Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada.
DeGroote School of Business, McMaster University, Hamilton, Ontario, Canada.
Int J Health Plann Manage. 2022 Sep;37(5):2534-2541. doi: 10.1002/hpm.3531. Epub 2022 Jun 12.
Over the last 15 years, there has been a trend in Canada to centralise the provision of health services that were previously administratively and fiscally decentralised. Canadian policy rhetoric on centralisation often identifies improved innovation as an anticipated outcome. This paper challenges the assumed relationship between centralisation and innovation. We incorporate evidence from the management literature into the debate on the structure of health systems to explore the effects that centralisation is likely to have on innovation in health systems. The findings of this paper will be of interest to international policymakers, who are currently grappling with the prospect of maintaining a decentralised approach or adopting a more centralised health system structure in the future.
在过去的 15 年中，加拿大一直存在将以前在行政和财政上分散的卫生服务集中化的趋势。加拿大关于集中化的政策言论经常将改进创新确定为预期结果。本文质疑集中化与创新之间的假定关系。我们将管理文献中的证据纳入卫生系统结构的辩论中，以探讨集中化可能对卫生系统创新产生的影响。本文的研究结果将引起国际政策制定者的兴趣，他们目前正在努力应对在未来保持分散方法或采用更集中的卫生系统结构的前景。
