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Abstract

Abstract - Hamid Sadri - The Economic Impact and Policy Implications of Innovative Medical Technologies on the Canadian Healthcare SystemDespite considerable per capita expenditure, the Canadian healthcare system faces a complex crisis characterised by strained operational capacity, substantial shortages of Health Human Resources (HHR), and suboptimal patient outcomes. This crisis arises from a decentralised and fragmented structure, further aggravated by isolated budget allocations and persistent underfunding of critical infrastructure and medical technologies. The outcomes of these issues include excessively prolonged wait times for essential procedures and diagnostics, limited access to primary and specialised care, and persistent health disparities that disproportionately affect residents of smaller provinces and rural areas. This doctoral dissertation addresses these urgent issues by investigating the manner in which the strategic incorporation of medical technologies may serve as an effective short- to medium-term solution. This approach aims to enhance system efficiency, improve patient health outcomes, and promote health equity across Canada. Grounded in the theoretical frameworks of economic evaluation and health policy, this research centres on three interrelated fundamental questions.• What are the implications of applying time-dependent activity-based costing (TDABC) and adopting a novel total cost of care framework that transcends traditional budgetary silos?• To what extent can the strategic implementation of medical technologies enhance access to healthcare and promote equity across the Canadian population?• How can a needs-stratification model for older adults be developed and implemented to improve the provision of long-term care (LTC) services in Canada?To attain these objectives, a series of integrated research initiatives and methodological analyses was systematically conducted. The methodologies encompassed (i) the application and validation of TDABC for precise cost measurement within the Canadian context, (ii) the evaluation of various innovative medical technologies through Budget Impact Analyses and Cost-Effectiveness Analyses. Specifically, the technologies assessed comprised implantable cardiac monitors for unexplained syncope, AI-assisted colonoscopy for colorectal cancer screening, and transcatheter aortic valve replacement for aortic stenosis. These evaluations were conducted from the perspectives of both a provincial healthcare payer and a hospital administrator to provide a comprehensive understanding of their financial implications and patient outcomes. Additionally, the scope of the research was expanded to include a critical review of the LTC sector, a need accentuated by the COVID-19 pandemic. This led to the development of a novel framework that integrates a needs-based screening and selection model for older adults and strategically incorporates technology to enhance the quality of care delivery. The findings of this dissertation challenge the conventional view that medical technologies are the primary drivers of escalating healthcare costs. Instead, the research offers empirical evidence suggesting that these technologies constitute strategic investments that yield long-term value for the healthcare system. The analyses demonstrate their economic viability by illustrating how they lead to improved outcomes and significant reductions in future healthcare resource utilisation, thereby compensating for initial capital expenditure. A key contribution is the effective employment of an integrated costing approach that transcends traditional budget silos, providing a more comprehensive and accurate depiction of the total cost of care. The dissertation introduces a novel strategy for the LTC sector, one that strategically exploits technology to enhance care efficiency and quality of life, primarily through the prioritisation of home-based LTC. By delivering robust, evidence-based solutions rooted in thorough economic analysis, this work offers policymakers practical guidance to address the most pressing challenges facing the Canadian healthcare system, guiding it toward a more sustainable and equitable future. 

Awarding Institution(s)

University of Plymouth

Supervisor

Mona Nasser, Daniela Oehring, Yang Zhou

Keywords

Health Economics, Health Policy, Healthcare System, Medical Technology, Canada

Document Type

Thesis

Publication Date

2025

Embargo Period

2025-11-27

Deposit Date

November 2025

Creative Commons License

Creative Commons Attribution-NonCommercial 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

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