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CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 1996 Mar 15;154(6):803–809.

Integrated delivery systems: has their time come in Canada?

P Leatt 1, G H Pink 1, C D Naylor 1
PMCID: PMC1487797  PMID: 8634958

Abstract

In the 1990s every Canadian province is struggling to reduce health care expenditures without jeopardizing access to health care or quality of care. The authors propose a new model for health care delivery: the Canadian Integrated Delivery System (CIDS). A CIDS is a network of health care organizations; it would provide, or arrange to provide, a coordinated continuum of services to a defined population and would be held clinically and fiscally accountable for the outcomes in and health status of that population. A CIDS would serve 100,000 to 2 million people; the care it would provide would be funded on a capitation basis. For providers, there would be explicit financial incentives to minimize costs. At the same time, service quality and consumer choice of primary care practitioner would be maintained. Primary care physicians and specialists would work with other health care service providers to offer a full spectrum of care. CIDS providers would form strategic alliances with community agencies, hospitals, the private sector and other health care services not managed by the CIDS, as needed. For physicians, affiliation with a CIDS that provided strong clinical leadership could be beneficial to their income stability and autonomy. Pilot projects of this model in several communities would determine whether this concept is feasible in the Canadian health care context.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Griffith J. R. The infrastructure of integrated delivery systems. Do you have the management foundation to support radical change? Healthc Exec. 1995 May-Jun;10(3):12–17. [PubMed] [Google Scholar]
  2. Kronick R., Goodman D. C., Wennberg J., Wagner E. The marketplace in health care reform. The demographic limitations of managed competition. N Engl J Med. 1993 Jan 14;328(2):148–152. doi: 10.1056/nejm199301143280225. [DOI] [PubMed] [Google Scholar]
  3. Leatt P., Barnsley J. Physicians in health care management: 9. Strategic alliances and relationships between organizations. CMAJ. 1994 Sep 15;151(6):763–767. [PMC free article] [PubMed] [Google Scholar]
  4. Pointer D. D., Alexander J. A., Zuckerman H. S. Loosening the Gordian Knot of governance in integrated health care delivery systems. Front Health Serv Manage. 1995 Spring;11(3):3–52. [PubMed] [Google Scholar]
  5. Shortell S. M., Gillies R. R., Anderson D. A., Mitchell J. B., Morgan K. L. Creating organized delivery systems: the barriers and facilitators. Hosp Health Serv Adm. 1993 Winter;38(4):447–466. [PubMed] [Google Scholar]

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