Abstracts Health Sciences

Accountability in health care in Canada, an analysis of its meaning and the development of a conceptual framework for its application

by Charlotte Johnson

'The problem'. As we enter the beginning of the new millennium, health care systems continue to change throughout Canada and the world. Many trends can be observed, from regionalisation of health administrations to better standards for appropriate care. Such trends may change over time, but one issue remains constant and central to all others – namely: Who is accountable for health care and the many systems in place to maintain it? The complexity of the health system and the importance of its outcomes necessitate the clearest possible understanding of accountability for decisions and for action. The Krever Commission highlighted this point, which has been more recently revisited by the Walkerton public health tragedy and the Manitoba cardiac surgery deaths inquiry. 'Purpose and methods'. This thesis has two related purposes. The first purpose is to answer the main question: What is the meaning of accountability to those in a position to influence the future of the health system as we enter the next century? The second purpose is to develop a conceptual framework for accountability for application to the Canadian health care system. (Abstract shortened by UMI.)