Doctors and Canadian Medicare: Improving Accountability and Performance.

Q3 Medicine
Gregory P Marchildon, Michael Sherar
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引用次数: 2

Abstract

Physician compensation has been a rapidly growing segment of healthcare costs in Canada since the late 1990s. In comparative terms, Canadian physicians are now well compensated compared to physicians in other high-income countries. This has caused provincial governments to begin constraining physician remuneration. However, physician payment should be examined in a larger governance context, including the potentially changing role of physicians, as provincial governments try to improve quality, increase coordination and improve overall health system performance. Although limited progress has been made through primary care reforms in a few jurisdictions, substantive improvement has been hampered by a misalignment between the policy goals and intentions of provincial governments and existing governance and accountability structures. This creates an environment in which both administrators and physicians feel they have limited input or control, seeding an adversarial rather than a collaborative relationship. Effective reform will require addressing governance and accountability at the same time as physician payment.

医生和加拿大医疗保险:改进问责制和绩效。
自20世纪90年代末以来,医生报酬一直是加拿大医疗保健费用中快速增长的一部分。与其他高收入国家相比,加拿大医生现在的薪酬很高。这导致省政府开始限制医生的报酬。然而,医生薪酬应该在更大的治理背景下进行审查,包括医生潜在的角色变化,因为省级政府试图提高质量,加强协调和改善整体卫生系统的绩效。虽然在一些司法管辖区通过初级保健改革取得了有限的进展,但由于省级政府的政策目标和意图与现有治理和问责制结构之间的不一致,实质性的改善受到了阻碍。这创造了一种环境,在这种环境中,管理人员和医生都觉得他们的投入或控制有限,从而产生了一种对抗而不是合作的关系。有效的改革需要在解决医生薪酬问题的同时解决治理和问责问题。
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来源期刊
Healthcare Papers
Healthcare Papers Medicine-Health Policy
CiteScore
2.50
自引率
0.00%
发文量
11
期刊介绍: Integrating community-based health and social care has grabbed international attention as a way of addressing the needs of aging populations while contributing to health systems" sustainability. However, integrating initiatives in different jurisdictions work (or do not work) within very various.
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