Leatt P, Leggatt S G
Department of Health Administration, Faculty of Medicine, University of Toronto.
Healthc Manage Forum. 1997 Winter;10(4):12-25. doi: 10.1016/S0840-4704(10)60976-3.
Many Canadian provincial governments are exploring methods to increase the integration of health services in an effort to improve the care provided, while maintaining or reducing the costs. Integrated health delivery systems are being implemented in the United States, Britain and other European countries. Such systems aim to provide a full continuum of care to a defined target population under a financing system of capitation. This article explores the issues associated with the governance accountabilities of an IDS. A review of potential governance models is completed, and the factors that influence the choice of a governance model for an integrated delivery system are presented. In 1987. Ewell identified governing boards as the weakest link in the integrated health care systems of the United States. It is suggested that early attention to governance in the development of IDS models in Canada may improve the effectiveness of these systems.
许多加拿大省级政府正在探索提高医疗服务整合度的方法，以改善所提供的护理，同时维持或降低成本。美国、英国和其他欧洲国家正在实施综合医疗服务体系。此类体系旨在在按人头付费的融资体系下，为特定目标人群提供全面的连续护理。本文探讨了与综合医疗服务体系治理责任相关的问题。完成了对潜在治理模式的审查，并阐述了影响综合医疗服务体系治理模式选择的因素。1987年，埃韦尔指出管理委员会是美国综合医疗体系中最薄弱的环节。有人认为，加拿大在综合医疗服务体系模式发展过程中尽早关注治理问题，可能会提高这些体系的有效性。
