Rural and remote Area Nursing

Evaluating the impact of sustainable comprehensive primary

health care on rural health

NRHA

• Australia’s peak non-government organisation for rural and remote health
• Goal of equal health for all Australians by the year 2020
• Comprises 34 Member Bodies
• E.g. representation from the ATSI health sector, health professional organizations, and service providers

Rachel Tham:

- Tutor at Monash University

- Phd Candidate at University of Melbourne

- Co-convenor Primary Health Care Special Interest Group

- Research areas & supervision interests; e.g. rural oral health, health service evaluation, access and equity, building effective collaborations, the impact of ecosystem change on public health, and international health.

John Humphreys:

- Emeritus Professor of Rural Health Research in Medicine, Nursing and Health Sciences at Monash University

- Qualification: Dr of Philosophy at the institute of Monash University

- Research and supervision interests: The provision of sustainable primary health care services in rural areas; the evaluation of rural health planning and policies

Leigh Kinsman:

- Associate Professor, Centre of Research Excellence in Rural & Remote Primary Health Care, and Director of the Office of Research at the School of Rural Health, Bendigo.

- Qualifications: PhD, Master of Health Science and Bachelor of Health science (Nursing studies) in the institute of La Trobe University, Bendigo.

Penny Buykx:

- Senior Research Fellow in Office of Research, based at the School of Rural Health, Bendigo.

- Dr of Philosophy in Curtin University of Technology

- Graduate Diploma applied Psychology in Swinburne University of Technology

- Bachelor of Behavioural Science in La Trobe University

- Research & Supervision interests: e.g. Models of health service provision, health service evaluation and population health

Adel Asaid:

- PhD Dr from Elmore Primary Health Service, Victoria, Australia

- General manager of primary health at Bendigo Community Health Services,

Kathy Tuohey:

- Researcher from Elmore Primary Health Service, Victoria, Australia

• Tham et al. established an outcome and evaluation framework measuring performance, sustainability, quality of care, utilization and health outcomes including individual and the communities’ growth, development, health behaviors and outcomes of services provided.
• The framework was used in conjunction with a study undertaken at the Elmore Primary Health Service (EPHS). The framework examined qualitative data to measure the quality and sustainability of the service and patient outcomes.

Answers:

• Services inequalities were experienced by people in rural area’s compared to that of metropolitan Australia.
• There is a need for greater evidence based knowledge on longitudinal evaluations of primary health services performance, sustainability, quality of care, utilization and health outcomes.
• There is a lack of evidence on how to approach and move forward to prevent the health services gap between rural and urban Australia widening.

Thank you :)

Rural and Remote Area Nursing

Questions?

Q2. How has this evaluation framework model assisted your understanding?

Q1. What are some focus issues experienced as to why the evaluation study was conducted?

A:

Reference

Strengths of the study

Strengths

• A conceptual framework
• Sentinel indicators for measuring the sustainability and effectiveness of rural primary health care services
• Rigorous comprehensive health service evaluation research are outlined.
• Evaluating helps to minimize the gap between rural and urban primary health care services and
• Allows for a greater understanding of successful and non-successful services.
• Framework gives health providers and policy maker’s reliable evidence
• Comprehensive evaluations are ideal
• Provide evidence for policy development and implementation and provides other primary health services with knowledge of what services work well.

Context and Authority

The Australian Journal of Rural Health &

National Rural Health Alliance Inc.

Critical Review

• Consistent throughout the article
• Coherent and concise layout
• Referred to relevant databases, e.g. PubMed, Medline
• Obtained current journal articles

Authors

Tham, R., Humphreys, J., Kinsman, L., Buykx, P., Asaid, A., Tuohey, K., et al., (2010). Evaluating the impact of sustainable comprehensive primary health care on rural health. The Australian Journal of Rural Health, 18, 166–172.

Karen Riley:

- Deputy CEO at Bendigo Community Health Services.

- Previously was the first Executive Officer of Bendigo Loddon Primary Care Partnership and held a senior lecturer position in Nursing and Public Health at Latrobe University, Bendigo.

ANJRH

• Australian based article
• Qualitative research
• A multidisciplinary refereed journal
• Peer reviewed
• Excellence in Research Australia 2012
• Published by Australian Research Council with Fields of Research, Medical & Health Science, and Studies in Human Society
• Listed in Medline

Additional weaknesses

Weaknesses

• Focuses on the structure and performance of Elmore primary health service rather than how the facilities actually manages and treats illness & disease.
• The information and data collected is limited to surveys and electronic records.
• The primary health centre that was used, was already a well established facility

• No specific age group identified
• Stated only ''focus groups''
• Lacks numerical data concerning number of participants or completed surveys
• No given statements or opinions from focus groups or participants
• Does not carry out further investigations or thorough research to provide rigour evidence in regards to which rural health service works well
• Limited to only one facility
• Results cannot be generalised of the outcomes of rural health care
• Leads to reduced reliability and validity of research findings

Summary

Focus

References:

Summary cont.

• At present there is a lack of evidence on how to approach and move forward to prevent the health services gap between rural and urban Australia widening.
• Article gives us insight into the health services outcomes and inequalities experienced by people in rural areas compared to that of metropolitan Australia.
• The article emphasizes the need for greater evidence based knowledge on longitudinal evaluations on the delivery of primary health services.

Elmore Primary Health Service (EPHS) framework

- Australian Journal of Rural Health. (2013). AJRH. Retrieved from http://www.ruralhealth.org.au/ajrh

- Bendigo Advertiser. (2013). Health study for Elmore. Retrieved from

http://www.bendigoadvertiser.com.au/story/691342/health-study-for-elmore/

- LinkedIn Corporation. (2013). Rachel Tham. Retrieved from http://au.linkedin.com/pub/rachel-tham/25/8bb/760

- McMurray, A., Clendon, J. (2010). Community Health and Wellness: Primary Health Care In practice. Churchill Livingstone, Elsevier

- Monash University. (2013). Assoc Prof Leigh Kinsman - Researcher Profile. Retrieved from

http://www.monash.edu.au/research/people/profiles/profile.html?sid=11356&pid=4282

- Monash University. (2013). Emeritus Prof John Humphreys - Researcher Profile. Retrieved from

http://www.monash.edu.au/research/people/profiles/profile.html?sid=2934&pid=3324

- Monash University. (2013). Dr Penelope Buykx - Researcher Profile. Retrieved from

http://www.monash.edu.au/research/people/profiles/profile.html?sid=16616&pid=4616

- National Rural Health Alliance Inc. (2013). Australian Journal of Rural Health. Retrieved from

http://www.ruralhealth.org.au/about

- Research gate. (2013). Kathy Tuohey. Retrieved from

http://www.researchgate.net/profile/Kathy_Tuohey/publications/

- Tham, R., Humphreys, J.S., Asaid, A., Riley, K., Jones, J., Kinsman, L., et al. (n.d). ‘Making a difference’— the impact of sustainable primary health care on rural health. Retrieved from http://www.ruralhealth.org.au/10thNRHC/10thnrhc.ruralhealth.org.au/papers/docs/Tham_Rachel_C3.pdf

- Zoom info. (2013). Karen Riley. Retrieved from http://www.zoominfo.com/p/Karen-Riley/574426007

• The results of the study provide feedback for health practitioners for the continual reliance on monitoring, routine data collection, engagement and feedback from the so that valid and reliable results can be established so that primary health care services can be modified and reforms can be made to existing health services being provided.
• The results from EPHS indicate the need for evaluation frameworks in rural primary health services to measure what is successful and unsuccessful.
• Continual evidence based research can provide sustainable and effective care and policies makers are able to determine what works well, where and why so that health inequalities and outcomes experienced by rural Australians can be managed.