This project designed, implemented, and evaluated a holistic model of health service delivery in Eskasoni, a First Nations community in Cape Breton, Nova Scotia. The project initiated the following elements: the continuing transfer of health care administration from the federal government to the local band; the change of physicians’ services from a solo, fee-for-service model to the model of a multi-doctor, multidisciplinary clinic; the construction of a new health complex, housing services from both within and outside the community; the better utilization of physicians, hospitals, and prescription drugs; the integration of doctor-based services with community health programs; and the establishment of links with the regional health centre. The model made improvements in the efficiency and effectiveness of programs. Although not all the data were available at the time of evaluation, during the first year, visits to the emergency department declined by 40 per cent; visits to family doctors declined from a high of 11 per year to four per year; and the cost of prescribed medicines decreased 7 per cent despite a 10 per cent increase in population.
This project was supported by the Health Transition Fund, which was created in 1997 to provide support for evidence-based decision-making in health care reform by supporting pilot and evaluation projects which test innovative approaches to health care delivery. The views expressed herein do no necessarily represent the official policy of federal, provincial, or territorial governments.