Grant: Project Grant

To alleviate pressures on the hospital and ensure timely access to low-complexity surgeries, the Ontario Government has recently passed Bill 60 (Your Health Act) that raises the possibility of building free-standing surgical centres, i.e., Integrated Community Health Services Centres (ICHSCs), within the publicly funded healthcare system. While such facilities are not a complete novelty in many Canadian provinces and given the clear appetite from the Ontario government to pursue them, to the best of our knowledge, there is a gap in knowledge regarding if investing in these facilities are truly worthwhile compared to improving the use of existing healthcare resources, and if so, where to place them, how to structure them and their impact on patients and Canadian healthcare. These urgent and high-impact inquiries form the rationale of this study. Working with an established national team of healthcare leaders, physicians, scientists, and patients, this study will use Ontario as an analytical model with national stakeholder engagement to assess four aims: 1) compare the experience and clinical outcomes of adults receiving a low-complexity outpatient surgery at an existing ICHSC vs. hospital; 2) estimate the cost-effectiveness of directing adult patients to receive a knee arthroscopy at an ICHSC vs. outpatient hospital as a case study for assessing the value-for-money of ICHSCs; 3) identify the optimal locations for new ICHSCs; and 4) measure the implications of new ICHSCs on surgical care delivery (e.g., shortening wait times), population health (e.g., reducing mortality), and health equity for marginalized populations (e.g., immigrants). Knowledge translation will be organized with national stakeholders, including a citizen advisory board, following a structured framework to promote timely dissemination of findings. These powerful data will help inform a provincial and national policy guideline on patient-centred and equitable ICHSC planning.