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Heart disease funding needed for when prevention isn’t enough

By Catherine Kells      

Canada’s inability to measure and improve outcomes on a national scale is not only a critical health issue, but an economic issue.

The Canadian Cardiovascular Society is urging Health Minister Ginette Petitpas Taylor, pictured, and Finance Minister Bill Morneau to fund the group's heart health initiative in Budget 2018, which would see the implementation of a pan-Canadian measurement and reporting system. The Hill Times photograph by Andrew Meade
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February is Heart Health Month in North America, and the government of Canada is, as always, engaging in campaigns centred on keeping the hearts of Canadians healthy through preventative measures.

In a public message issued earlier this month, for instance, Health Minister Ginette Petitpas Taylor highlighted recent federal investments into anti-smoking programs and healthy eating initiatives, and encouraged Canadians to “make one change to protect or improve their heart health”.

Prevention of heart disease is important, and the Canadian Cardiovascular Society is supportive of ongoing government initiatives such as the Healthy Eating Strategy, which aims to improve the health of Canadians and prevent conditions like diabetes and heart disease. We also support and collaborate with Heart & Stroke, whose national efforts are largely focused on prevention.

However, sometimes prevention is not enough—as evidenced by the approximately 20 percent of Canadians who continue to die as a result of heart-related diseases.

Heart disease affects approximately 2.4 million Canadian adults, and is a leading cause of death in the country. While the government touts its considerable investments into preventative programs that aim to keep Canadians healthy, there are far too few federal dollars being channeled into ensuring high quality care for those who end up sick anyway.

As an interventional cardiologist, I’m the doctor you will meet in the middle of the night if you have a heart attack. I spend most of my days and nights working to save the lives of those mothers, husbands and friends for whom prevention was not enough.

Although I am extremely well trained and keep up with all the latest research and techniques, I cannot tell my patients my success rate or complication rate, or reassure them that their risk of death or re-admission is low – because I honestly do not know.

In Canada, unlike many other countries, we do not have a pan-Canadian, unbiased reporting system that measures and feeds back the outcomes of cardiovascular interventions or therapies. This means that health professionals and policy makers currently have no evidence-based way to improve the quality of care and treatment being delivered to patients.

While certain provinces and institutions do report some health outcome data, there is huge regional variation in terms of what is available. From those reports we have seen, we know that the quality of cardiac care varies substantially depending on the city or province in which patients receive treatment.

Canada’s inability to measure and improve outcomes on a national scale is not only a critical health issue, but an economic issue, as well. The cost of treating heart disease is currently estimated at $20.9 billion dollars, and is expected to rise to $28.3 billion dollars by 2020 as our population continues to age.

Given the growing burden of heart disease, the government of Canada needs to begin looking at prevention in a broader way. It is not only important to fund prevention initiatives prior to Canadians developing heart disease, but to invest in ensuring a high quality of care for Canadians when (and for many it is a “when”, not an “if”) they do suffer a cardiac event.

This Heart Health Month, the government of Canada should prioritize sustainable health systems, accountability and ensuring quality and value for money spent on cardiovascular care in Canada, in order to prevent the burden of heart disease from worsening.

The Canadian Cardiovascular Society has submitted a recommendation to the federal government to fund our heart health initiative in Budget 2018, which would improve patient care and outcomes by enabling doctors to make evidence-based decisions and practice changes through the implementation of a pan-Canadian measurement and reporting system.

I sincerely hope the health and finance ministers are able to recognize the need for cardiovascular disease funding along the entire continuum of care (not solely on the prevention side) and will begin investing federal dollars into areas that help protect and improve heart health; when prevention is not enough.

Dr. Catherine Kells is president of the Canadian Cardiovascular Society.

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