{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T12:37:10Z","timestamp":1768480630221,"version":"3.49.0"},"reference-count":81,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T00:00:00Z","timestamp":1768089600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Systems"],"abstract":"<jats:p>The COVID-19 pandemic highlighted critical issues in health services and public policy, particularly in long-term care facilities across Canada. Failures in these facilities revolving around chronic underfunding, staffing shortages, inadequate infection control, and inconsistent regulatory oversight, underscore the need to rethink health service interventions, especially considering varying implementation contexts among provinces. The Ontario Long-Term Care COVID-19 Commission Final Report pointed to long-standing systemic issues as the primary causes of the sector\u2019s failures. To explore this issue, a narrative review was conducted with findings indicating that the long-term care crisis in Canada cannot be solved by more privatization, regulation or efficiency measures, as these have contributed to the problem\u2019s root causes. Ontario\u2019s long-term care crisis stems from systemic misalignments in policy, structure and stakeholder dynamics, requiring a shift toward systems thinking and resident-centered care to build an equitable and sustainable long-term care sector. Ultimately, governments must lead a policy redesign that reflects shared responsibility, stakeholder interdependence, and public involvement, offering a model for broader healthcare reform.<\/jats:p>","DOI":"10.3390\/systems14010079","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T09:13:01Z","timestamp":1768209181000},"page":"79","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Redesigning Long-Term Care Policy Using Systems Thinking in the Post-Pandemic Era"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8611-7378","authenticated-orcid":false,"given":"Peter","family":"Tsasis","sequence":"first","affiliation":[{"name":"School of Health Policy and Management, Faculty of Health, York University, 4700 Keele St, Toronto, ON M3J 1P3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2219-6281","authenticated-orcid":false,"given":"Joachim","family":"Sturmberg","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Health Policy and Management, Faculty of Health, York University, 4700 Keele St, Toronto, ON M3J 1P3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Owen","sequence":"additional","affiliation":[{"name":"School of Health Policy and Management, Faculty of Health, York University, 4700 Keele St, Toronto, ON M3J 1P3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/S0140-6736(21)00083-0","article-title":"COVID-19 Highlights Canada\u2019s Care Home Crisis","volume":"397","author":"Webster","year":"2021","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1080\/08959420.2020.1764319","article-title":"COVID-19 and Long-Term Care policy for older people in Canada","volume":"32","author":"Marier","year":"2020","journal-title":"J. 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