van Soeren Mary, Hurlock-Chorostecki Christina, Pogue Pamela, Sanders Jane
Canadian Health Care Innovations.
Healthc Pap. 2008;8(2):39-44; discussion 64-7. doi: 10.12927/hcpap.2008.19707.
Primary healthcare renewal was an important government initiative arising in the early 21st century. This sector of the healthcare system in Canada had been under-resourced and ignored for decades. Recent changes include the development of salaried models for physician care, the use of other professionals in primary care, the integration of inter-professional teams, funding for information management systems and some incentives to provide directed primary care services. However, these changes are limited by a lack of overall policy direction to drive innovation, the absence of a shift in the locus of control of healthcare, a lack of education for healthcare providers to support inter-professional team-based practices and a failure to be more accountable to the Canadian public's needs. Without these innovations, the primary healthcare system will again be overwhelmed by future healthcare needs. Based on these limitations, we question whether this renewal represents lasting change in primary healthcare or a band-aid solution to the continued issue of primary healthcare delivery.
初级医疗保健的复兴是21世纪初出现的一项重要政府举措。加拿大医疗保健系统的这一部门在几十年里一直资源不足且被忽视。近期的变化包括发展医生薪酬模式、在初级保健中使用其他专业人员、跨专业团队的整合、信息管理系统的资金投入以及一些提供定向初级保健服务的激励措施。然而,这些变化受到以下因素的限制:缺乏推动创新的总体政策方向、医疗保健控制权未发生转移、缺乏对医疗保健提供者的教育以支持基于跨专业团队的实践,以及未能更好地满足加拿大公众的需求。没有这些创新,初级医疗保健系统将再次被未来的医疗需求压垮。基于这些限制,我们质疑这种复兴是代表着初级医疗保健的持久变革,还是对初级医疗保健服务持续问题的权宜之计。