance studies , Innis College with film studies and urban studies , New College with gender studies , Woodsworth College with industrial relations and St. Michael's College with Medieval studies . The faculty teaches undergraduate commerce in collaboration with
27004-428: The university was governed under a bicameral system composed of the board of governors and the university senate. The chancellor, usually a former governor general , lieutenant governor , premier or diplomat, is the ceremonial head of the university. The president is appointed by the council as the chief executive. Unlike most North American institutions, the University of Toronto is a collegiate university with
27176-590: The university's various programs and curricula in international affairs, foreign policy, and public policy . As the Cold War heightened, Toronto's Slavic studies program evolved into an important institution on Soviet politics and economics, financed by the Rockefeller , Ford and Mellon foundations. The Munk School is also home to the G20 Research Group , which conducts independent monitoring and analysis on
27348-672: The university, including the Dictionary of Canadian Biography since 1959 and the Collected Works of Erasmus since 1969. The Records of Early English Drama collects and edits the surviving documentary evidence of dramatic arts in pre- Puritan England, while the Dictionary of Old English compiles the early vocabulary of the English language from the Anglo-Saxon period. The Munk School of Global Affairs and Public Policy encompasses
27520-408: The university, known as Front Campus, is near the campus centre in an oval lawn enclosed by King's College Circle. The centrepiece is the main building of University College , built in 1857 with an eclectic blend of Richardsonian Romanesque and Norman architectural elements. The dramatic effect of this blended design by architect Frederick William Cumberland drew praise from European visitors of
27692-582: The university. The founding of a colonial college had long been the desire of John Graves Simcoe , the first Lieutenant-Governor of Upper Canada and founder of York , the colonial capital. As an Oxford -educated military commander who had fought in the American Revolutionary War , Simcoe believed a college was needed to counter the spread of republicanism from the United States . The Upper Canada Executive Committee recommended in 1798 that
27864-486: The word "Don't" or "Avoid"; for example, one of the recommendations released in the first wave of the campaign was Don't order screening chest X-rays and ECGs for asymptomatic or low risk outpatients . National specialty societies are free to determine the process for generating their lists, as long as they are done in accordance with the following principles: Choosing Wisely Canada recommendations are not intended to be used to establish payment and coverage decisions. Rather,
28036-441: The world by UBI Global in the "World Top Business Incubator – Managed by a University" category. Since 1926, the University of Toronto has been a member of the Association of American Universities , a consortium of the leading North American research universities. The university manages by far the largest annual research budget of any university in Canada with sponsored direct-cost expenditures of $ 878 million in 2010. In 2021,
28208-462: Was (until January 1, 2020) supplemented by a fixed monthly premium that was waived or reduced for those on low incomes. In Ontario, there is an income tax identified as a health premium on taxable income above $ 20,000. In addition to funding through the tax system, hospitals and medical research are funded in part by charitable contributions. For example, in 2018, Toronto's Hospital for Sick Children embarked on campaign to raise $ 1.3 billion to equip
28380-574: Was a transitional policy on the way to universal, public coverage of dental care. In 2023, the government established the Canadian Dental Care Plan , which began a staggered enrolment rollout in December 2023, to pay costs for covered dental services of eligible residents. Coverage for services by physiotherapists , occupational therapists (also known as OTs) and Registered Massage Therapists (RMTs) varies by province. For example, in Ontario
28552-438: Was an increase in chronic disease rates as Canada's population aged. Home care is generally considered to be a lower cost alternative at a time when governments are concerned about the cost of healthcare and is generally the preferred option for seniors. One in four caregivers provide care related to aging. A 2016 study published in the Journal of Canadian Studies said that with an increasing elder population , in Canada,
28724-409: Was first identified in 1997 by Toronto researchers, who have since found stem cell associations in leukemia , brain tumours and colorectal cancer . Medical inventions developed at Toronto include the glycaemic index , the infant cereal Pablum , the use of protective hypothermia in open heart surgery and the first artificial cardiac pacemaker . The first successful single-lung transplant
28896-414: Was implemented at WCH, wherein free T4 tests would not be conducted unless TSH levels are abnormal, or if there are clinical indications of situations when measurement of free thyroid hormones would be necessary. When it is found that TSH levels are abnormal, free T4 levels would then be automatically measured. In addition to reducing inappropriate thyroid function testing, the impact of Choosing Wisely Canada
29068-546: Was performed at Toronto in 1981, followed by the first nerve transplant in 1988, and the first double-lung transplant in 1989. Researchers identified the maturation promoting factor that regulates cell division , and discovered the T-cell receptor , which triggers responses of the immune system. The university is credited with isolating the genes that cause Fanconi anemia , cystic fibrosis and early-onset Alzheimer's disease , among numerous other diseases. Between 1914 and 1972,
29240-596: Was ranked in spite of having opted out—along with several other universities in Canada—of participating in Maclean's graduate survey since 2006. The university's research performance has been noted in several bibliometric university rankings, which use citation analysis to evaluate the impact a university has on academic publications. In 2019, the Performance Ranking of Scientific Papers for World Universities ranked
29412-406: Was the birthplace of insulin , stem cell research, the first artificial cardiac pacemaker , and the site of the first successful lung transplant and nerve transplant. The university was also home to the first electron microscope , the development of deep learning , neural network , multi-touch technology, the identification of the first black hole Cygnus X-1 , and the development of
29584-470: Was the first Canadian university to amass a financial endowment greater than one billion dollars in 2007. From 2011 to 2018, the university embarked on the Boundless fundraising campaign, which concluded in 2018 at $ 2.641 billion raised, setting a new all-time fundraising record in Canada. On September 24, 2020, the university announced the single largest donation in Canadian history, a $ 250 million gift to
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