承诺和危险:卫生系统改革如何影响加拿大三个省的公共卫生
Tamika Jarvis1,2, Robert W Smith3, Harman Singh Sandhu4
1Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
概括
加拿大卫生系统的集中改革旨在提高效率,但影响了公共卫生运营和劳动力. 调查结果表明,需要包容性治理和稳定的资金来支持公共卫生功能.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 卫生政策 卫生政策
背景情况:
- 加拿大各省和地区正在集中卫生系统,巩固权力,资源和责任.
- 这一改革旨在提高医疗保健服务的效率和价值.
研究的目的:
- 探索卫生系统集中化改革背后的动机因素.
- 检查这些改革对公共卫生系统和基本操作的感知影响.
主要方法:
- 采用多个案例研究设计,重点关注加拿大三个正在进行卫生系统改革的省份.
- 在战略和运营层面,与58名公共卫生利益相关者进行了半结构化访谈.
- 专题分析被用来确定和完善与改革相关的关键主题.
主要成果:
- 集中化旨在巩固权威并实现"金钱的价值",在核心公共卫生功能中注意到一些效率,特别是在阿尔伯塔省.
- 改革对跨部门和社区层面的合作产生了负面影响.
- 人们担心不优先考虑公共卫生工作,转移资源,减少公共卫生工作人员.
结论:
- 利益相关者的优先事项和对公共卫生系统缺乏理解影响了改革实施.
- 现代化的治理,稳定的资金和对公共卫生工作人员的投资对于未来的改革至关重要.
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