An environmental scan conducted by Realize Canada (2017) of publicly-funded rehab services across Canada shows that pulmonary rehab (PR) access issues are not specific to New Brunswick as there is a trend across the country. This scan notes that only 0.4% of Canadians with COPD having access to PR services and this issue will only worsen as the rate of diagnosis continues to climb (Camp et al., 2015). This review outlines that a potential cause of some of these access issues is that community-based services are not considered "medically necessary" as outlined by the Canada Health Act (CHA) (Realize Canada, 2017). Since each province outlines what it covers under the Medicare program, Realize Canada has outlined that it is difficult to determine what services are available nationally as these funding issues have resulted in a mix of private and publicly-funded programs to emerge (Realize Canada, 2017).
While this scan reviews PR within the realm of community-based rehab services, this scan is not designated specifically to this type of rehab service but provides an overview of all community-based rehab services. In order to provide the public with more detailed information on access issues with respect to PR, an environmental scan specific to PR in the country would be of more benefit. This does not diminish the information provided from this scan though and actually results in an encouraging argument with respect to access issues nationally. These issues require patient advocacy with respect to Medicare coverage of community-based clinics as this scan notes that the funding of community-based clinics is typically private as community-based rehab services are not typically deemed "medically necessary" by the provinces (Realize Canada, 2017).
Due to the fact that this scan looks at provinces within each area of the country, but not every province and territory, they are generalizing the access issues to include all of Canada where they cannot necessary do so as each province has their own system and set their own guidelines for Medicare coverage. In order to provide the best data, communities from all provinces should be included in an environmental scan so that generalization can be more accurate. Despite the generalizations made, this scan provides some insight on what issues may be impacting these access issues, such as lack of information on where and how to access services, waitlists and different availabilities of services, which may help on addressing these access issues (Realize Canada, 2017). By outlining the current issues and providing recommendations on how to improve access issues to rehab services nationally, this scan may help to address the access issues specific to our province.
References
Camp, P. G., Hernandez, P., Bourbeau, J., Kirkham, A., Debigare, R., Stickland, M. K., Goodridge, D., Marciniuk, D. D., Road, J. D., Bhutani, M., & Dechman, G. (2015). Pulmonary rehabilitation in Canada: A report from the Canadian Thoracic Society COPD Clinical Assembly. Canadian respiratory journal, 22(3), 147–152. https://doi.org/10.1155/2015/369851
Realize Canada. (2017). An environmental scan of publicly-funded rehabilitation services across Canada. https://www.realizecanada.org/wp-content/uploads/Environmental-Scan-of-Rehabilitation-Services.pdf
RT Sleep World. (2020). Free Online Pulmonary Rehab During COVID-19 Outbreak [Photograph]. https://rtsleepworld.com/2020/03/11/free-online-pulmonary-rehab-during-covid-19-outbreak/
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