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Does Integrated Care Carry the Gene of Bureaucracy? Lessons from the Case of Québec
- Source :
- International Journal of Integrated Care; Vol 21 (2021): IJIC 20th Anniversary Issue; 13, International Journal of Integrated Care, Vol 21, Iss S2 (2021), International Journal of Integrated Care
- Publication Year :
- 2021
- Publisher :
- Ubiquity Press, 2021.
-
Abstract
- Introduction: Demographic and epidemiological transitions of industralized countries mean health systems have to integrate health and social services to respond to the changing needs of their populations. Efforts to integrate care involve important policy and structural changes. This paper examines whether integration efforts are lost in translation during the bureaucratic appropriation of models, or, in an allegorical way, do they reveal genes of bureaucracy? Description: Since the 1960s, the health system of Quebec has undergone four major structural and progressively integrative transformations, characterized as – modernization, shock of reality, explicit integration, and centralization phases. Discussion: Although integration efforts progressively transformed Quebec’s health and social services system, embedded bureaucracies impeded the realisation of these projects. Notably, inadequate change management strategies and lack of integrated funding models hindered integration efforts. Furthermore, there was variability in government prioritisation and support of different aspects of the model by making some components happen, helping others happen and letting others happen. Conclusion: Drawing insights from bureaucratic obstacles to integration efforts may improve implementation strategies. This paper highlights important policy and administrative challenges that have to be taken into consideration in improving the implementation of integrated care initiatives in a real-life context.
- Subjects :
- Government
Medicine (General)
Health (social science)
Sociology and Political Science
Healthcare policies
Policy Paper
Health Policy
media_common.quotation_subject
Change management
Context (language use)
Social Welfare
bureaucracy
Public administration
healthcare reforms
Modernization theory
Integrated care
Appropriation
R5-920
Political science
Bureaucracy
implementation
media_common
integrated care
Subjects
Details
- Language :
- English
- ISSN :
- 15684156
- Database :
- OpenAIRE
- Journal :
- International Journal of Integrated Care (IJIC)
- Accession number :
- edsair.doi.dedup.....31b547ef092d2f0c4bd0c832d7ba1620