scholarly journals Building an evidence base for community health: a review of the quality of program evaluations

2007 ◽  
Vol 31 (4) ◽  
pp. 603 ◽  
Author(s):  
Gwyn M Jolley ◽  
Angela P Lawless ◽  
Fran E Baum ◽  
Catherine J Hurley ◽  
Denise Fry
Keyword(s):  
Health Services ◽  
Community Health ◽  
Good Deal ◽  
Evidence Base ◽  
Community Health Services ◽  
Services Research ◽  
Policy Makers ◽  
Program Evaluations ◽  
Australian Community

An assessment of the quality of program evaluations conducted in South Australian community health services investigated how effective evaluation reporting is in producing an evidence base for community health. Evaluation reports were assessed by a team of reviewers. Practitioner workshops allowed an understanding of the uses of evaluation and what promotes or acts as a barrier to undertaking evaluations. Community health services do undertake a good deal of evaluation. However, reports were not generally explicit in dealing with the principles that underpin community health. Few engaged with program theory or rationale. Typically, reports were of short-term projects with uncertain futures so there may seem little point in considering issues of longterm health outcomes and transferability to other settings. The most important issue from our study is the lack of investment in applied health services research of the sort that will be required to produce the evidence for practice that policy makers desire. The current lack of evidence for community health reflects failure of the system to invest in research and evaluation that is adequately resourced and designed for complex community settings.

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 future of community-centred health services in Australia: 'When too many beds are not enough'

2012 ◽  
Vol 36 (3) ◽  
pp. 239 ◽  
Author(s):  
Alan Rosen ◽  
Roger Gurr ◽  
Paul Fanning ◽  
Alan Owen
Keyword(s):  
Health Services ◽  
Community Health ◽  
Support Services ◽  
Evidence Base ◽  
Models Of Care ◽  
Community Health Services ◽  
Economic Factors ◽  
Australian Health ◽  
The Future ◽  
Health Review

The authors welcome a constructive debate on the future of community-centred health services. Therefore, we have written this piece in response to an article published by Cunningham in the previous edition of the Australian Health Review (Cunningham, Australian Health Review 2012; 36: 121–124), which was a very limited analysis and misleading critique of our previous contribution to this journal (Rosen et al. Australian Health Review 2010; 34: 106–115). The focus here is necessarily brief and does not stand in for a detailed analysis of the evidence base. The aim instead, is to draw attention back to the broader political, economic and social dimensions of how the retreat from community health services has affected clinical care. We also outline a response to a longstanding assumption, or belief, that ‘too many hospital beds are not enough’ and may never be enough. How we understand the problem of resource allocation in healthcare shapes the remedies that are considered realistic. We explain that the reasons for the systematic underdevelopment of community health services are complex, historical, and largely relate to political and economic factors, but they are still amenable to change. What is known about the topic? There is a growing evidence base and consensus of expert opinion supporting the gradual shift in health service delivery away from hospital-based models of care to community-centred ones. Wherever possible, speciality community health services should be co-located with primary health care in communal shopping and transport hubs so that patients have access to ‘one-stop-shops’ providing both primary healthcare and community treatment, and support services. It is important that these speciality community health services retain their integrity and control of their budgets, but also that they maintain functional integration with their respective hospital-based services. What does this paper add? In response to a recently published vigorous but narrowly targeted critique of community-based models of care, we explore the wider context of the debate about the appropriate balance between hospital and community health services. We pay particular attention to the current debate in mental health services. What are the implications for practitioners? Clinicians need to understand the historical, political and economic factors that have influenced the underdevelopment of community-centred health services, so as to avoid unhelpful conflicts between specialists and those working in different care settings. Rear-guard attempts to restore the dominance of hospital-centric services are unsustainable in terms of ethics and economic reality. Policy-makers and health planners should instead aim to rebalance resources in the health sector so that people in all age groups and regions have equitable access to the full range of human health and support services across the continuum of care.

scholarly journals Increasing autonomy in publically owned services

2015 ◽  
Vol 29 (6) ◽  
pp. 778-794
Author(s):  
Ailsa Cameron ◽  
Pauline Allen ◽  
Lorraine Williams ◽  
Mary Alison Durand ◽  
Will Bartlett ◽  
...  
Keyword(s):  
Health Services ◽  
Service Delivery ◽  
Community Health ◽  
Design Methodology ◽  
Community Health Services ◽  
Policy Makers ◽  
Content Type ◽  
Organisational Form ◽  
Foundation Trusts ◽  
Improve Service Delivery

Purpose – The purpose of this paper is to explore government efforts to enhance the autonomy of community health services (CHS) in England through the creation of Foundation Trusts status. It considers why some CHS elected to become nascent Community Foundation Trusts (CFTs) while others had not and what advantages they thought increased levels of autonomy offered. Design/methodology/approach – Data are drawn from the evaluation of the Department of Health’s CFT pilot programme. Participants were purposively selected from pilot sites, as well as from comparator non-pilot organisations. A total of 44 staff from 14 organisations were interviewed. Findings – The data reveals that regardless of the different pathways that organisations were on, they all shared the same goal, a desire for greater autonomy, but specifically within the NHS. Additionally, irrespective of their organisational form most organisations were considering an almost identical set of initiatives as a means to improve service delivery and productivity. Research limitations/implications – Despite the expectations of policy makers no CFTs were established during the course of the study, so it is not possible to find out what the effect of such changes were. Nevertheless, the authors were able to investigate the attitudes of all the providers of CHS to the plans to increase their managerial autonomy, whether simply by separating from PCTs or by becoming CFTs. Originality/value – As no CFTs have yet been formed, this study provides the only evidence to date about increasing autonomy for CHS in England.

scholarly journals Continuing to enhance the quality of case study methodology in health services research

2021 ◽  
pp. 084047042110288
Author(s):  
Shannon L. Sibbald ◽  
Stefan Paciocco ◽  
Meghan Fournie ◽  
Rachelle Van Asseldonk ◽  
Tiffany Scurr
Keyword(s):  
Health Services Research ◽  
Health Services ◽  
Research Process ◽  
Services Research ◽  
Policy Makers ◽  
Case Study Methodology ◽  
Study Methodology ◽  
Complex Relationships

Case study methodology has grown in popularity within Health Services Research (HSR). However, its use and merit as a methodology are frequently criticized due to its flexible approach and inconsistent application. Nevertheless, case study methodology is well suited to HSR because it can track and examine complex relationships, contexts, and systems as they evolve. Applied appropriately, it can help generate information on how multiple forms of knowledge come together to inform decision-making within healthcare contexts. In this article, we aim to demystify case study methodology by outlining its philosophical underpinnings and three foundational approaches. We provide literature-based guidance to decision-makers, policy-makers, and health leaders on how to engage in and critically appraise case study design. We advocate that researchers work in collaboration with health leaders to detail their research process with an aim of strengthening the validity and integrity of case study for its continued and advanced use in HSR.

Determining priority of access to physiotherapy at Victorian community health services

2011 ◽  
Vol 35 (2) ◽  
pp. 178 ◽  
Author(s):  
Alison M. C. Brown ◽  
Marie Pirotta
Keyword(s):  
Health Services ◽  
Community Health ◽  
Allied Health ◽  
Evidence Base ◽  
Community Health Services ◽  
Client Outcomes ◽  
Priority Service ◽  
Department Of Health ◽  
Wide Range ◽  
Victorian Department

Prioritisation of clients requesting physiotherapy in Victorian community health services has occurred in the absence of a uniform evidence-based prioritisation process. The effect of the varying prioritisation procedures on client outcomes is unknown. This two-part study sought to answer two questions: what are the current prioritisation practices? And what is the evidence for prioritisation? Staff of Victorian community health services offering physiotherapy (n = 67) were sent a structured questionnaire regarding their prioritisation practices. The questionnaire data revealed a wide range of poorly defined criteria and methods of assessment for prioritisation. The evidence for prioritisation and the use of specific prioritisation criteria were examined via a literature search. The literature suggested the use of acute severe pain, interference with activities of daily living and falls as indicators of need for priority service. The lack of uniformity found in determining priority of access reflects the complexity of determining need and the lack of research and validated tools to assist decision making. Further research into prioritisation criteria is required to determine their validity and if their use in a prioritisation tool would actually improve outcomes for clients. What is known about the topic? Although there is some research on medical prioritisation of clients awaiting surgery little is known about prioritisation practices in allied health in general and physiotherapy in particular. There is also little known about client outcomes when clients are either not prioritised or have been incorrectly prioritised. The literature provides expert opinion on the potential usefulness of prioritisation criteria in determining client need. What does this paper add? This paper highlights the discrepancy between the various poorly defined and complex physiotherapy prioritisation practices that occurred in Victorian Community Health Services at the time of the study and the literature regarding the assessment of need. The underpinning evidence base for uniform prioritisation criteria is explored. Further research is required into the risks and effect on client outcomes of prioritisation. What are the implications for practitioners? Although practitioners, in the absence of any guidelines, have developed their own prioritisation protocols, the Victorian Department of Health has recently mandated the use of a uniform community health prioritisation procedure for physiotherapy and other allied health services, developed from the findings of this research. This study provides practitioners with an understanding of the evidence base for prioritisation criteria and approaches for assessing criteria in practice.

scholarly journals Current status of antenatal care of pregnant women—8 provinces in China, 2018

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenling Hu ◽  
Huanqing Hu ◽  
Wei Zhao ◽  
Aiqun Huang ◽  
Qi Yang ◽  
...  
Keyword(s):  
Health Services ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Community Health ◽  
First Trimester ◽  
Community Health Services ◽  
Current Status ◽  
Categorical Variables ◽  
Chi Square ◽  
Prenatal Care Visit

Abstract Background Antenatal care (ANC) played a crucial role in ensuring maternal and child safety and reducing the risk of complications, disability, and death in mothers and their infants. The objective of this study was to evaluate the current status of ANC emphasizing the number, timing, and content of examinations on a national scale. Methods The data was collected from maternal and newborn’s health monitoring system at 8 provinces in China. After ethical approval, all pregnant women registered in the system at their first prenatal care visit, we included 49,084 pregnant women who had delivered between January 1, 2018 and December 31, 2018. Descriptive statistics of all study variables were calculated proportions and chi-square for categorical variables. Results Of the 49,084 women included in this study, the mean number of ANC visits was 6.95 ± 3.45. By percentage, 78.79% women received ANC examinations at least five times, 39.93% of the women received ANC examinations at least eight times and 16.66% of the women received ANC examinations at least 11 times. The proportion of first ANC examination in first trimester was 61.87%. The percentage of normative ANC examinations and the percentage of qualified ANC examinations were 30.98 and 8.03% respectively. Only 49.40% of the total women received all six kinds of examination items in first ANC examination: 91.47% received a blood test, 91.62% received a urine test, 81.56% received a liver function examination, 80.52% received a renal function examination, 79.07% received a blood glucose test, and 86.66% received a HIV/HBV/syphilis tests. 50.85% women received the first ANC examination in maternal and child health care (MCH) institutions, 14.07% in a general hospital, 18.83% in a township hospital, 13.15% in a community health services center, and 3.08% in an unspecified place. The proportion of women who received each of the ANC examination items in community health services center was the highest, but that in the MCH institutions was the lowest. Conclusions There is a big difference between the results of this study and the data in official reports, this study found the current status of antenatal care is not optimal in China, findings from this study suggest that the systematization, continuity and quality of ANC examinations need to be improved.

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