Abstract
In December 1997, public health units in Ontario received revised mandatory program guidelines from the Ministry of Health in advance of the downloading of public health to municipalities. Public health units face difficult decisions in allocating municipal resources to meet the Province’s mandated programs. To set priorities for resource allocation, it is critical to assess need across program areas and to use a common unit in doing so. This paper applies the Healthy Life Years (HeaLYs) method in assessing health need related to the mandatory programs for the population of Wellington and Dufferin counties in Ontario. The HeaLYs method incorporates duration and severity of illhealth, incidence and mortality in calculating years of healthy life lost (YHLL). For Wellington-Dufferin, the leading causes of YHLL were concentrated in the program areas of chronic disease, injury, and substance abuse and included four areas not addressed in the MPG (suicide, depression, dementia, and osteoarthritis).
Résumé
En décembre 1997, les services de santé publique ontariens ont reçu les critères obligatoires révisés des programmes du ministère de la Santé en prévision du transfert de la santé publique aux municipalités. Les services de santé publique, qui doivent répartir les ressources municipales entre les programmes provinciaux obligatoires, sont confrontés à des décisions difficiles. Pour fixer les priorités en la matière, ils doivent absolument évaluer les besoins des divers secteurs de programme et utiliser un indicateur commun. Le présent article porte sur la méthode des années de vie en santé (AVS), qui a permis d’évaluer les besoins de santé de la population des comtés ontariens de Wellington et de Dufferin par rapport aux programmes obligatoires. La méthode des AVS tient compte de la durée et de la gravité des maladies, de leur incidence et du taux de mortalité pour calculer les années de vie en santé perdues (AVSP). Pour Wellington-Dufferin, on a recensé les principales causes d’AVSP essentiellement dans les secteurs de programme des maladies chroniques, des blessures et de la toxicomanie, mais aussi dans quatre secteurs non visés par les critères obligatoires des programmes (le suicide, la dépression, la démence et l’ostéoarthrose).
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