Week 2: Canadian Healthcare Organizations and Managing Change

Canada Health Transfer

federal funding is given to provinces and territories so that they can provide healthcare services, assuming the provinces and territories meet specific criteria and conditions.

Public administration

Operated as not-for-profit by public accountability to the government

Comprehensiveness

Provincial and territorial health insurance plans must cover all “medically
necessary” health care services, including physician services, hospital care, and dental care when provided in a hospital. Provinces and territories have the autonomy to indicate what services they deem to be “medically necessary,” and they must cover the full costs of these services

Universality

All plans must ensure coverage for all insured citizens with a uniform approach

Portability

Provinces and territories must cover insured health care services provided to individuals when they are travelling within Canada, and to some degree when travelling outside of the country.

Accessibility

Insured persons must have reasonable access to medically necessary health care services, without barriers, financial or otherwise

Regionalization

Process used to decentralize services for efficiency: creation of regional branches based on geographical boundaries called health regions. Health regions are responsible for planning, prioritizing, budgeting, and allocating
funds to health agencies

Primary Health Care Services

First-contact services for routine checkups and problems, management of chronic conditions, as well as emergencies. Provision of coordination of patient’s health care services to ensure a holistic approach, continuity of care, a focus on health promotion, and disease prevention.

Secondary Health Care Services

Refers to specialized care in hospitals, long-term care, or the community. Services may be provided in the home, community, or institutions.

Additional health care services

Prescription drugs, dental care, vision care, and therapies (e.g. physical therapy) not usually covered by public health insurance. May be part of first contact services or secondary services. 

Hospital Care Services

Care services that are organized into primary, secondary, tertiary, and quaternary care. 

Primary Care

Typically offered by a GP, family physician, or nurse practitioner outside of the hospital.

Secondary Care

The starting point of hospital inpatient care, involving treatment by specialists focusing on a particular system and whom a patient has been referred to by a primary care provider.

Tertiary Care

Care needing highly specialized services, equipment, expertise

Quaternary

Centers for treatment of extremely specialized medical conditions

Ambulatory Care

Care provided to outpatients, ranging from primary to urgent care, in clinics or emergency departments. Care provided by hospitals for special health care needs that cannot easily be offered through home care services; patients do not stay overnight. 

Primary Care

first point of entry into the Canadian health care system and
comprises the assessment, diagnosis, and treatment of an individual by a general practitioner or family physician, NP, or other authorized health care provider.

Primary Health Care

broad concept that encompasses the provision of primary care but also includes efforts to address the social determinants of health and promote health equity.

Integrated Primary Care

healthcare approach that combines primary medical care with services such as behavioral health, pharmacy, and community services to provide a coordinated, person- and family-centered approach to care for individuals, especially those with complex needs

Open-Systems Theory

Theory that organizations are complex, interactive systems that exchange energy, information, and resources with their surrounding environment, rather than operating as self-contained entities. Contemporary health care organizations have adopted a more flexible, responsive, team-oriented approach to management, consistent with the principles of this theory.