IHPME Researchers Lead CIHR Project Grant-Funded Study Evaluating Provincial Healthcare Reforms

Structural shifts are seeing provinces move away from more decentralized healthcare systems towards a more centralized approach that favours accountable, integrated, community-focused healthcare. While these provincial healthcare reforms are being carried out with patient wellbeing in mind, providers and system managers are navigating these new models without a roadmap.

By: Marielle Boutin

Since changes have moved into their implementation phase, there has been no formal evaluation in place to see if and how these changes are working. To help establish an independent evaluation process, a new study led by two IHPME researchers and supported by a CIHR Project Grant, will examine systems in four provinces to better understand the new models, with the goal of identifying areas for strengthening and provide key decision makers with useful insights to improve health systems across Canada.

Sara Allin, Associate Professor at IHPME and Director of the North American Observatory on Health Systems and Policies (NAO), and Jean-Louis Denis, IHPME Professor, will be leading the multi-province study to develop tangible lessons for improved governance and accountability in light of these new reforms.

“These provincial healthcare reforms were implemented in the hope that they will address long-term system challenges such as care fragmentation across health providers, and overcrowding in acute care,” says Dr. Denis. “But we have limited knowledge of how more centralized governance authority can improve the functioning and the performance of health systems.”

The study will be rolled out in three stages, beginning with the development of profiles for each focus province: Alberta, Ontario, Quebec and Newfoundland and Labrador. According to Dr. Allin, “the detailed descriptions of the new provincial governing bodies will enable close comparison across the four provinces and will be foundational for this research and others interested in studying macro-level system reforms in Canada.”

These profiles will provide an overview of how each health agency works and how they engage its partners to achieve health objectives. The team will also identify key policy areas, or sub-cases, that will provide the backdrop for further examination.

According to Dr. Denis, priority policy areas will vary by province save for primary care, which all provinces have prioritized to improve access to care and more effectively respond to population needs.

Other possible areas of focus are the evolving role of Ontario Health Teams and long-term and home care in Quebec.

The finalized list of priority policy areas will be determined following consultations with key policy and decision-makers in different jurisdictions.

“As researchers we look for both comparability of some policy areas across jurisdictions and relevance of specific policy areas for a given jurisdiction,” says Dr. Denis.

This twofold approach is key to the project’s success, according to the research team. By bringing both shared and local priorities to the forefront, this study has the potential to inspire health leaders towards improved governance and improved systems.

The second stage will leverage the newly developed provincial profiles and sub-cases, paring them with interviews with healthcare professionals from each focus province to better understand how each system operates and what tools are implemented.

The project will conclude with meetings to discuss findings and hear from participants about their experiences working within the provincial systems.

“Through deliberative dialogues with provincial decision-makers and stakeholders, we aim to transform research findings into actionable policy recommendations, helping provinces fully realize the potential of these governance reforms,” says Dr. Denis.

This will be the first research project to take a closer look at recent provincial healthcare changes. Results will provide crucial insights, not only in helping to better understand how these systems are organized, but how these new governing agencies can steer key stakeholders toward improved health outcomes for all Canadians.