title: Care access in rural areas: what leverage mechanisms do regulatory agencies have in a public system?
abstract: Based on observations of the government's vital role in enhancing rural health care accessibility, in this article, we analyze solutions implemented by Quebec's public health system by highlighting the limitations in incentives used to remedy the dearth of rural medical resources and the consequent interest in ameliorating health care accessibility through service integration. The current challenge lies in fostering cooperation between health care institutions not subject to market incentives and integrating private practice physicians into the public system. To this end, regulatory agencies in public systems use four main leverage mechanisms: formal power, economic power, influence, and commitment, as illustrated in an experiment conducted in rural Quebec.
authors.affiliation: Centre de recherche, Hôpital Charles-Lemoyne, Quebec, Canada.
authors.forename: Nassera
authors.initials: N
authors.lastname: Touati
authors.forename: André-Pierre
authors.initials: AP
authors.lastname: Contandriopoulos
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Denis
authors.forename: Charo
authors.initials: C
authors.lastname: Rodriguez
authors.forename: Claude
authors.initials: C
authors.lastname: Sicotte
mesh_terms: D033161:Government Regulation; D006297:Health Services Accessibility / Q000331:legislation & jurisprudence*; D006801:Humans; D009313:National Health Programs; D017150:Public Sector; D011792:Quebec; D019035:Rural Health Services / Q000706:statistics & numerical data*