Assessing the value of rural community health services
Jane Farmer A C , Hilary Davis A , Irene Blackberry B and Tracy de Cotta AA Centre for Social Impact, Swinburne University, John Street, Hawthorn, Vic. 3122, Australia.
B John Richards Initiative, La Trobe University, University Drive, Wodonga, Vic. 3690, Australia.
C Corresponding author. Email: jcfarmer@swin.edu.au
Australian Journal of Primary Health 24(3) 221-226 https://doi.org/10.1071/PY17125
Submitted: 6 September 2017 Accepted: 11 February 2018 Published: 22 May 2018
Abstract
Rural health services are challenging to manage, a situation perhaps exacerbated by necessity to comply with one-size-fits-all performance frameworks designed for larger services. This raises the questions: do we know what rural health services are doing that is valuable and how should that be evaluated? Twenty-eight qualitative interviews with CEOs and staff of seven Victorian rural health services were conducted, exploring what they value about their ‘best practice’. Themes emergent from analysis were compared with 19 government-produced health planning and performance documents. It was found that most dimensions of rural services value aligned with current performance frameworks, but a significant theme about ‘community’ was missing. Highlighting the relevance of this theme, achieving community-oriented goals accounted for one-third of best practice case studies identified by health services personnel. It is concluded that generating community outcomes is a significant area of value aimed for by rural health services that is missing from current performance measurement frameworks applied to Victorian health services. In this study, a new Evaluative Framework is outlined and further steps needed are suggested.
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