The health of northern residents.

OBJECTIVES: This article examines differences in health status and health determinants between residents of the North (Yukon and Northwest Territories) and of the provinces, and between Aboriginal and non-Aboriginal territorial residents. The use of health services and medications is also analyzed. DATA SOURCE: The data are from the 1994/95 National Population Health Survey (NPHS), both the territorial and provincial components. The population analyzed consists of household residents aged 12 and older. MAIN RESULTS: Compared with non-Aboriginal Northerners, Aboriginal people in the territories more frequently rated their health poorly. However, they reported fewer injuries and diagnosed chronic conditions. The prevalence of alcohol consumption was lower among Aboriginal people, while the proportion of smokers was substantially higher. A lower proportion of Aboriginal territorial residents had consulted a general practitioner in the previous year, and a higher proportion had consulted a nurse. Aboriginal people also had a low rate of medication use.

Follow-up practices for patients with early stage breast cancer: a survey of Canadian oncologists.

The value of routine follow-up programs for patients with early stage breast cancer remains an area of controversy. In recent years, the cost-effectiveness of routine investigations has been questioned, and 2 prospective randomized clinical trials have shown no survival advantage to more intensive diagnostic follow-up approaches. Under the auspices of the Ottawa Regional Cancer Centre, a national survey of the practice patterns of Canadian surgical, radiation and medical oncologists was undertaken to measure current Canadian standards of care and to determine average costs of 5-year follow-up for patients completing primary treatment for stage I and II breast cancer. Standardized questionnaires were sent out to 130 surgeons, 59 radiation oncologists and 89 medical oncologists. The overall response rate was 44%. Based on the frequency of follow-up visits and investigations recommended by respondents, an average cost per patient for a 5-year follow-up plan was derived for each subspecialist group: $791, $911 and $904 for surgeons, radiation oncologists and medical oncologists respectively. Use of a less interventionist follow-up program was estimated to result in a cost saving of $300 per patient over 5 years. The results indicate that, for the most part, Canadian oncologists have been influenced by the available literature concerning follow-up practices and are ordering fewer routine tests. Further cost savings to the Canadian health care system could be achieved with the adoption of even less interventionist follow-up programs.