Service management: an epidemiological model of health services organization

The New Zealand health system is undergoing a major paradigm shift. Services and programs have largely replaced hospitals and other institutions as the basic organizational framework, with each service having an epidemiologically defined responsibility for the provision of integrated personal and public health services for the population it serves. Primary health care as the infrastructure service is being implemented in some areas. These changes are being reinforced by the National Government's continuing reform process in which population-based and funded regional health authorities are purchasing all health services--primary, secondary, personal, public, acute and continuing--from a capitated and capped budget based on meeting the health needs of their populations.