title: Applying a prism: the spectrum of a sustainable healthcare system.
abstract: Initiatives aimed at reducing wait times for surgical and diagnostic procedures and comprehensive chronic disease management programs focus, respectively, on the supply and demand aspects of access to healthcare. Addressing either in isolation can have a salutary health effect for segments of the population and produce system improvement. Approaching healthcare access issues even more broadly, in the context of population health and with a patient-centred perspective, carries the promise of sustainability, the potential for superior health outcomes across a continuum of patient care and the possibility of enhanced system competency through true integration of multiple sectors. A model for comprehensive access to health services includes a plan for a network of primary care providers, appropriate capacity and flow efficiency for the provision of unplanned (emergency) services, operationalization of wait times initiatives to sustain planned services (most surgeries and diagnostic procedures) and a strategy for decreasing demand for care by engaging primary and community care capabilities and a robust chronic disease management strategy.
authors.affiliation: University Health Network, Department of Medicine, University of Toronto.
authors.forename: Catherine
authors.initials: C
authors.lastname: Zahn
mesh_terms: D002170:Canada; D002908:Chronic Disease / Q000191:economics / Q000517:prevention & control* / Q000628:therapy*; D019468:Disease Management; D017598:Efficiency, Organizational; D015276:Health Care Rationing / Q000458:organization & administration; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006801:Humans; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration; D011787:Quality of Health Care / Q000458:organization & administration; D014850:Waiting Lists