In many Canadian provinces the formal and informal regionalization of health services has lead to the creation of geographic districts that manage the health services of populations. The creation of these health regions is intended to both reduce costs through centralized health administration as well as better address the unique needs of local populations.

Is regionalization good?

The performance of regionalization in health care system administration has been mixed. In some provinces, frequent changes in the boundaries and responsibilities of health regions has compromised long-term planning.  Some even suggest that regionalization has increased rather than decreased administrative costs.

One obstacle to maximizing the effectiveness of regionalization  is that regions may not always be formed in a way that benefits the health needs of the population.  Regional administration is made complicated by tensions between the benefits of centralization (in terms of service provision and cost savings) and the burden of increased travel for people living in sparsely populated areas.  Furthermore, regionalization plans may not always represent the geographical character of the population–for example, sometimes creating boundaries between communities that have similar character and needs.

Our team has developed methods to assess the effectiveness of current and historical regionalization schemes.  Using these methods we plan to compare actual regionalization schemes with theoretical schemes aimed at specific objectives–such as economic efficiency and representation of the population.  Our work will shed light on how future regionalization plans can be improved.