The impact of health needs assessment and prioritisation on District Health Board planning in New Zealand

2009 ◽  
Vol 24 (4) ◽  
pp. 276-289 ◽  
Author(s):  
Gregor Coster ◽  
Nicholas Mays ◽  
Claudia Scott ◽  
Jacqueline Cumming
Keyword(s):  
New Zealand ◽  
Needs Assessment ◽  
Health Needs ◽  
Health Board ◽  
Health Needs Assessment ◽  
District Health ◽  
The Impact

scholarly journals Health Needs Assessment: Impact on Planning and Purchasing in the Public Health Sector in New Zealand

2021 ◽  
Author(s):  
◽  
Gregor David Coster
Keyword(s):  
Public Health ◽  
New Zealand ◽  
Needs Assessment ◽  
Health Sector ◽  
Document Analysis ◽  
Health Needs ◽  
Health Needs Assessment ◽  
The Public ◽  
Strategic Plans ◽  
The Impact

<p>Health needs assessment (HNA) is one of the features of the New Zealand health system established by the New Zealand Public Health and Disability Act 2000. District Health Boards (DHBs) are to conduct HNAs, and planning of health services is intended to take into account the health needs of the population. Key questions for research relate to the impact of HNA on DHB planning and purchasing in a political/bureaucratic model of governance. This research was undertaken within a public policy framework that focused on evaluating the reforms against policy goals and expectations, and particularly against the influences that might be predicted from the HNA and prioritisation policy. Consideration was given to the range and effectiveness of past HNAs as well as the expectations and experiences of the DHB model in regard to HNA. Document analysis and 34 interviews were conducted regarding 50 HNAs conducted in the public health sector from 1991-2000 to assess their impact on service delivery, decision-making, and policy. Document analysis was undertaken on DHB HNAs, prioritisation frameworks, board priorities, District Strategic Plans, and District Annual Plans for each of 20 DHBs. Planning and Funding managers were interviewed using semi-structured interview techniques to ascertain their experiences and views regarding the use of HNAs in planning. Grounded theory approaches were mainly used for the interview analysis. Case studies of five DHBs provided an in-depth understanding of the connections between health needs assessment, prioritisation, District Strategic Plans and District Annual Plans. Collection of contextual data provided an understanding of the influence of other policy decisions made locally or nationally. Using triangulation, conclusions were drawn regarding the effectiveness and impact of HNA and prioritisation on planning and health service purchasing by DHBs. The implications for public policy were then considered. Recent needs assessments conducted by DHBs mostly met the minimum requirements of the Ministry of Health, but the quality was variable. DHB Planning and Funding Managers were unanimously positive regarding the usefulness of HNAs, and felt that there were good connections between them and the planning process (Connection Score). However, the impact of HNAs on planning and purchasing measured using document analysis (Impact Factor) was lower than expected. A number of barriers to effective use were identified. More focused HNA by DHBs is recommended with the use of mixed scanning approaches and service development groups directed towards specific service planning areas. Recommendations are made regarding future policy for HNA and prioritisation.</p>

scholarly journals Health Needs Assessment: Impact on Planning and Purchasing in the Public Health Sector in New Zealand

2021 ◽  
Author(s):  
◽  
Gregor David Coster
Keyword(s):  
Public Health ◽  
New Zealand ◽  
Needs Assessment ◽  
Health Sector ◽  
Document Analysis ◽  
Health Needs ◽  
Health Needs Assessment ◽  
The Public ◽  
Strategic Plans ◽  
The Impact

<p>Health needs assessment (HNA) is one of the features of the New Zealand health system established by the New Zealand Public Health and Disability Act 2000. District Health Boards (DHBs) are to conduct HNAs, and planning of health services is intended to take into account the health needs of the population. Key questions for research relate to the impact of HNA on DHB planning and purchasing in a political/bureaucratic model of governance. This research was undertaken within a public policy framework that focused on evaluating the reforms against policy goals and expectations, and particularly against the influences that might be predicted from the HNA and prioritisation policy. Consideration was given to the range and effectiveness of past HNAs as well as the expectations and experiences of the DHB model in regard to HNA. Document analysis and 34 interviews were conducted regarding 50 HNAs conducted in the public health sector from 1991-2000 to assess their impact on service delivery, decision-making, and policy. Document analysis was undertaken on DHB HNAs, prioritisation frameworks, board priorities, District Strategic Plans, and District Annual Plans for each of 20 DHBs. Planning and Funding managers were interviewed using semi-structured interview techniques to ascertain their experiences and views regarding the use of HNAs in planning. Grounded theory approaches were mainly used for the interview analysis. Case studies of five DHBs provided an in-depth understanding of the connections between health needs assessment, prioritisation, District Strategic Plans and District Annual Plans. Collection of contextual data provided an understanding of the influence of other policy decisions made locally or nationally. Using triangulation, conclusions were drawn regarding the effectiveness and impact of HNA and prioritisation on planning and health service purchasing by DHBs. The implications for public policy were then considered. Recent needs assessments conducted by DHBs mostly met the minimum requirements of the Ministry of Health, but the quality was variable. DHB Planning and Funding Managers were unanimously positive regarding the usefulness of HNAs, and felt that there were good connections between them and the planning process (Connection Score). However, the impact of HNAs on planning and purchasing measured using document analysis (Impact Factor) was lower than expected. A number of barriers to effective use were identified. More focused HNA by DHBs is recommended with the use of mixed scanning approaches and service development groups directed towards specific service planning areas. Recommendations are made regarding future policy for HNA and prioritisation.</p>

scholarly journals Geographical Variation in Dementia Mortality in Italy, New Zealand, and Chile: The Impact of Latitude, Vitamin D, and Air Pollution

2016 ◽  
Vol 42 (1-2) ◽  
pp. 31-41 ◽  
Author(s):  
Tom C. Russ ◽  
Laura Murianni ◽  
Gloria Icaza ◽  
Andrea Slachevsky ◽  
John M. Starr
Keyword(s):  
Vitamin D ◽  
New Zealand ◽  
Southern Hemisphere ◽  
Geographical Variation ◽  
Health Board ◽  
District Health ◽  
Men And Women ◽  
The North ◽  
Dementia Risk ◽  
The Impact

Background: Dementia risk is reported as being higher in the north compared to the south, which may be related to vitamin D deficiency. If this were the case, an opposite gradient of risk would be observed in the southern hemisphere, but this has not been investigated previously. Methods: We calculated standardised mortality ratios (SMRs) for deaths in 2012 where dementia (Alzheimer's disease, vascular or unspecified dementia) was recorded as the underlying cause for 20 regions in Italy, 20 District Health Board areas in New Zealand and 29 Health Service areas in Chile. Results: Dementia SMRs were higher in northern than central or southern Italy. The inverse pattern was seen in women in New Zealand, with rates higher on South Island than North Island. However, dementia risk was raised in eight regions in the north and centre of Chile in both men and women. Conclusions: Geographical variation plays a key role in dementia risk, but patterns vary in men and women. In the northern hemisphere, dementia mortality is higher in the north, but the pattern in the southern hemisphere is more complex.

scholarly journals Strategies and processes emergency department nurses consider important to safely manage during an influenza pandemic: A qualitative descriptive study

2021 ◽  
Author(s):  
◽  
Jessica Lockett
Keyword(s):  
Emergency Department ◽  
New Zealand ◽  
Healthcare System ◽  
Emergency Departments ◽  
Influenza Pandemic ◽  
Health Board ◽  
District Health ◽  
Emergency Department Nurses ◽  
Qualitative Descriptive ◽  
The Impact

<p>The influenza virus is responsible for significant morbidity and mortality worldwide each year, with influenza pandemics occurring every 10 to 50 years and responsible for millions of deaths and substantial economic impact. Increasing globalisation through travel and trade means New Zealand is vulnerable to the risks of pandemic influenza, placing a strain on the healthcare system, putting lives at risk and posing a significant cost to the country. Emergency Departments are at the frontline of New Zealand’s healthcare system and are a crucial component in the response to an influenza pandemic, however little research has been done on the impact such an event would have on the nursing staff who work in this area and the care they provide to influenza patients.  This study aims to explore what New Zealand Emergency Department nurses perceive as the biggest challenges to nursing care and staff safety during an influenza pandemic, in order to provide information on how to ensure the engagement of these nurses at the frontline of the pandemic response. With a lack of evidence-based research available, a qualitative descriptive design was used to allow an exploration of the first-hand perspectives of Emergency Department nurses, gaining meaningful insights into a phenomena which has been little explored.  Sixteen nurses from two Emergency Departments participated in face-to-face interviews conducted using semi-structured questions. Raw data was transcribed, and an inductive approach was taken to data analysis, guided by the principles of both content and thematic analysis.  The findings demonstrate that Emergency Department nurses work in an environment that poses risk to patient and staff safety every day, and an understanding of these safety problems is provided in the theme ‘the everyday reality for Emergency Department nurses’. Working within this context shapes the fears that Emergency Department nurses hold about what could happen if an influenza pandemic were to affect New Zealand in the future, and are summarised within the theme ‘fears for a pandemic’. The final theme, ‘strategy and planning for pandemics’ provides insight into how Emergency Department nurses feel these issues could be managed within future pandemic planning at Emergency Department, District Health Board and government level.  This thesis identifies both existing and potential future safety concerns in relation to the management of influenza in New Zealand Emergency Departments, affecting the safety of patients and staff. It also provides specific multi-level and multi-agency recommendations for future pandemic plans that could help to mitigate the significant risks highlighted by those who work within the system every day.</p>

scholarly journals Protocol for a mixed methods realist evaluation of regional District Health Board groupings in New Zealand

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e030076
Author(s):  
Tim Stokes ◽  
Carol Atmore ◽  
Erin Penno ◽  
Lauralie Richard ◽  
Emma Wyeth ◽  
...  
Keyword(s):  
Mixed Methods ◽  
New Zealand ◽  
Health Outcomes ◽  
Health Equity ◽  
Service Integration ◽  
Realist Evaluation ◽  
Health Board ◽  
Programme Theory ◽  
District Health ◽  
The Impact

IntroductionAchieving effective integration of healthcare across primary, secondary and tertiary care is a key goal of the New Zealand (NZ) Health Strategy. NZ’s regional District Health Board (DHB) groupings are fundamental to delivering integration, bringing the country’s 20 DHBs together into four groups to collaboratively plan, fund and deliver health services within their defined geographical regions. This research aims to examine how, for whom and in what circumstances the regional DHB groupings work to improve health service integration, healthcare quality, health outcomes and health equity, particularly for Māori and Pacific peoples.Methods and analysisThis research uses a mixed methods realist evaluation design. It comprises three linked studies: (1) formulating initial programme theory (IPT) through developing programme logic models to describe regional DHB working; (2) empirically testing IPT through both a qualitative process evaluation of regional DHB working using a case study design; and (3) a quantitative analysis of the impact that DHB regional groupings may have on service integration, health outcomes, health equity and costs. The findings of these three studies will allow refinement of the IPT and should lead to a programme theory which will explain how, for whom and in what circumstances regional DHB groupings improve service integration, health outcomes and health equity in NZ.Ethics and disseminationThe University of Otago Human Ethics Committee has approved this study. The embedding of a clinician researcher within a participating regional DHB grouping has facilitated research coproduction, the research has been jointly conceived and designed and will be jointly evaluated and disseminated by researchers and practitioners. Uptake of the research findings by other key groups including policymakers, Māori providers and communities and Pacific providers and communities will be supported through key strategic relationships and dissemination activities. Academic dissemination will occur through publication and conference presentations.

scholarly journals Strategies and processes emergency department nurses consider important to safely manage during an influenza pandemic: A qualitative descriptive study

2021 ◽  
Author(s):  
◽  
Jessica Lockett
Keyword(s):  
Emergency Department ◽  
New Zealand ◽  
Healthcare System ◽  
Emergency Departments ◽  
Influenza Pandemic ◽  
Health Board ◽  
District Health ◽  
Emergency Department Nurses ◽  
Qualitative Descriptive ◽  
The Impact

<p>The influenza virus is responsible for significant morbidity and mortality worldwide each year, with influenza pandemics occurring every 10 to 50 years and responsible for millions of deaths and substantial economic impact. Increasing globalisation through travel and trade means New Zealand is vulnerable to the risks of pandemic influenza, placing a strain on the healthcare system, putting lives at risk and posing a significant cost to the country. Emergency Departments are at the frontline of New Zealand’s healthcare system and are a crucial component in the response to an influenza pandemic, however little research has been done on the impact such an event would have on the nursing staff who work in this area and the care they provide to influenza patients.  This study aims to explore what New Zealand Emergency Department nurses perceive as the biggest challenges to nursing care and staff safety during an influenza pandemic, in order to provide information on how to ensure the engagement of these nurses at the frontline of the pandemic response. With a lack of evidence-based research available, a qualitative descriptive design was used to allow an exploration of the first-hand perspectives of Emergency Department nurses, gaining meaningful insights into a phenomena which has been little explored.  Sixteen nurses from two Emergency Departments participated in face-to-face interviews conducted using semi-structured questions. Raw data was transcribed, and an inductive approach was taken to data analysis, guided by the principles of both content and thematic analysis.  The findings demonstrate that Emergency Department nurses work in an environment that poses risk to patient and staff safety every day, and an understanding of these safety problems is provided in the theme ‘the everyday reality for Emergency Department nurses’. Working within this context shapes the fears that Emergency Department nurses hold about what could happen if an influenza pandemic were to affect New Zealand in the future, and are summarised within the theme ‘fears for a pandemic’. The final theme, ‘strategy and planning for pandemics’ provides insight into how Emergency Department nurses feel these issues could be managed within future pandemic planning at Emergency Department, District Health Board and government level.  This thesis identifies both existing and potential future safety concerns in relation to the management of influenza in New Zealand Emergency Departments, affecting the safety of patients and staff. It also provides specific multi-level and multi-agency recommendations for future pandemic plans that could help to mitigate the significant risks highlighted by those who work within the system every day.</p>

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