Health System Regionalization in Canada's Provincial and Territorial Health Systems: Do Citizen Governance Boards Represent, Engage, and Empower?

Abstract

Regionalization of the health care system, through the creation of sub-provincial service-delivery regions and governance authorities (i.e., regional health authorities, RHAs), has been a key part of Canadian health reform initiatives of the past two decades. Increased public participation in health care planning and service delivery is one of the explicit goals of regionalization. Based on a reanalysis of data from a 2001 survey of health system governors from 134 RHAs throughout Canada, this study explores the overall demographic composition of the citizen governance boards, as well as their responses to various opinion and attitude questions. To enable consideration of the extent to which these sites may support public deliberation and community development, overall responses are examined, as are responses within two subtypes of governors: system-experienced citizen governors and lay citizen governors--governors with or without previous health-system employment experience, respectively. The findings suggest that attention needs to be paid to these citizen governance boards if they are truly meant to be sites of citizen engagement in health policy and governance.