Contracts and the Quasi-market in Community Health Services

1995 ◽  
Vol 24 (4) ◽  
pp. 529-550 ◽  
Author(s):  
Rob Flynn ◽  
Susan Pickard ◽  
Gareth Williams
Keyword(s):  
Health Care ◽  
Health Services ◽  
Community Health ◽  
Community Health Services ◽  
Acute Hospital ◽  
Three Dimensions ◽  
Hospital Services ◽  
Care Community ◽  
Qualitative Evidence ◽  
Contracting Process

ABSTRACTIn the NHS quasi-market, contracts are the crucial mechanism through which purchasers influence providers of health care. Most attention has been given to the commissioning and contracting process in acute hospital services. However, there is another important but neglected sector of health care – community health services (CHS) – in which the specification and implementation of contracts is particularly difficult. In this article, three dimensions of contracting are analysed, illustrated by qualitative evidence from case studies, concerning: the measurement of activity; the estimation of costs and prices; and the monitoring of outcomes and quality. This article argues that community health services are intrinsically problematic within the quasi-market, and suggests that the nature of the services and the system of delivery militate against provider competition. It is argued that CHS have more in common with ‘clans’ and ‘networks’ rather than markets and hierarchies, and that this requires collaborative rather than adversarial relationships between purchasers and providers.

scholarly journals Patient experience surveys for children’s community health services: A scoping review

2021 ◽  
pp. 136749352110058
Author(s):  
Helen J Nelson ◽  
Catherine Pienaar ◽  
Anne M Williams ◽  
Ailsa Munns ◽  
Katie McKenzie ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Community Health ◽  
Patient Experience ◽  
Scoping Review ◽  
Emotional Support ◽  
Community Health Services ◽  
Experience Of Care ◽  
Healthcare Experience

Patient experience surveys have a user focus and measure the quality of person-centered health care for hospital inpatients and consumers of community health services, providing a governance process to evaluate the quality of care and to action improvement. Experience of care has been described as effective communication, respect and dignity, and emotional support. Measurement criteria for these domains are not standardized, leading to inconsistent reporting of patient experience. The objective of this scoping review was to synthesize evidence for measuring experience of care in children’s community health services using the Joanna Briggs Institute framework for scoping review method. Three parent-reported surveys met the inclusion criteria, and 50 survey items were assessed by expert reviewers for fit to domains of healthcare experience. Conceptual domains of parent experience in children’s community health services included respect and dignity, effective communication, and emotional support. A gap was identified, in that few items in identified surveys measured emotional support. This contribution will promote consistent reporting of healthcare experience, informing policy and practice for person-centered health care.

The effect of the latest health care reforms on the quality of community health services in China

2018 ◽  
Vol 33 (4) ◽  
pp. e1225-e1231 ◽  
Author(s):  
Yanhong Gong ◽  
Juan Xu ◽  
Ting Chen ◽  
Na Sun ◽  
Zuxun Lu ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Community Health ◽  
Community Health Services ◽  
Health Care Reforms

The COAG Reforms and Community Health Services

1995 ◽  
Vol 1 (1) ◽  
pp. 3 ◽  
Author(s):  
Stephen Duckett ◽  
Tracie Hogan ◽  
Jan Southgate
Keyword(s):  
Health Care ◽  
Health Services ◽  
Community Health ◽  
Acute Care ◽  
Community Health Services ◽  
Community Wellbeing ◽  
Care Services ◽  
Acute Care Services ◽  
English Speaking ◽  
The Impact

Ultimately, the reform directions announced by the Council of Australian Governments (COAG) in April 1995 have the potential to touch all aspects of health care and community wellbeing, and the impact will be felt as much by community health services, and for groups with special needs, such as people from non-English speaking backgrounds, as it will for acute care services.

scholarly journals How to Screen Suitable Service Improve Community Health Care Services by University Students in Taiwan

2020 ◽  
Vol 17 (15) ◽  
pp. 5402 ◽  
Author(s):  
Guey-Shin Shyu ◽  
Shinn-Jou Lin ◽  
Wei-Ta Fang ◽  
Bai-You Cheng
Keyword(s):  
Health Care ◽  
Health Services ◽  
University Students ◽  
Community Health ◽  
Health Care Services ◽  
Explanatory Power ◽  
Community Health Services ◽  
Community Health Care ◽  
Care Services ◽  
Study Results

Engaging in social contributions to enhance social participation and attending community experiential service learning or internship courses have become an essential learning experience for university students. On the basis of postmodern education theories, this study adopted images and oral accounts involving personal experiences to construct a postmodern education research scheme by using the method of collaborative ethnography. This study selected and performed the following services: filming a community documentary, administering community health dance classes, and archiving community cultural artifacts in databases. Interviews were also administered to facilitate implementation of the actual services. Community health services commonly seen in Taiwan and abroad were compiled, and the resources required for each service were examined. Subsequently, factor analysis was performed to explore the characteristic of these services in order to recommend feasible services for university students to undertake. The results indicated that the eight resources required for the 59 common community health services were (1) a designated space or venue, (2) materials, (3) monetary resources, (4) human resources, (5) expertise, (6) professional equipment, (7) patience, and (8) empathy. The results revealed three principal components, namely labor services, high-resource services, and professional services, for a total explanatory power of 67.99%; the individual explanatory power of these components accounted for 25.04%, 21.81%, and 21.15%, respectively. Next, community health care services suitable for university students to perform were selected and implemented, and these services were well received. The study results indicated that community and environmental justice can be realized by identifying with the value of community health services and promoting postmodern education theories and social norms. The research results are suitable for implementation after the COVID-19 pandemic.

Community health services and health care utilization in rural Bangladesh

1989 ◽  
Vol 29 (12) ◽  
pp. 1343-1349 ◽  
Author(s):  
Ruhul Amin ◽  
Shifiq A. Chowdhury ◽  
G.M. Kamal ◽  
J. Chowdhury
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Utilization ◽  
Community Health ◽  
Community Health Services ◽  
Care Utilization ◽  
Rural Bangladesh

scholarly journals Integrated care facilitation for older patients with complex health care needs reduces hospital demand

2007 ◽  
Vol 31 (3) ◽  
pp. 451 ◽  
Author(s):  
Stephen R Bird ◽  
William Kurowski ◽  
Gillian K Dickman ◽  
Ian Kronborg
Keyword(s):  
Health Care ◽  
Older People ◽  
Community Health ◽  
Hospital Admissions ◽  
Acute Hospital ◽  
Health Care Needs ◽  
Hospital Services ◽  
Model Of Care ◽  
Care Needs ◽  
Bed Days

Objective: The evaluation of a new model of care for older people with complex health care needs that aimed to reduce their use of acute hospital services. Method: Older people (over 55 years) with complex health care needs, who had made three or more presentations to a hospital emergency department (ED) in the previous 12 months, or who were identified by community health care agencies as being at risk of making frequent ED presentations, were recruited to the project. The participants were allocated a ?care facilitator? who provided assistance in identifying and accessing required health care services, as well as education in aspects of self management. Data for the patients who had been participants on the project for a minimum of 90 days (n = 231) were analysed for their use of acute hospital services (ED presentations, admissions and hospital bed-days) for the period 12-months pre-recruitment and postrecruitment. A similar analysis on the use of hospital services was conducted on the data of patients who were eligible and who had been offered participation, but who had declined (comparator group; n=85). Results: Post recruitment, the recruited patients displayed a 20.8% reduction in ED presentations, a 27.9% reduction in hospital admissions, and a 19.2% reduction in bed-days. By comparison, the patients who declined recruitment displayed a 5.2% increase in ED presentations, a 4.4 % reduction in hospital admissions, and a 15.3% increase in inpatient bed-days over a similar timeframe. Conclusion: A model of care that facilitates access to community health services and provides coordination between existing services reduces hospital demand.

scholarly journals Nurse competence in implementing public health care

2021 ◽  
Vol 10 (2) ◽  
pp. 428
Author(s):  
Suprapto Suprapto ◽  
Trimaya Cahya Mulat ◽  
Nur Syamsi Norma Lalla
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Community Health ◽  
Health Center ◽  
Community Health Services ◽  
Public Health Care ◽  
Community Health Care ◽  
Public Health Center ◽  
And Training

Health development is a way of increasing awareness, willingness and ability to live healthy for everyone so that an optimal degree of public health can be achieved. The purpose of knowing how the relationship between nurse competence and community health care activities. This study employed quantitative approach and correlation analysis. The population was nurses who work at public health center in Makassar City, Indonesia, however there were 118 nurses who meet the criteria in their selection. There were relationships between attitudes, skills, and competencies with the level of implementation of community health services and that there is an interaction between competence and training. The results of the competency analysis obtained an OR value of 6.429, meaning that public health center nurses who have good competence have a chance of 6.429 times to carry out community health care activities optimally. Most dominant with the implementation of public health care is the interaction between competence and training. The competence of nurses need to be improved in order to optimize the implementation of community health services through training, coaching through assigned teams, and collaborating with peers and providing support in the form of policies for rewards and sanctions such as nurse career paths.

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