Breton Mylaine, Lévesque Jean-Frédéric, Pineault Raynald, Lamothe Lise, Denis Jean-Louis
University of Montreal, Montreal, QC.
Healthc Policy. 2009 Feb;4(3):e159-78.
The quest for greater efficiency in health systems encourages governments to bring together two fields of practice that have largely developed in parallel in industrialized countries: public health and healthcare. Current healthcare reform in the province of Quebec formally integrates these two fields within a common governance structure. The objective of this paper is to discuss the issues arising from the integration of public health services into the planning and delivery of local healthcare services, and its potential effect on the overall performance of the healthcare system. The authors begin by describing the characteristics of these two sectors; then, they discuss current reforms in Quebec and the impact of various transitions (epidemiological, technological and organizational) that bring the sectors into greater convergence. The paper concludes with a discussion of obstacles and potential opportunities at two levels: (a) the development of population-based planning of services within healthcare organizations, and (b) the articulation of public health and healthcare services concerns at the local level. The ongoing reform in Quebec is a unique opportunity to maximize outcomes from the resources invested in the healthcare system, based on a collective vision for improving health. This paper was originally published in French, in the journal Pratiques et organisation des soins 39(2): 113-24.
公共卫生和医疗保健。魁北克省当前的医疗保健改革正式将这两个领域整合到一个共同的治理结构中。本文的目的是讨论将公共卫生服务纳入地方医疗保健服务规划和提供过程中产生的问题，以及其对医疗保健系统整体绩效的潜在影响。作者首先描述这两个部门的特征；然后，他们讨论魁北克省当前的改革以及使这些部门走向更大融合的各种转变（流行病学、技术和组织方面）的影响。本文最后讨论了两个层面上的障碍和潜在机遇：（a）医疗保健组织内基于人群的服务规划的发展，以及（b）地方层面公共卫生和医疗保健服务问题的衔接。魁北克省正在进行的改革是一个独特的机会，可基于改善健康的集体愿景，最大限度地提高投入到医疗保健系统中的资源的效益。本文最初以法语发表于《Pratiques et organisation des soins》39(2): 113 - 24期刊。
