This paper offers a detailed historical description of the development of Alberta's population-based funding model for Regional Health Authorities (RHAs). It focuses on key political factors that may have facilitated this transition — in particular, the role of institutions, organized interests, and ideas and values. Understanding the politics of policy change as exemplified in this case can be useful in assessing future prospects for health system reform in Canada and laying the groundwork for further comparative study.
JacobsPHallEPlainR. Alberta's acute care funding plan: Update to December 1994. Healthcare Management Forum1995; 8(2): 17–22.
3.
EliasophHAshdownC. Development, testing and implementation of an emergency services methodology in Alberta. Healthcare Management Forum1995; 8(1): 31–37.
4.
McKillopIPinkGHJohnsonLM. The financial management of acute care in Canada: A review of funding, performance monitoring and reporting practices. Ottawa, ON: Canadian Institute for Health Information; 2001. Available from: http://secure.cihi.ca
5.
EylesJBirchS. A population needs-based approach to health-care resource allocation and planning in Ontario: A link between policy goals and practice?Canadian Journal of Public Health1993; 84(2): 112–7.
6.
CreswellJ. Qualitative inquiry and research design: Choosing among five traditions. Thousand Oaks, CA: Sage Publications; 1998; 2.
StakeRE. The art of case study research. Thousand Oaks, CA: Sage Publications; 1995.
9.
YinRK. Applications of case study research. Thousand Oaks, CA: Sage Publications; 1993.
10.
YinRK. Case study research: Design and methods (3rd ed.) Thousand Oaks, CA: Sage Publications; 2003.
11.
PattonMQ. Qualitative evaluation and research methods (2nd ed.). Newbury Park, CA: Sage Publications; 1990.
12.
KingN. Template analysis. In: SymonGCassellC, editors. Qualitative methods and analysis in organizational research. London: Sage Publications; 1998; 118–134.
13.
WaddellCLavisJNAbelsonJLomasJShepherdCABird-GaysonT. Research use in children's mental health policy in Canada: Maintaining vigilance amid ambiguity. Social Science & Medicine2005; 61(8): 1649–1657.
14.
HallP. The role of interests, institutions, and ideas in the comparative political economy of the industrialized nations. In: LichbachMIZuckermanAS, editors. Comparative politics: Rationality, culture, and structure. New York: Cambridge University Press; 1999; 174–207.
15.
HayC. Ideas, interests and institutions in the comparative political economy of great transformations. Review of International Political Economy2004; 11(1): 204–226.
16.
LavisJN. A political science perspective on evidence-based decision-making. In: Lemieux-CharlesLChampagneF, editors. Using knowledge and evidence in health care: Multidisciplinary perspectives. Toronto, ON: University of Toronto Press; 1989; 70–85.
17.
TaylorM. Health insurance: The roller coaster in federal-provincial relations. In: ShugarmanDPWhitakerR, editors. Federalism and political community: Essays in honour of Donald Smiley. Peterborough, ON: Broadview Press; 1989; 73–92.
18.
EkstrandCWD. The economics of health care in Alberta: Relationship to planning. In: LarsonDELoveEJ, editors. Health care research: A symposium. Calgary, AB: University of Calgary; 1974; 133–142.
19.
HaazenD. Redefining the globe: Recent changes in the financing of British Columbia hospitals. In: DeberRBThompsonGG, editors. Restructuring Canada's health services system: How do we get there from here?. Toronto, ON: U of T Press; 1992; 73–84.
20.
Government of Alberta. An agenda for action: Report of the Advisory Committee on the Utilization of Medical Services [the Watanabe Committee]. Edmonton, AB: Author; 1989; 60.
21.
Alberta Hospitals and Medical Care. Acute care hospital funding review: Discussion paper. Edmonton, AB: Author; 1988; 8.
22.
EliasophE. Funding hospital-based emergency services. Journal of Ambulatory Care Management1993; 16(2): 90–100.
23.
Alberta Health Planning Secretariat. Starting points: Recommendations for creating a more accountable and affordable health system. Edmonton, AB:Author; 1993; 18.
24.
Health Plan Coordination Project. Action Plan: Part I. Mimeo; 1994; 8.
25.
Health Plan Coordination Project. Action Plan: Part IV Mimeo; 1994; 2.
26.
Health Services Funding Advisory Committee. Funding regional health services in Alberta: A report by the Health Services Funding Advisory Committee. Edmonton, AB: Author; 1996.
27.
Alberta Hansard: November 1, 1995; 2290.
28.
Alberta Health and Wellness. 2007/2008 Regional Health Authority global funding: Methodology and funding manual. Edmonton, AB: Author; 2007. Available from: http://www.health.alberta.ca/.
29.
Auditor General of Alberta. Annual report of the Auditor General of Alberta, 1997–98Edmonton, AB: Author; 1998; 128.
30.
Health Services Funding Review Committee. Building confidence in our health care system for the future: Report of the Health System Funding Review Committee. Edmonton, AB: Author; 1998.
31.
Auditor General of Alberta. Annual report of the Auditor General of Alberta, 1999–2000. Edmonton, AB: Author; 2000.
32.
Edmonton Journal. Leave health funding formula alone. 2002 July 24; Sect. A:10.
33.
PedersenR. Leaders want Klein to help WestView; Claim basic health care not being met. Edmonton Journal. 1999 April 6; Sect. A:8.
34.
DalalS. WestView Health Authority disbanded: Mismanagement, deficits, likely behind gov't decision. Edmonton Journal. 2002 June 28; Sect. A:1.
35.
GeddesA. Hospital operations ‘dysfunctional’: Probe orders major changes at Mistahia Health Authority. Edmonton Journal. 2002 October 17; Sect. A:7.
36.
Deloitte and Touche. Lakeland Regional Health Authority population formula review; 2002.
37.
Alberta Hansard. April 23, 1996; 1294.
38.
Alberta Hansard. May 14, 1996; 1837.
39.
Alberta Hansard. April 22, 1997; 98.
40.
ChurchJSmithN. Health reform and privatization in Alberta. Canadian Public Administration2006; 49(4): 486–505.
41.
ArcherKGibbinsRKnopffRPalLA. Parameters of power. Canada's political institutions (2nd ed.). Scarborough, ON: ITP Nelson; 1995.
42.
HurleyJ. Regionalization and the allocation of healthcare resources to meet population health needs. HealthcarePapers2004; 5(1): 34–39.
43.
FinlaysonGSForgetEOkechukwuEDerksenSBondRMartensPDe CosterC. Allocating funds for healthcare in Manitoba regional health authorities: A first step — population-based funding. Winnipeg, MB: Manitoba Centre for Health Policy; October 2007.
44.
FitzgeraldA. Public health funding approach: Report from the ad hoc funding task team. Halifax, NS: Nova Scotia Health Protection and Promotion; 2006.
45.
RachlisM. Health equity and Ontario's health based allocation model. Toronto, ON: The Wellesley Institute; 2008.
46.
GTA/905 Healthcare alliance growing pains: An urgent message from the strong communities coalition. Mississauga, ON: The United Way of Peel, York, Durham and Oakville Region; 2006. Available from: http://ww.unitedwaypeel.org
