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Coordinating primary care services: A case of policy layering
David Rudoler1, Allie Peckham2, Agnes Grudniewicz3
1Faculty of Health Sciences, University of Ontario Institute of Technology, Canada; Institute of Mental Health Policy Research, Centre for Addiction and Mental Health, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Canada.
Health Policy (Amsterdam, Netherlands)
|December 26, 2018
Summary
Incremental policy layering can drive health care reform, but may cause unintended consequences. New principles of
Area of Science:
- Health policy analysis
- Health systems research
- Policy implementation studies
Background:
- Health care reform often faces institutional barriers.
- Incremental policy layering is a common approach to reform.
- Existing layering methods can lead to unintended consequences.
Purpose of the Study:
- To analyze policy layering in health care reform.
- To propose principles for 'smart' policy layering.
- To guide decision-makers in achieving effective incremental change.
Main Methods:
- Conceptual analysis of policy layering.
- Case study application to Ontario primary care reforms.
- Development of 'smart' policy layering principles.
Main Results:
- Incremental policy layering can achieve material change in health systems.
- Unintended consequences are a significant risk of policy layering.
- 'Smart' policy layering offers a framework to mitigate risks and improve outcomes.
Conclusions:
- Policy layering is a viable strategy for health care reform, especially with institutional barriers.
- 'Smart' policy layering principles can enhance the effectiveness of incremental reforms.
- Application in Ontario demonstrates the potential of this approach for coordinated primary care.
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