Community Health Within the Context of Health Reform

2000 ◽  
Vol 6 (1) ◽  
pp. 85 ◽  
Author(s):  
Rhonda M. Brown
Keyword(s):  
Health Care ◽  
Health Services ◽  
Community Health ◽  
Market Model ◽  
Health Reforms ◽  
Community Needs ◽  
Alternative Funding ◽  
Funding Sources ◽  
Efficiency And Effectiveness ◽  
The Impact

Recent health reforms in Victoria based on a market model characterised by competition and market control of health services, have radically changed the funding and management of community health organisations and the way health services are provided. Community health has sustained ongoing funding cuts, restructures, amalgamations, and corporatisation over the past decade. Within the context of reform community health has been forced to become competitive through improvement in the efficiency and effectiveness of services. At the same time organisations must collaborate to ensure a co-ordinated approach to health care and continue to provide services which are responsive to community needs. With diminishing government funding community health organisations must seek alternative funding sources through the tendering process. A 1998 study of one of the largest metropolitan community health organisations in Victoria gives some insights into the impact of these reforms. The findings of this study show that health reforms based on market principles are not compatible with the delivery of health care, and in particular with primary health care, the underlying philosophy of community health. Organisations are becoming more bureaucratic and hierarchical with decision making being driven by management rather than by consultation with community and staff. Resources are being diverted from health promotion and community development activities to direct services, that are individual and problem focused rather than community and prevention focused.

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 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.

scholarly journals Activation of Occupational Health Services in Community Health Care System

Sangyo Igaku ◽  
1986 ◽  
Vol 28 (7) ◽  
pp. 530-532
Author(s):  
Tsutomu TAKATA ◽  
B. UKON ◽  
S. TANAKA ◽  
Y. FUKUWATARI ◽  
Y. KAWAGUCHI
Keyword(s):  
Health Care ◽  
Occupational Health ◽  
Health Services ◽  
Community Health ◽  
Health Care System ◽  
Occupational Health Services ◽  
Community Health Care ◽  
Community Health Care System ◽  
Care System

scholarly journals INTERCAMBIO TRASFRONTERIZO DE SERVICIOS DE SALUD Y MEDICINAS EN LA REGIÓN DE TIJUANA Y SAN DIEGO

2010 ◽  
Vol 5 (10) ◽  
pp. 303
Author(s):  
José G. Vargas-Hernández
Keyword(s):  
Health Care ◽  
Health Services ◽  
Regional Development ◽  
San Diego ◽  
Negative Consequences ◽  
Review Of The Literature ◽  
Border Area ◽  
Future Studies ◽  
Documentary Analysis ◽  
The Impact

Este trabajo tiene por objetivo analizar el intercambio fronterizo en la región Tijuana-San Diego de los servicios de atención médica, cuidados de la salud y medicamentos. Aun con un gran número de investigaciones y estudios, todavía se tienen muchos cuestionamientos con respecto al impacto de este intercambio en el desarrollo regional. El método empleado es exploratorio, analítico documental y de revisión de la literatura existente. En este trabajo se delimita el mercado trasfronterizo del sur de California y la zona fronteriza de Tijuana, las motivaciones de los usuarios y compradores, las principales barreras, características y tipología. Se enuncian algunas de las áreas para futuras investigaciones y finalmente se formulan algunas propuestas que tienen implicaciones en las políticas públicas. Este estudio arroja luz sobre la posibilidad de elevar los ingresos provenientes del comercio de los servicios de salud, mejorar la satisfacción de los usuarios y consumidores y mitigar las consecuencias negativas asociadas con el diseño de políticas y de iniciativas en los ámbitos multilateral, binacional, regional.    ABSTRACTThe objective of this article is to analyze the border exchange in the Tijuana-San Diego region of medical services, health care and medicines. Despite the numerous research studies conducted, there are still many questions regarding the impact from this exchange on regional development. The exploratory method, documentary analysis and a review of the literature were utilized. This article is focused on the transboundary market of southern California and the Tijuana border area, the motivations of users and buyers, the main barriers, characteristics and typology. Some areas for future studies are specified, and lastly, some proposals with implications for public policies are formulated. This study sheds light on the possibilities of increasing income from commerce in health services, improving the satisfaction of users and consumers, and mitigating the negative consequences associated with the design of policies and initiatives at the multilateral, binational and regional levels.

scholarly journals Evaluation of a novel approach to community health care delivery in Ifanadiana District, Madagascar

2020 ◽  
Author(s):  
Bénédicte Razafinjato ◽  
Luc Rakotonirina ◽  
Jafeta Benony Andriantahina ◽  
Laura F. Cordier ◽  
Randrianambinina Andriamihaja ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Community Health ◽  
Access To Health Care ◽  
Care Delivery ◽  
Local Level ◽  
Scale Up ◽  
P Value ◽  
The Impact

AbstractDespite the widespread global adoption of community health (CH) systems, there are evidence gaps in how to best deliver community-based care aligned with global best practice in remote settings where access to health care is limited and community health workers (CHWs) may be the only available providers. PIVOT partnered with the Ministry of Public Health to pilot a new two-pronged approach for care delivery in rural Madagascar: one CHW provided care at a stationary CH site while 2-5 additional CHWs provided care via proactive household visits. The pilot included professionalization of the CHW workforce (i.e. recruitment, training, financial incentive) and twice monthly supervision of CHWs. We evaluated the impact of the CH pilot on utilization and quality of integrated community case management (iCCM) in the first six months of implementation (October 2019-March 2020).We compared utilization and proxy measures of quality of care (defined as adherence to the iCCM protocol for diagnosis, classification of disease severity, treatment) in the intervention commune and five comparison communes, using a quasi-experimental study design and relying on routinely collected programmatic data. Average per capita monthly under-five visits were 0.28 in the intervention commune and 0.22 in the comparison communes. In the intervention commune, 40.0% of visits were completed at the household via proactive care. CHWs completed all steps of the iCCM protocol in 77.8% of observed visits in the intervention commune (vs 49.5% in the comparison communes, p-value=<0.001). A two-pronged approach to CH delivery and professionalization of the CHW workforce increased utilization and demonstrated satisfactory quality of care. National stakeholders and program managers should evaluate program re-design at a local level prior to national or district-wide scale-up.

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

Engaging Elected Officials to Improve Community Health

2019 ◽  
pp. 113-118
Author(s):  
Edward L. Hunter
Keyword(s):  
Public Health ◽  
Health Care ◽  
Community Health ◽  
Elected Officials ◽  
Public Officials ◽  
Health Goals ◽  
Care Partners ◽  
The Impact ◽  
Improve Community Health

Improving the health of populations and communities requires all sorts of actors to be involved. This chapter looks at the importance of involving elected officials in collaboration for community health improvements. Elected officials can be important allies in efforts to achieve health goals at all levels of government it states, but these people are often overlooked as potential collaborators. In fact, the chapter notes, public health and health care partners can enhance the impact of cross-sector collaborations with greater awareness and preparation for working with elected officials. The chapter ends with some useful tips for engaging with public officials.

Evaluation of Outreach Community Health Care to Insecurely Housed Sydney Men

1999 ◽  
Vol 5 (3) ◽  
pp. 82 ◽  
Author(s):  
Margaret L. Basser
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Centre ◽  
Pilot Project ◽  
Community Health Services ◽  
Community Services ◽  
Community Health Care ◽  
Referral Networks ◽  
Homeless Men ◽  
The Impact

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.

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