Defining community health services in Australia: a qualitative exploration
Virginia J. Lewis
A * , Jenny Macmillan A and Ben Harris-Roxas B
A Centre for Health Systems Development, Australian Institute for Primary Care and Ageing, La Trobe University, Plenty Road and Kingsbury Drive, Bundoora, Vic. 3086, Australia.
B School of Population Health, Faculty of Medicine and Health, UNSW, Sydney, NSW 2052, Australia.
Australian Journal of Primary Health 28(6) 482-489 https://doi.org/10.1071/PY21265
Submitted: 12 November 2021 Accepted: 27 June 2022 Published: 16 August 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: The Community Health Program of the 1970s was an attempt to introduce a national community health model. However, although community-based health care is an important element of the health systems of all Australian states and territories, the definition of what constitutes a ‘community health service’ in Australia today is not clear.
Methods: A search of government websites failed to provide information about the types and characteristics of services that would be included in the term. Therefore, semi-structured interviews were conducted with 13 key informants in roles with responsibility for primary and community health services from health departments in all Australian states and territories. Questions explored their understanding of community health services as they operated in their jurisdiction. The study adopted a blended inductive and deductive orientation within a qualitative descriptive method.
Results: There was little consistency in the way community health services were described across jurisdictions. The defining attributes of a ‘community health centre’ described by an international peak body did not apply to services in the majority of jurisdictions in Australia. Victoria was more aligned with the description than other jurisdictions, with organisations defined through legislation and a separate funding stream to support aspects of service delivery.
Conclusions: Those designing and implementing national health system programs and reforms need to be aware that terms, such as ‘community health’, do not mean the same thing across jurisdictions; attempts to create consistency have to recognise differences that will affect new initiatives, as well as the spread of successful policies and programs from one jurisdiction to another. Without a consistent description, it is difficult to explore the current role of community-based health care across Australia in improving access to health care.
Keywords: Australian health system, community health characteristics, community health models, community health planning, community health services, defining health care terms, description of community health, health care reform, primary health care.
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