期刊论文详细信息
BMC Family Practice
What core primary health care services should be available to Australians living in rural and remote communities?
Research Article
Susan L Thomas1  John Wakerman2  John S Humphreys3 
[1] Centre for Remote Health, Flinders University and Charles Darwin University, PO Box 4066, Northern Territory 0871, Alice Springs, Australia;Centre of Research Excellence in Rural and Remote Primary Health Care, Bendigo, Australia;Centre of Research Excellence in Rural and Remote Primary Health Care, Bendigo, Australia;Flinders Northern Territory, Darwin, Australia;Centre of Research Excellence in Rural and Remote Primary Health Care, Bendigo, Australia;School of Rural Health, Monash University, Bendigo, Australia;
关键词: Primary health care;    Equity;    Access;    Core services;    Health service planning;    Health policy;    Rural;    Remote;   
DOI  :  10.1186/1471-2296-15-143
 received in 2014-04-14, accepted in 2014-08-15,  发布年份 2014
来源: Springer
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【 摘 要 】

BackgroundAustralians living in rural and remote areas experience poorer access to primary health care (PHC) and poorer health outcomes compared to metropolitan populations. Current health reform in Australia aims to ensure all Australians, regardless of where they live, have access to essential PHC services. However, at a national level policy makers and health planners lack an evidence-based set of core PHC services to assist in implementing this goal.MethodsA Delphi method was used to reach consensus on an evidence-based list of core PHC services to which all Australians should have access and their necessary support functions. Experts in rural and remote and/or Indigenous PHC, including policy-makers, academics, clinicians and consumers, were invited to consider a list of core services derived from the literature.ResultsThirty nine experts agreed to participate. After three survey rounds there was a strong consensus (≥80% agreement) on core PHC services namely; ‘care of the sick and injured’, ‘mental health’, ‘maternal/child health’, ‘allied health’, ‘sexual/reproductive health’, ‘rehabilitation’, ‘oral/dental health’ and ‘public health/illness prevention’; and on the PHC support functions of; ‘management/governance/leadership’, ‘coordination’, ‘health infrastructure’, ‘quality systems’, ‘data systems’, ‘professional development’ and ‘community participation’. Themes emerging from qualitative data included challenges in providing equitable PHC in rural and remote areas, the importance of service coordination and diverse strategies to overcome access barriers.ConclusionThis study identifies a basket of PHC services that consumers in rural and remote communities can expect to access. It provides rigorously derived evidence that will contribute to a more systematic approach to PHC service planning and availability and will assist policy makers in the allocation of scarce resources necessary to improve the health outcomes of residents of rural and remote areas.

【 授权许可】

CC BY   
© Thomas et al.; licensee BioMed Central Ltd. 2014

【 预 览 】
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