Primary Health Care in Canada: Systems in Motion
Primary Health Care in Canada: Systems in Motion
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DOI：
10.1111/j.1468-0009.2011.00628.x
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发表时间：
2011-06-01
影响因子：
6.6
通讯作者：
Coyle, Natalie
中科院分区：
文献类型：
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作者：
Hutchison, Brian;Levesque, Jean-Frederic;Coyle, Natalie
背景：在 20 世纪 80 年代和 90 年代，加拿大初级卫生保健的组织、资金和提供方面的创新处于该系统的外围，而不是其核心。 2000 年代初，出现了新的政策环境。 方法：本政策分析借鉴了已发表的灰色文献和对加拿大初级卫生保健知情观察者的一系列半结构化访谈中的描述性信息，考察了过去十年加拿大的初级卫生保健改革努力。研究结果：加拿大的初级卫生保健已进入一个潜在的变革时期。主要举措包括支持跨专业初级卫生保健团队、团体实践和网络、初级卫生保健提供者的患者登记、经济激励和混合支付计划、发展初级卫生保健治理机制、扩大初级卫生保健提供者库、实施电子病历以及质量改进培训和支持。结论：加拿大的经验表明，只要有强有力的政府和专业领导的共同努力，初级卫生保健转型可以在私人卫生保健提供的多元化体系中自愿实现。
Context: During the 1980s and 1990s, innovations in the organization, funding, and delivery of primary health care in Canada were at the periphery of the system rather than at its core. In the early 2000s, a new policy environment emerged.Methods: This policy analysis examines primary health care reform efforts in Canada during the last decade, drawing on descriptive information from published and gray literature and from a series of semistructured interviews with informed observers of primary health care in Canada.Findings: Primary health care in Canada has entered a period of potentially transformative change. Key initiatives include support for interprofessional primary health care teams, group practices and networks, patient enrollment with a primary care provider, financial incentives and blended-payment schemes, development of primary health care governance mechanisms, expansion of the primary health care provider pool, implementation of electronic medical records, and quality improvement training and support.Conclusions: Canada's experience suggests that primary health care transformation can be achieved voluntarily in a pluralistic system of private health care delivery, given strong government and professional leadership working in concert.