Lamarche Paul A
Health Administration and GRIS, University of Montreal.
Healthc Pap. 2008;8(2):26-32; discussion 64-7. doi: 10.12927/hcpap.2008.19705.
Brian Hutchison views the numerous initiatives on primary healthcare in provinces and territories as indications that transformative changes are finally under way in Canada. Changes are indeed occurring. New primary healthcare models are being introduced. One could question whether they are the most promising models and whether they have the characteristics to become performing ones. These initiatives are being taken precisely at the time when the performance of the Canadian healthcare system is at the bottom. But performance was a lot better long before these changes were being introduced. Something else is at play in shaping the Canadian healthcare system, which involves but goes beyond primary healthcare: a tilting healthcare system. Unless a rebalance in favour of primary healthcare is accomplished, it is unlikely that the introduction of new PHC models alone could make the difference.
布赖恩·哈钦森认为,各省和地区在初级医疗保健方面开展的众多举措表明,加拿大终于开始进行变革性的改变了。变革确实正在发生。新的初级医疗保健模式正在被引入。人们可能会质疑这些模式是否是最有前景的模式,以及它们是否具备成为有效模式的特征。这些举措恰恰是在加拿大医疗保健系统表现处于低谷的时候实施的。但在这些变革实施之前很久,其表现要好得多。在塑造加拿大医疗保健系统方面,还有其他因素在起作用,这涉及但不限于初级医疗保健:一个失衡的医疗保健系统。除非实现有利于初级医疗保健的重新平衡,仅引入新的初级医疗保健模式不太可能带来改变。