scholarly journals Rural health service planning: the need for a comprehensive approach to costing

2016 ◽  
Author(s):  
Jude Kornelsen ◽  
Lesley Barclay ◽  
Stefan Grzybowski ◽  
Yu Gao
2017 ◽  
Vol 41 (5) ◽  
pp. 492 ◽  
Author(s):  
Matthew R. McGrail ◽  
Deborah J. Russell ◽  
John S. Humphreys

Objective Improving access to primary health care (PHC) remains a key issue for rural residents and health service planners. This study aims to show that how access to PHC services is measured has important implications for rural health service and workforce planning. Methods A more sophisticated tool to measure access to PHC services is proposed, which can help health service planners overcome the shortcomings of existing measures and long-standing access barriers to PHC. Critically, the proposed Index of Access captures key components of access and uses a floating catchment approach to better define service areas and population accessibility levels. Moreover, as demonstrated through a case study, the Index of Access enables modelling of the effects of workforce supply variations. Results Hypothetical increases in supply are modelled for a range of regional centres, medium and small rural towns, with resulting changes of access scores valuable to informing health service and workforce planning decisions. Conclusions The availability and application of a specific ‘fit-for-purpose’ access measure enables a more accurate empirical basis for service planning and allocation of health resources. This measure has great potential for improved identification of PHC access inequities and guiding redistribution of PHC services to correct such inequities. What is known about the topic? Resource allocation and health service planning decisions for rural and remote health settings are currently based on either simple measures of access (e.g. provider-to-population ratios) or proxy measures of access (e.g. standard geographical classifications). Both approaches have substantial limitations for informing rural health service planning and decision making. What does this paper add? The adoption of a new improved tool to measure access to PHC services, the Index of Access, is proposed to assist health service and workforce planning. Its usefulness for health service planning is demonstrated using a case study to hypothetically model changes in rural PHC workforce supply. What are the implications for practitioners? The Index of Access has significant potential for identifying how rural and remote primary health care access inequities can be addressed. This critically important information can assist health service planners, for example those working in primary health networks, to determine where and how much redistribution of PHC services is needed to correct existing inequities.


2018 ◽  
Vol 42 (1) ◽  
pp. 111 ◽  
Author(s):  
Elena Wilson ◽  
Amanda Kenny ◽  
Virginia Dickson-Swift

Community participation in health service decision making is entrenched in health policy, with a strong directive to develop sustainable, effective, locally responsive services. However, it is recognised that community participation is challenging to achieve. The aim of the present study was to explore how a rural health service in Victoria enacts community participation at the local level. Using case study methodology, the findings indicate that enactment of community participation is desired by the health service, but a lack of understanding of the concept and how to enact associated policy are barriers that are exacerbated by a lack of resources and community capacity. The findings reveal a disconnect between community participation policy and practice. What is known about the topic? The need to involve communities in health service planning, implementation and evaluation is a feature of health policy across major Western countries. However, researchers have identified a dearth of research on how community participation is enacted at the local service level. What does this paper add? The study that is presented herein addresses a gap in knowledge of community participation policy enactment within a rural health service. Insights are provided into the challenges faced by rural health services, with a disconnect between policy ideal and the reality of implementation. What are the implications for practitioners? Health service staff need clear direction from chief executive officers about the purpose of community participation policy and the expectations for individual roles. Community advisory committees need clarity about the community member role and the processes for making decisions. Services and their boards would benefit from targeted government funding to resource community participation activity.


BMJ ◽  
1978 ◽  
Vol 2 (6135) ◽  
pp. 498-498
Author(s):  
D R Wood ◽  
D Ranger

Nature ◽  
1978 ◽  
Vol 275 (5678) ◽  
pp. 264-264
Author(s):  
Zaka Imam

Author(s):  
David Lawrence

This chapter shows you how to contribute to planning health services successfully at strategic and operational levels. It first explains what health service planning is and the nature of health services as mainly ‘soft’ systems. It provides a conceptual framework for planning and then goes through steps and tasks in planning. It then suggests some ways of overcoming pitfalls, notes some common fallacies about planning, and provides a real planning case study with its successes and failures. Finally, it notes ways to assess how well you are doing


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