The ownership elephant: ownership and community-governance in primary care.

摘要: Ownership of primary care is an often neglected but important health systems design parameter. The New Zealand Primary Health Care Strategy has established Organisations (PHOs) as non-profit umbrella organisations, however in most instances their constituent general practices are for-profit small businesses. This viewpoint paper aims to: (a) define ownership and community participation; (b) summarise some the evidence from NatMedCa study pertaining to ownership-related differences; (c) discuss policy implications different forms care, merging under PHOs. confers governance responsibility (ultimate control) for organisation, accountability its actions. Community involves vesting overall control resources users community, rather than with service managers or professionals. Results three studies using survey indicate that community-governed non-profits differ a number respects counterparts. As have social roles, meaningful participation determined large part by structures, there need frameworks be used more widely making. Because boundary exists between PHOs may little real ability effectively govern practices.