A surprisingly large and ever-growing number of alternative models of primary care service delivery have been developed in Ontario. The models are relatively poorly understood, and it is unclear why there are so many of them. What needs of providers and of government as payer are they attempting to address? Through a literature review and interviews with key informants, we sought to explain why there are so many models.
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References
1.
NaylorCD. Private practice, public payment: Canadian medicine and the politics of health insurance 1911–1966. Kingston and Montreal: McGill—Queen's University Press; 1986.
2.
Commission on the Future of Health Care in Canada (R.J. Romanow, Commissioner). Building on values: The future of health care in Canada — Final report. Ottawa, ON: Health Canada; November 2002. Cat. no. CP32-85/2002E-N.
Health Services Restructuring Commission. Primary health care strategy: Advice and recommendations to the Honourable Elizabeth Witmer, Minister of Health. Toronto, ON: Author; 1999.
WatsonDBroemelingAReidRBlackC. A results-based logic model for primary health care: Laying the evidence-based foundation to guide performance measurement, monitoring and evaluation. Vancouver, BC: Centre for Health Services and Policy Research; 2004.
7.
Committee on Quality of Health Care in America, U.S.Institute of Medicine. Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press; 2001.
8.
U.K. Department of Health. A responsive and high-quality local NHS — The primary care progress report 2004. London: Department of Health Publications; April 2004. [Accessed April 24, 2006]. Available at: http://www.dh.gov.uk/assetRoot/04/07/93/97/04079397.pdf
9.
McGuireTG. Physician agencies. In: CulyerATNewburyJP, editors. Handbook of health economics. Vol. 1 (pp. 462–535). Amsterdam: Elsevier; 2000.
10.
LamarchePBeaulieuMPineaultRConstandroipoulosADenisJHaggertyJ. Choices for change: The path for restructuring primary healthcare services in Canada (pp. 11, 22). Ottawa, ON: Canadian Health Services Research Foundation; 2003.
11.
Commission on the Future of Health Care in Canada (R.J. Romanow, Commissioner). Building on values: The future of health care in Canada — Final report (p. 106). Ottawa, ON: Health Canada; November 2002. Cat. no. CP32-85/2002E-IN.
12.
StarfieldB. Primary care: Balancing health needs, services, and technology (p. 11). New York: Oxford University Press; 1998.
13.
HutchisonBAbelsonJLavisJ. Primary care in Canada: So much innovation, so little change. Health Aff2001; 20(3): 116–121.
14.
CreswellJW. Qualitative inquiry and research design: Choosing among five traditions. Thousand Oaks, CA: Sage Publications; 1998.
15.
StraussACorbinJ. Basics of qualitative research: Techniques and procedures for developing grounded theory. Thousand Oaks, CA: Sage Publications; 1998.
16.
CoulsonDB. Primary health care models in Ontario. Toronto, ON: Coulson & Associates; September 2005.
