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• W2898816635 abstract "In 2006, Ontario became the last Canadian province to implement health services regionalization with the establishment of Local Health Integration Networks (LHINs). Facing a large health reform agenda to be implemented in a of disconnected health service silos, the Ontario government created the LHINs as a recognition of the need for system change to achieve health reform. As a component of greater provincial health reform goals, the LHINs were specifically designed to integrate health services; however, they may have been implicitly created to shift accountability away from the central government. While some stakeholders supported reform goals of increased health system integration and responsiveness, others opposed the reform stating concern about increased bureaucracy and lack of stakeholder input. Nevertheless, the reform was achieved with the policy framework developed by a government-mandated team and the creation of legislation called the Local Health System Integration Act. To date, no robust evaluations have assessed the causal impact of the LHINs on the integration of the health system in Ontario. The lack of primary care integration and the retention of local health organization boards may have prevented the LHINs from realizing their potential. The decade long experience of the LHINs is a lesson for the Patients First Act enacted in 2016, the next phase of Ontario health care reform involving LHINs as key players.L’Ontario est devenue en 2006 la derniere province canadienne a regionaliser ses services de sante avec la mise en place des Reseaux Locaux d’Integration des Services de Sante (RLISS). Souhaitant mettre en œuvre un programme ambitieux de reformes dans un « systeme » fractionne de services de sante travaillant separement, le gouvernement de l’Ontario a cree les RLISS, reconnaissant que la reforme passait par une refonte du systeme. Le role des RLISS comme composante de la reforme de la sante de la province etait specifiquement de faire collaborer les services de sante entre eux; cependant, il est aussi possible qu’ils aient ete implicitement crees pour detourner la responsabilite du gouvernement central. La reforme a ete bien accueillie par certaines parties prenantes, qui soutenaient les objectifs d’integration du systeme et de plus grande flexibilite, mais des voix se sont elevees pour denoncer le poids accru de la bureaucratie et le manque de consultations des acteurs. Quoiqu’il en soit, la reforme a abouti au developpement d’un cadre legislatif par une equipe mandatee par le gouvernement et la creation d’une legislation, la Loi sur l’Integration du Systeme de Sante. A ce jour, aucune evaluation de l’effet des RLISS sur l’integration du systeme de sante en Ontario n’a ete tentee. Le fait que la sante primaire n’ait pas ete incluse dans le mandat d’integration, et le maintien des conseils des organisations sanitaires locales ont sans doute empeche les RLISS de realiser pleinement leur mission. La loi de 2016 donnant la priorite au patient, prochaine etape de la reforme sanitaire en Ontario, dans laquelle les RLISS jouent un role central, peut tirer les lecons des dix ans d’experience des RLISS." @default.
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• W2898816635 date "2018-11-02" @default.
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• W2898816635 title "The Establishment of Ontario's Local Health Integration Networks: A Conflation of Regionalization with Integration of Health Services" @default.
• W2898816635 doi "https://doi.org/10.13162/hro-ors.v6i2.2850" @default.
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