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加拿大的区域化:一份有待传承的宝贵遗产。

Regionalization in Canada: a promising heritage to build on.

作者信息

Denis Jean-Louis, Contandriopoulos Damien, Beaulieu Marie-Dominique

机构信息

Administration de Santé Faculté de Médecine, Université de Montréal, Canada.

出版信息

Healthc Pap. 2004;5(1):40-5; discussion 96-9. doi: 10.12927/hcpap..16837.

Abstract

Regionalization has been a major policy experiment in Canadian healthcare. Objectives attached to this policy were ambitious and somewhat unrealistic. Regional health authorities have shown that they can play a useful role in implementing healthcare reform. However, their legitimacy is difficult to sustain, and they need to renew their roles in order to remain a valuable asset in the improvement of healthcare delivery. A model of leadership for RHAs based on content and process dimensions is proposed to support the development of their role in improving the delivery of care. RHAs need to depart from a too distant mode of managing healthcare and support more healthcare organizations in their search for innovative ideas and organizing models and strategies. By adopting such an approach to their roles, it is expected that RHAs will further contribute to the improvement of healthcare and consequently will gain legitimacy to develop more autonomous policies with regard to broad ideals such as democratization and health improvement.

摘要

区域化一直是加拿大医疗保健领域的一项重大政策试验。该政策所附目标雄心勃勃,但有些不切实际。区域卫生当局已表明,它们在实施医疗改革方面可以发挥有益作用。然而,它们的合法性难以维持,需要重新定位其角色,以便在改善医疗服务方面继续成为一项宝贵资产。本文提出了一种基于内容和过程维度的区域卫生当局领导模式,以支持其在改善医疗服务方面作用的发展。区域卫生当局需要摒弃过于疏远的医疗管理模式,支持更多医疗组织寻求创新理念、组织模式和战略。通过采用这种角色定位方式,预计区域卫生当局将进一步推动医疗保健的改善,从而获得合法性,以制定更多关于民主化和健康改善等广泛理想的自主政策。

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