影响证据基础的区域中级初级医疗保健计划的因素:定性检查和概念框架
Alice Windle1, Sara Javanparast2, Toby Freeman3
1College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia. alice.windle@flinders.edu.au.
Health research policy and systems
|September 25, 2023
概括
区域组织中的初级医疗保健 (PHC) 规划是复杂的,受到许多政府和服务提供商的影响. 了解这些因素是改善基于证据的医疗保健计划的关键.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
- 组织研究 组织研究
背景情况:
- 在分散的中级区域组织中,对基于证据的初级医疗保健 (PHC) 规划的研究很少.
- 本研究探讨了在这些特定环境中影响PHC规划的因素.
研究的目的:
- 检查影响证据基础的初级医疗保健规划的多方面的因素.
- 开发一个概念框架来理解和改进这个规划过程.
主要方法:
- 混合方法方法利用澳大利亚五个初级卫生网络 (PHN) 的案例研究.
- 包括29次初级采访,对38次先前采访的二次分析,以及对所有31个PHN的规划文件的审查.
- 以世卫组织为基础的政策制定和制度理论框架为指导的分析.
主要成果:
- 关键的有影响力的参与者包括联邦和州/地区政府,地方卫生网络和土著社区控制的卫生组织.
- 联邦政府严重限制了PHN的规划范围,时间和资金.
- 外部因素 (医疗服务格局,社会人口统计学,政治) 和内部因素 (组织结构,能力,文化) 复杂的规划.
结论:
- 中级 PHC 规划在一个复杂的环境中运作,类似于国家政策制定,但有额外的区域影响.
- 提出了一个概念框架,以帮助区域组织识别影响因素.
- 这一框架可以指导制定透明,以证据为基础的PHC规划战略,以改善健康结果.
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