A community health outreach service was piloted among older homeless Sydney men in 1997/98 from Darlinghurst Community Health Centre, responding to an observed disparity between their high health needs and low use of community health care. The project tried to improve their access to community health services, their health and quality of life by allocating a project worker who built referral networks, assisted the men and advocated for them with other agencies. From the impact evaluation, the conclusion could be drawn that the men's access to community services improved, but whether lasting benefits were delivered by the interventions remained ambiguous. Referrals of homeless men from GPs and hospitals to the health centre increased in the year following the pilot, despite the absence of a project worker for most of that time. The project was guided by an inter-sectoral advisory committee, whose deliberations altered the evaluation questions, the interpretation of findings and recommendations. Reflection on this process led to some lessons about working with committees. The pilot project has contributed to the current planning in South Eastern Sydney Area Health Service to address homeless people's health care issues by highlighting some of the issues and viable responses to them.
Health professionals’ perspective on the impact of community health care reform in different regions of China
