By Peggy Leatt, George H. Pink, Michael Guerriere
HealthcarePapers, 1(2) 2000: 13-35
Canada does not have integrated healthcare. Canada has a series of disconnected parts, a hodge-podge patchwork, healthcare industry comprising hospitals, doctors' offices, group practices, community agencies, private sector organizations, public health departments and so on. Each Canadian province is experimenting with different types of organizational structures and processes with the intent of improving the coordination of services, facilitating better collaboration among providers and providing better healthcare to the population. However, regional health authorities and their variants in Canada do not possess most of the basic characteristics of integrated healthcare such as physician integration and a rostered population (Hospital Management Research Unit 1996,1997).
In contrast, most developed countries are currently emphasizing integration of the components of healthcare as a solution to many of the problems that plague national health systems (Raffel 1997; Saltman and Figueras 1998). This paper uses evidence from the international experience to recommend strategies for achieving integrated healthcare in Canada. In the first section integrated healthcare is defined. Next, some of the reasons why countries are moving towards integrated healthcare are presented. Canadian progress to date towards an integrated system is then outlined. In the last sections of the paper, lessons learned from the international experience are summarized and used as a basis for proposing several strategies of moving towards a distinctive Canadian model.