UBC Theses and Dissertations
Strategies for regional health planning in British Columbia Ryan, Patricia
In 1981/82 there was renewed interest in the concept of a regionalized form of health service delivery in British Columbia. A discussion paper which outlined a proposal for regionalizing those services funded directly by the Ministry of Health was circulated to the senior managers in the Ministry in August of that year. In this paper it was suggested that regionalization would encourage the integration and co-ordination of health services at a regional level, thereby increasing the efficiency and effectiveness of the health delivery system. This study considers strategies for planning health service delivery at this regional level, with the model of regionalization outlined in the 1981 proposal used as a basis for discussion. Every effort has been made to develop an approach to planning that is feasible, given the context within which health policy decisions are made in British Columbia in 1982. To do this the changing trends in health care management in B.C. have been considered, and relevant planning and organization theory reviewed. Evaluations of regional planning systems in three other jurisdictions are also described. The potential difficulties a Regional Manager might face in developing an integrated approach to regional planning are identified, and strategies to deal with these possible conflicts outlined. It would seem from this analysis that the degree to which authority is decentralized to the region is central to any decision about planning at the regional level. A model based on normative centralization, and operational decentralization is suggested, with needs assessments, and prioritization of needs taking place at the region. Support for integrated regional health planning by both the government and the provider groups seems to be necessary if good regional plans are to be developed, and if implementation of the plans and policies that evolve from the process are to be successful. It is suggested that introducing the structures and processes for planning at the regional level should involve two stages. During the first, the administrative functions for direct services would be decentralized, and a general review of health services and health care in the region undertaken. The development of a regional identity and liaison among the many subgroups operating in the region would be an important aspect of this first stage. The second stage, which would be implemented after one year, would see the development of a Regional Advisory Council and multidisciplinary, multiagency, Service Development Committees formed along service or functional lines. More authority would be transferred to the Regional Manager during this time in the areas of hospital budget review, and physician manpower planning. This is the most important stage as it has the potential to make the health care system more efficient and effective. In this model support is built into the structure for planning and there are regional wide coordinating and integrating mechanisms.
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