Brunet J, Genest C, Martin N
Can Med Assoc J. 1977 May 7;116(9):1074, 1076-8, 1085.
The reform of health services in Quebec, of which the most important stage was the creation of the Department of Social Affairs and the Quebec Health Insurance Board, has solved certain problems such as the inaccessibility to care because of the cost, the paucity of medical personnel and the excessive increase in the cost of the services offered to hospital patients. A critical analysis of both the reform and its practical consequences points to certain conclusions which, far from rejecting the principle of the reform, indicate none the less various possibilities for reorienting its priorities. Observing the rate of recourse to health services as well as the attitudes and conduct of health professionals have helped us to identify the causes of certain tendencies inspired by the incentives inherent in the reform. The organization of health services in Quebec must be oriented toward new priorities: the prevention and treatment both of environmental diseases and diseases associated with ageing plus the definition of a global approach to public health.
魁北克省的医疗服务改革,其中最重要的阶段是设立社会事务部和魁北克医疗保险委员会,解决了某些问题,如因费用而无法获得医疗服务、医务人员短缺以及向住院患者提供的服务费用过度上涨等问题。对改革及其实际后果进行批判性分析得出了某些结论,这些结论远非否定改革的原则,而是指出了重新调整其优先事项的各种可能性。观察医疗服务的求助率以及医疗专业人员的态度和行为,有助于我们确定改革内在激励因素所引发的某些趋势的原因。魁北克省的医疗服务组织必须朝着新的优先事项发展:预防和治疗环境疾病以及与老龄化相关的疾病,同时确定公共卫生的全球方法。