How do Policy and Institutional Settings Shape Opportunities for Community-Based Primary Health Care? A Comparison of Ontario, Québec and New Zealand
Community-based primary health care describes a model of service provision that is oriented to the population health needs and wants of service users and communities, and has particular relevance to supporting the growing proportion of the population with multiple chronic conditions. Internationally...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Ubiquity Press
2017-06-01
|
| Series: | International Journal of Integrated Care |
| Subjects: | |
| Online Access: | http://www.ijic.org/articles/2514 |
| _version_ | 1818138628309647360 |
|---|---|
| author | Tim Tenbensel Fiona Miller Mylaine Breton Yves Couturier Frances Morton-Chang Toni Ashton Nicolette Sheridan Alexandra Peckham A Paul Williams Tim Kenealy Walter Wodchis |
| author_facet | Tim Tenbensel Fiona Miller Mylaine Breton Yves Couturier Frances Morton-Chang Toni Ashton Nicolette Sheridan Alexandra Peckham A Paul Williams Tim Kenealy Walter Wodchis |
| author_sort | Tim Tenbensel |
| collection | DOAJ |
| description | Community-based primary health care describes a model of service provision that is oriented to the population health needs and wants of service users and communities, and has particular relevance to supporting the growing proportion of the population with multiple chronic conditions. Internationally, aspirations for community-based primary health care have stimulated local initiatives and influenced the design of policy solutions. However, the ways in which these ideas and influences find their way into policy and practice is strongly mediated by policy settings and institutional legacies of particular jurisdictions. This paper seeks to compare the key institutional and policy features of Ontario, Québec and New Zealand that shape the ‘space available’ for models of community-based primary health care to take root and develop. Our analysis suggests that two key conditions are the integration of relevant health and social sector organisations, and the range of policy levers that are available and used by governments. New Zealand has the most favourable conditions, and Ontario the least favourable. All jurisdictions, however, share a crucial barrier, namely the ‘barbed-wire fence’ that separates funding of medical and ‘non-medical’ primary care services, and the clear interests primary care doctors have in maintaining this fence. Moves in the direction of system-wide community-based primary health care require a gradual dismantling of this fence. |
| first_indexed | 2024-12-11T10:15:13Z |
| format | Article |
| id | doaj.art-0a61bf5ed7f947fca9ae070530ecaae3 |
| institution | Directory Open Access Journal |
| issn | 1568-4156 |
| language | English |
| last_indexed | 2024-12-11T10:15:13Z |
| publishDate | 2017-06-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | International Journal of Integrated Care |
| spelling | doaj.art-0a61bf5ed7f947fca9ae070530ecaae32022-12-22T01:11:37ZengUbiquity PressInternational Journal of Integrated Care1568-41562017-06-0117210.5334/ijic.25142642How do Policy and Institutional Settings Shape Opportunities for Community-Based Primary Health Care? A Comparison of Ontario, Québec and New ZealandTim Tenbensel0Fiona Miller1Mylaine Breton2Yves Couturier3Frances Morton-Chang4Toni Ashton5Nicolette Sheridan6Alexandra Peckham7A Paul Williams8Tim Kenealy9Walter Wodchis10University of AucklandUniversity of TorontoUniversity of SherbrookeUniversity of SherbrookeUniversity of TorontoUniversity of AucklandUniversity of AucklandUniversity of TorontoUniversity of TorontoUniversity of AucklandUniversity of TorontoCommunity-based primary health care describes a model of service provision that is oriented to the population health needs and wants of service users and communities, and has particular relevance to supporting the growing proportion of the population with multiple chronic conditions. Internationally, aspirations for community-based primary health care have stimulated local initiatives and influenced the design of policy solutions. However, the ways in which these ideas and influences find their way into policy and practice is strongly mediated by policy settings and institutional legacies of particular jurisdictions. This paper seeks to compare the key institutional and policy features of Ontario, Québec and New Zealand that shape the ‘space available’ for models of community-based primary health care to take root and develop. Our analysis suggests that two key conditions are the integration of relevant health and social sector organisations, and the range of policy levers that are available and used by governments. New Zealand has the most favourable conditions, and Ontario the least favourable. All jurisdictions, however, share a crucial barrier, namely the ‘barbed-wire fence’ that separates funding of medical and ‘non-medical’ primary care services, and the clear interests primary care doctors have in maintaining this fence. Moves in the direction of system-wide community-based primary health care require a gradual dismantling of this fence.http://www.ijic.org/articles/2514community-based primary health careCanadaNew Zealandpolicyinstitutions |
| spellingShingle | Tim Tenbensel Fiona Miller Mylaine Breton Yves Couturier Frances Morton-Chang Toni Ashton Nicolette Sheridan Alexandra Peckham A Paul Williams Tim Kenealy Walter Wodchis How do Policy and Institutional Settings Shape Opportunities for Community-Based Primary Health Care? A Comparison of Ontario, Québec and New Zealand International Journal of Integrated Care community-based primary health care Canada New Zealand policy institutions |
| title | How do Policy and Institutional Settings Shape Opportunities for Community-Based Primary Health Care? A Comparison of Ontario, Québec and New Zealand |
| title_full | How do Policy and Institutional Settings Shape Opportunities for Community-Based Primary Health Care? A Comparison of Ontario, Québec and New Zealand |
| title_fullStr | How do Policy and Institutional Settings Shape Opportunities for Community-Based Primary Health Care? A Comparison of Ontario, Québec and New Zealand |
| title_full_unstemmed | How do Policy and Institutional Settings Shape Opportunities for Community-Based Primary Health Care? A Comparison of Ontario, Québec and New Zealand |
| title_short | How do Policy and Institutional Settings Shape Opportunities for Community-Based Primary Health Care? A Comparison of Ontario, Québec and New Zealand |
| title_sort | how do policy and institutional settings shape opportunities for community based primary health care a comparison of ontario quebec and new zealand |
| topic | community-based primary health care Canada New Zealand policy institutions |
| url | http://www.ijic.org/articles/2514 |
| work_keys_str_mv | AT timtenbensel howdopolicyandinstitutionalsettingsshapeopportunitiesforcommunitybasedprimaryhealthcareacomparisonofontarioquebecandnewzealand AT fionamiller howdopolicyandinstitutionalsettingsshapeopportunitiesforcommunitybasedprimaryhealthcareacomparisonofontarioquebecandnewzealand AT mylainebreton howdopolicyandinstitutionalsettingsshapeopportunitiesforcommunitybasedprimaryhealthcareacomparisonofontarioquebecandnewzealand AT yvescouturier howdopolicyandinstitutionalsettingsshapeopportunitiesforcommunitybasedprimaryhealthcareacomparisonofontarioquebecandnewzealand AT francesmortonchang howdopolicyandinstitutionalsettingsshapeopportunitiesforcommunitybasedprimaryhealthcareacomparisonofontarioquebecandnewzealand AT toniashton howdopolicyandinstitutionalsettingsshapeopportunitiesforcommunitybasedprimaryhealthcareacomparisonofontarioquebecandnewzealand AT nicolettesheridan howdopolicyandinstitutionalsettingsshapeopportunitiesforcommunitybasedprimaryhealthcareacomparisonofontarioquebecandnewzealand AT alexandrapeckham howdopolicyandinstitutionalsettingsshapeopportunitiesforcommunitybasedprimaryhealthcareacomparisonofontarioquebecandnewzealand AT apaulwilliams howdopolicyandinstitutionalsettingsshapeopportunitiesforcommunitybasedprimaryhealthcareacomparisonofontarioquebecandnewzealand AT timkenealy howdopolicyandinstitutionalsettingsshapeopportunitiesforcommunitybasedprimaryhealthcareacomparisonofontarioquebecandnewzealand AT walterwodchis howdopolicyandinstitutionalsettingsshapeopportunitiesforcommunitybasedprimaryhealthcareacomparisonofontarioquebecandnewzealand |