医疗人力资源的管理:加拿大的经验

Management of human resources in health care: The Canadian experience

Health Economics · 1992
被引 4
人大 A-

中文导读

介绍加拿大各省公共医疗保险体系,指出医疗人力资源规划进展有限,核心问题是医生供给与角色,并分析按服务收费制度对任务下放的阻碍以及政府角色转变。

Abstract

Each of Canada's ten provinces has a publicly administered system of health insurance, funded by provincial and federal taxes, that is accessible to all citizens and covers all medically necessary services provided by physicians and hospitals. Canadians spend an estimated 9.2 percent of their gross national product on health care (about 2.8 percentage points below US spending), of which three quarters is public-sector spending. According to the Organization for Economic Cooperation and Development, Canada's health status is equal to or better than that of the United States, despite lower per capita health spending. About seven percent of the Canadian labour force works in health care, and attempts to introduce coordinated planning of human resources in health care have not as yet proceeded far. The predominant policy issue here is the supply and the role of physicians. It has been argued that entrenching within the system the fee-for-service method of paying physicians has created a disincentive to the delegation of responsibility to health personnel other than doctors. It is also argued that introduction of government-run health insurance provided the opportunity for human resource planning, but that the decision by governments to act only as the payer resulted in ad-hoc planning approaches. However, governments' concern over health care costs has led to a more direct role by them in the planning of the human resources in health. They are re-examining the autonomy and jurisdictional rights of the professions that deliver health care to Canadians.

加拿大医疗人力资源医生供给按服务收费人力资源规划