Abstract
Analyzing The Pace and Direction of Primary Health Care Reform in Ontario, Canada: Transformative Change or Tranformation Lite?
Highlights
Almost four decades after the ground-breaking Declaration of Alma-Ata identified primary health care (PHC) as “essential health care,” there is growing consensus across the industrialized world that improvements in “first contact” care are crucial to enhance population health but to sustain increasingly stretched health c are systems
Since the 1980s, Ontario has implemented successive waves of primary care reform, producing a plethora of reform models, each with widely varying organizational characteristics, focus and “spread.” For example, Community Health Centres (CHCs), first advocated in the 1970s, feature salaried physicians, interdisciplinary teams, community boards, and a focus on health promotion and population health; they are limited by policy fiat to serving underserviced and marginalized populations such as the poor, recent immigrants, and persons with special needs
Conceptual Approach: In this paper, funded through a CIHR grant looking at integrating care for older people with complex health needs, we draw on the comparative policy literature to develop a conceptual approach which recognizes the multidimensional nature of primary health care and PHC reform models, and which weights these models to account for Willams; Analyzing The Pace and Direction of Primary Health Care Reform in Ontario, Canada: Transformative Change or Tranformation Lite?
Summary
Almost four decades after the ground-breaking Declaration of Alma-Ata identified primary health care (PHC) as “essential health care,” there is growing consensus across the industrialized world that improvements in “first contact” care are crucial to enhance population health but to sustain increasingly stretched health c are systems. In many jurisdictions, including Ontario, Canada’s richest and most populous province, progress toward primary health care (PHC) has been uneven.
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