Canadian cancer care: organizational models

Canadian cancer care has evolved under systems of provincial and federal fiscal control and aims to optimize the management of patients within each province. In Manitoba, patients are initially assessed at one centre but can subsequently receive chemotherapy at an outreach centre closer to home. In British Columbia, two outreach mechanisms exist: consultative clinics provide consultative and follow-up care by radiotherapists and medical oncologists who travel to outreach centres, and community-based regional oncologists provide diagnostic and treatment services in small communities. In Ontario, peripheral clinics are staffed by oncologists from the two provincial cancer institutions, but efforts have been made to find newer outreach models that will better serve certain communities in that province. Two basic models of cancer care organization in the community presently exist in Canada: one stresses the extension of resources outward to the community from major cancer centres, and the other stresses the support of already established resources in the community. Efforts to coordinate these activities are being initiated.