scholarly journals How far can systematic reviews inform policy development for “wicked” rural health service problems?

2009 ◽  
Vol 33 (4) ◽  
pp. 592 ◽  
Author(s):  
John S Humphreys ◽  
Pim Kuipers ◽  
Leigh A D Kinsman ◽  
Robert Wells ◽  
Judith Jones ◽  
...  

Policy makers and researchers increasingly look to systematic reviews as a means of connecting research and evidence more effectively with policy. Based on Australian research into rural and remote primary health care services, we note some concerns regarding the suitability of systematic review methods when applied to such settings. It suggests that rural and other health services are highly complex and researching them is akin to dealing with ?wicked? problems. It proposes that the notion of ?wicked? problems may inform our understanding of the issues and our choice of appropriate methods to inform health service policy. Key issues including the complexity of health services, methodological limitations of traditional reviews, the nature of materials under review, and the importance of the service context are highlighted. These indicate the need for broader approaches to capturing relevant evidence. Sustained, collaborative synthesis in which complexity, ambiguity and context is acknowledged is proposed as a way of addressing the wicked nature of these issues.

2017 ◽  
Vol 17 (3) ◽  
pp. 47-57
Author(s):  
Muhammad Haikal Bin Ghazali ◽  
Shamsul Azhar Bin Shah ◽  
Mohd Rizal Bin Abd Manaf

As air travelling now becomes cheaper and available to almost all people of any walk of life, travelling across international borders is fast becoming a lifestyle of many. Having travel health service as part of health care services is important to address the issues of travel related illnesses among travellers. However, lacks of published guidelines pertaining to travel health service rendering many countries to overlook its importance. The aim of this paper is to review published literatures and authoritative websites on the components needed to develop guideline to establish travel health services. A systematic literature search was done using pre-specified keywords for literatures published between years 2000 – 2016. Literatures written in English and fully accessible were all included. No exclusion criteria was set before the search. Online authoritative websites pertaining to travel health were also referred. A total of six literatures ranging from expert opinion, review paper and original study, together with three authoritative websites related to travel health were reviewed. Among the important components needed to be considered for developing the guideline for establishing travel health services are to prioritise pre-travel health service, to set up specialised travel health clinic, to produce travel health/medicine specialist, to emphasize on continuous education and training of the practitioners and to apply multiagency and multidisciplinary approach with adequate fund for research in travel health. As a conclusion, policy makers should prioritise and select the most important components in developing guideline for travel health service.


Curationis ◽  
1981 ◽  
Vol 4 (3) ◽  
Author(s):  
Delene Mcnulty

Article 30 areas are those in which the Department of Health, Welfare and Pensions act as the local authority in terms of health services. The Department has been developing comprehensive primary health care services, provided by registered nurses, in these areas since 1975. These services are challenged by complex problems and methods for primary health care used successfully in other areas are inappropriate. As those served are mostly immigrant farm labourers, village workers cannot be used. A lack of demographic and epidemiological data complicates the setting of objectives and thus planning of services. There are few clinic services and supportive services and sources for referral are inadequate or non-existent. The nurse mostly provides the service from a car at suitable central points. Sophisticated technology cannot be used and equipment, techniques and procedures must be carefully selected or even improvised. The success of the service depends on the nurses’ ability to gain the co-operation and acceptance of the farmer who is the employer; doctors and pharmacists; school principals; magistrates; the nearest hospitals which may be in another country; and of the target group comprising the workers and their families. In this time of fragmentation and specialised care in health services the nurses providing the section 30 services must be able to meet all promotive, preventive, curative and rehabilitative health needs — she is expected to be a model of versatility.


2019 ◽  
Vol 43 (3) ◽  
pp. 314 ◽  
Author(s):  
Kylie Gwynne ◽  
Thomas Jeffries Jr ◽  
Michelle Lincoln

Objective The aim of the present systematic review was to examine the enablers for effective health service delivery for Aboriginal Australians. Methods This systematic review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Papers were included if they had data related to health services for Australian Aboriginal people and were published between 2000 and 2015. The 21 papers that met the inclusion criteria were assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Seven papers were subsequently excluded due to weak methodological approaches. Results There were two findings in the present study: (1) that Aboriginal people fare worse than non-Aboriginal people when accessing usual healthcare services; and (2) there are five enablers for effective health care services for Australian Aboriginal people: cultural competence, participation rates, organisational, clinical governance and compliance, and availability of services. Conclusions Health services for Australian Aboriginal people must be tailored and implementation of the five enablers is likely to affect the effectiveness of health services for Aboriginal people. The findings of the present study have significant implications in directing the future design, funding, delivery and evaluation of health care services for Aboriginal Australians. What is known about the topic? There is significant evidence about poor health outcomes and the 10-year gap in life expectancy between Aboriginal and non-Aboriginal people, and limited evidence about improving health service efficacy. What does this paper add? This systematic review found that with usual health care delivery, Aboriginal people experience worse health outcomes. This paper identifies five strategies in the literature that improve the effectiveness of health care services intended for Aboriginal people. What are the implications for practitioners? Aboriginal people fare worse in both experience and outcomes when they access usual care services. Health services intended for Aboriginal people should be tailored using the five enablers to provide timely, culturally safe and high-quality care.


1992 ◽  
Vol 5 (4) ◽  
pp. 48-53 ◽  
Author(s):  
Jeffrey L. Weatherill

This paper received the 1992 Agnew Peckham Literary Prize of the Canadian College of Health Service Executives in recognition of excellence in content and presentation of ideas related to a current issue in the management of health services.


1995 ◽  
Vol 25 (2) ◽  
pp. 271-282 ◽  
Author(s):  
Jack Reamy

New Brunswick moved swiftly in 1992 to regionalize hospital and physician services along with the reform and expansion of other health care services. The dissolution of 51 hospital and community health services center boards and the establishment of eight region hospital corporations to oversee services in the seven health regions set the tone for regionalization in the province. The plan provides the flexibility to meet specific regional needs. The initial regionalization of hospital services was followed by the determination of the appropriate number, mix, and distribution of physician resources for each region, also to be managed by the region hospital corporation. The provincial government's central role not only guides the regions, but also uses incentives and disincentives to ensure that regional goals are met. While regionalization is not new and some components of the New Brunswick plan have been used elsewhere, the effort offers an integrated model for the regionalization of hospital and physician services, with the expansion of complementary services.


2020 ◽  
Vol 9 (3) ◽  
pp. 131-138
Author(s):  
Sebahat Gücük ◽  
Erdal Dilekçi ◽  
Mehmet Kayhan

Aim: Our study aimed to determine the relationship between health literacy and the use of primary health care services in our patient group, where the demand for health services is quite frequent due to their complaints. Methods: This cross-sectional study was carried out with 725 patients with various diagnoses of musculoskeletal disorders hospitalizing to whom physical therapy and/or rehabilitation was applied. The volunteer participants filled out a sociodemographic questionnaire which consisted of 26 questions and Adult Health Literacy Scale using face-to-face interview method. Results: The mean total score of health literacy of the participants was identified as 12.02±3.77. In terms of those who previously took medical home service before for any reason, who received counseling by the midwife, and who have consulted their family physician about their current complaints, health literacy score was found to be significantly higher than the others. Conclusion: In order to increase the level of health literacy, which is an integral part of preventive health services especially in primary health care which is the first medical contact point, training programs should be planned according to the level of people’s need and understanding in every opportunity like seeing the patient in polyclinic or giving mobile care or during health screening programs. Keywords: health literacy, health education, national health policy


2020 ◽  
Vol 9 (2) ◽  
pp. 81-86
Author(s):  
Elif Fatma Ozkan Pehlivanoglu ◽  
Gokben Kayacan ◽  
Huseyin Balcioglu ◽  
Ugur Bilge ◽  
Ilhami Unluoglu

Aim: Use of health services is considered to be the most basic right. For this purpose, many methods have been searched to provide the health service. In this study, our aim is to investigate the use of primary health care services for patients receiving healthcare services at the university hospital in Eskişehir, Turkey. Methods: Our study was conducted in Eskişehir Osmangazi University Faculty of Medicine. 531 patients who applied to Eskişehir Osmangazi University Hospital with some problems between 2 April 2018 to 31 July 2018 included in our study. The questionnaire form, which was formed by the researchers, was completed by using face to face interview method. Results: When the place they apply for their non-emergency complaints were asked, 42% of the respondents stated that family health centers is the first application place. When reasons of applying to health centers were examined; patients who apply to family health centers stated that they preferred family health centers because they think it’s reliable and they’re being examined better without waiting for their results for too long. Conclusion: Application rates to family physicians who can treat a majority of diseases are considerably lower than target rates. Keywords: Family Practice, primary prevention, public health


2006 ◽  
Vol 6 ◽  
pp. 81-95 ◽  
Author(s):  
Mohammed Morad ◽  
Shifra Shvarts ◽  
Joav Merrick ◽  
Jeffrey Borkan

The extension of universal health service insurance to national populations is a relatively new phenomenon. Since 1995, the Israeli National Health Insurance Law (NHIL) has provided universal health services to every resident, but the effect of this law on health and health services among minorities has not been examined sufficiently. The goals of this study were to track some of the first changes engendered by the NHIL among the Negev Bedouin Arabs to examine the effects of universal health care services. Methods included analysis of historical and health policy documents, three field appraisals of health care services (1994, 1995, 1999), a region-wide interview survey of Negev Bedouins (1997), and key informant interviews. For the interview survey, a sample of 515 households was chosen from different Bedouin localities representing major sedentarization stages. Results showed that prior to the NHIL, a substantial proportion of the Negev Bedouins were uninsured with limited, locally available health service. Since 1995, health services, particularly primary care clinics and health manpower, have dramatically expanded. The initial expansion appears to have been a marketing ploy, but real improvements have occurred. There was a high level of health service utilization among the Bedouins in the Negev, especially private medical services, hospitals, and night ambulatory medical services. The NHIL brought change to the structure of health services in Israel, namely the institution of a national health system based on proportional allocation of resources (based on size and age) and open competition in the provision of quality health care. The expansion of the pool of potential members engendered by the new universal coverage had profound effects on the Health Funds' attitudes towards Negev Bedouins. In addition, real consumer choice was introduced for the first time. Although all the health care needs of this rapidly growing population have yet to be met fully, the assurances under the Law and the new level of competition promise a higher level of service in the future.


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