Table 1.
Key policy shifts towards integrated care in Quebec and Ontario
| Time points | Quebec | Ontario |
|---|---|---|
| 1970s | • Development of clinical and social service (CLSCs) • Creation of regional health authorities | • Establishment of Health Service Organisations (HSOs) and Community Health Centres (CHCs) |
| 1980s | • Formation of Comprehensive Health Organisations (CHOs) • Release of mental health reports: the Heseltine and Graham reports | |
| 1990s | • Expansion of regional health authorities powers • Rationalisation of hospitals • Development of special integrated care initiatives e.g. SIPA, Bois-Francs | • Rationalisation of hospitals • Formation of Rural-Northern Physician Group and Primary Care Networks (PCNs) • Integration of home care services: Community Care Access Centres (CCACs) • Development of ‘Shared Care’ in mental health model in Southern Ontario |
| 2000—current | • Launch of the current reforms (Bills 83, 90, 21, 30) • Creation of health and social service networks (95 CSSSs) • Formation of the university-based health-care networks (4 RUIS—ultra-specialised care networks) • Implementation of family medicine groups or network clinics • Launch of mental health reforms (primary mental health care and shared care, 2005–2010) • Development of increased initiatives toward chronic care prevention and treatment (e.g. provincial public health program in 2001, and framework for preventing and managing chronic diseases in 2007) | • Formation of Family Health Networks, Family Health Groups (FHGs), Comprehensive Care Models (CCM), Family Health Teams and Family Health Organisations (FHOs) • Restructuring of integrated Cancer Care Ontario (CCO) • Increased investment in mental health, specifically community-based care • Development of chronic disease prevention and management framework; implementation of diabetes strategy • Increased investment in electronic health records • Establishment of Local Health Integration Networks (14 LHINs) • Increase in Nurse Practitioner-Led Clinics |