| Titre : | Selected Papers from the 8th International Symposium on Medical Geography. Long-term care restructuring in rural Ontario : retrieving community service user and provider narratives. (2000) |
| Auteurs : | D. CLOUTIER-FISHER ; Robert EARIKSON, éd. ; A.E. JOSEPH ; International Symposium on Medical Geography. (1998; Baltimore. USA) |
| Type de document : | Article |
| Dans : | Social science and medicine (vol. 50, n° 7-8, 2000) |
| Pagination : | 1037-1045 |
| Langues: | Anglais |
| Mots-clés : | Canada ; Amérique ; Personne âgée ; Homme ; Etat santé ; Milieu rural ; Soins ; Long terme ; Système santé ; Restructuration ; Santé communautaire ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST QV2hqR0x. Diffusion soumise à autorisation]. This paper examines the extensive restructuring of community-based long-term care that was initiated in Ontario, Canada in 1996, and does so with particular reference to longstanding problems of provision in rural communities. Specifically, it draws on a case study focussed on two small rural towns to develop a situated understanding'of service-user and service-provider perspectives on service coordination issues and on service cuts, particularly as they affect the ability of elderly people reliant on publicly-funded community services to stay in their homes, to continue to'age in place'The general and specific antecedents of long-term care reform are considered prior to the presentation of the case study. General antecedents include the rapid aging of Canada's population and aggressive strategies to reduce government deficits, while specific antecedents flow from a decade of failed attempts to address longstanding issues of service coordination and from the ideologically-driven, free market stance of the provincial government elected in 1995. The analysis of interviews conducted with 14 community-service users and 17 providers suggests that the managed competition system introduced as the centerpiece of long-term care reform has resulted in increasing diversity and uncertainty on both sides of the service provision equation. (...) |
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