Abstract
The co-ordination of hospital services in large metropolitan areas presents a formidable challenge. History, university relationships, geography and a tradition of independence and autonomy mitigate against co-operative regional ventures.
A new program is evolving in Metropolitan Toronto which represents a significant change in the delivery of specialized geriatric services. The regional geriatric program has been established with direct funding from the Ontario Ministry of Health and contractual agreements with participating hospitals to provide specific geriatric services. It is a collaborative venture with the participating hospitals and the University of Toronto voluntarily participating in its management and policy direction.
Although many issues have yet to be resolved regarding the relationship of the program to the Ministry, between the hospitals and with the community, this model may become prevalent in other areas of specialty services, such as trauma and oncology.
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