overview
In Canada, health responsibilities are divided between federal and provincial governments. The federal government is responsible for setting and administering national standards, financing the system through payments to the provinces, delivering care to First Nations, Inuit and veterans, and providing drug and food safety regulation, data collection and research but provincial governments retain responsibility for the shape and administration of their health systems, guided by the Canada Health Act.
Most family physicians are remunerated on a fee-for-service basis paid by the national insurance system (Medicare), which is funded through taxation. There are some salaried GPs and in some areas there is a blended system of salary, capitation and fee-for-service in order to provide incentives for better preventive and chronic disease care. Primary health care is delivered at no charge to the patient. GPs receiving any funding from the public system cannot charge higher than the rate fixed for the specified service.
Outcome measurement
 A results based logic model for primary health care Watson D, Broemeling A, et al. (2004). Centre for Health Services and Policy Research, University of British Columbia.
Enhancing the Primary Health Care Data Collection Infrastructure in Canada : Report 2 Pan-Canadian Primary Health Care Indicator Development Project Canadian Institute for Health Information (CIHI) (2006).
Public Reporting on the Quality of Healthcare: Emerging Evidence on Promising Practices for Effective Reporting Wallace J, Teare G, et al. (2007). Canadian Health Services Research Foundation and the Ontario Health Quality Council. Ontario. September 7, 2007.
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More information on Canadian primary health care
European Observatory of Health Systems and Policies
Health Systems in Transition: Canada Marchildon, G. (2005). Copenhagen, WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies. Observatory E-Bulletin, January 2006: Item 2.
Health Policy Monitor
Health Council of Canada: Quality of Care Renewal MacAdam, M. (2007). Health Policy Monitor October 2007.
Health Canada Website: Primary Health Care
Statistics Canada
Canadian Health Services Research Foundation
Health Canada: Primary Health Care Transition Fund
Recent reviews and reforms
Canada Health Act
Madore O. (2003). The Canada Health Act: Overview and options. Parliamentary Information and Research Service, Library of Parliament, Canada.
Kirby Report
Standing Senate Committee on Social Affairs Science and Technology (2002). Standing Senate Committee on Social Affairs, Science and Technology Study on the State of the Health Care System in Canada (1999-2002) (Kirby report). Health Canada.
Romanow Report
Romonow R. (2002). Building on Values: The future of health care in Canada. Final Report November 2002. Commission on the future of health care in Canada.
Ten Year Plan to Strengthen Health Care
Health Canada (2004). First Minister's Meeting on the Future of Health Care 2004: A 10-year plan to strengthen health care. Health Canada.
Information about family physicians and nurse practitioners
'Primary health care nurse practitioners in Canada'
DiCenso A, Auffrey L, Bryant-Lukosius D, Donald F, Martin-Misener R, Matthews S, Opsteen J. (2007). Contemp Nurse. Aug;26(1):104-15.
Canada's Health Care Providers 2007
Canadian Institute for Health Information (CIHI). (2007). Canadian Institute for Health Information, Canada’s Health Care Providers, 2007. Ottawa, CIHI.
2007 National Physician Survey Online
College of Family Physicians of Canada (CFPC), Canadian Medical Association (CMA), et al. (2007).
'How family physicians are funded in Canada'
Martin C & Hogg W. (2004). MJA 181(2): 111-112.
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