University of Toronto, Toronto, Ontario, Canada.
Family Medicine, 8613North York General Hospital, Toronto, Ontario, Canada.
Healthc Manage Forum. 2020 Nov;33(6):259-264. doi: 10.1177/0840470420935474. Epub 2020 Jul 15.
Although national spending on healthcare has progressed on an upward trend over several decades, issues regarding performance remain. Challenges such as access to specialist care and maternal and infant mortality rates contributed to Canada's recent ranking of ninth among 11 Organisation for Economic Co-operation and Development countries for overall health system performance. Although disruptive transformation is required to resolve our chronic performance issues, effective change cannot be realized without addressing the foundational elements of patient-centred care, interprofessional care, and system integration. Inspired by examples of innovative disruption in other jurisdictions and industries, these three concepts are outlined as the core ingredients for healthcare transformation and describe how they currently function in a paradoxical manner-as self-contradictory statements which in reality are not executed to their true meaning. This article illustrates how improvements in health system performance are hinged to the need to rectify and fuse these three mutually inclusive and inseparable concepts.
尽管几十年来，各国在医疗保健方面的支出呈上升趋势，但绩效问题依然存在。加拿大在医疗体系绩效方面的总体排名仅为经济合作与发展组织（OECD）11 个成员国中的第 9 位，这主要是由于获取专科护理和母婴死亡率方面存在挑战。尽管需要进行颠覆性变革来解决我们长期存在的绩效问题，但如果不解决以患者为中心的护理、多专业团队合作和系统整合的基本要素，就无法实现有效的变革。受其他司法管辖区和行业创新颠覆的启发，这三个概念被概述为医疗保健转型的核心要素，并描述了它们目前如何以自相矛盾的方式发挥作用——作为自相矛盾的陈述，实际上并没有按照其真正的含义执行。本文说明了要改善医疗体系的绩效，就必须纠正和融合这三个相互包容且不可分割的概念。
