A framework for regional primary health care to organise actions to address health inequities
A framework for regional primary health care to organise actions to address health inequities
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DOI：
10.1007/s00038-018-1083-9
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发表时间：
2018-06-01
影响因子：
4.6
通讯作者：
Mackean, Tamara
中科院分区：
文献类型：
--
作者：
Freeman, Toby;Javanparast, Sara;Mackean, Tamara
区域初级卫生保健组织在指定区域规划、协调和资助一些初级卫生保健服务。本文基于理论、文献和研究者的思考，提出了一个检验区域初级卫生保健机构公平绩效的框架，并将其应用于澳大利亚医疗保险地方机构（2011 - 2015年）。数据来自Medicare Local文件，对210名Medicare Local高级员工的在线调查，以及对50名调查受访者的访谈，该框架包括规划公平性，公平数据收集，社区参与和解决公平性的战略，获得健康结果和健康的社会决定因素。当该框架适用于医疗保险当地人时，他们将公平作为一个目标，收集公平数据，社区参与和改善公平获得的行动都很强，但在更广泛的宣传和解决健康社会决定因素的战略方面存在差距，公平框架提供了一个平台，可以促进对区域卫生公平努力的了解和国际比较，初级卫生保健组织。
Regional primary health-care organisations plan, co-ordinate, and fund some primary health-care services in a designated region. This article presents a framework for examining the equity performance of regional primary health-care organisations, and applies it to Australian Medicare Locals (funded from 2011 to 2015).The framework was developed based on theory, literature, and researcher deliberation. Data were drawn from Medicare Local documents, an online survey of 210 senior Medicare Local staff, and interviews with 50 survey respondents.The framework encompassed equity in planning, collection of equity data, community engagement, and strategies to address equity in access, health outcomes, and social determinants of health. When the framework was applied to Medicare Locals, their inclusion of equity as a goal, collection of equity data, community engagement, and actions improving equity of access were strong, but there were gaps in broader advocacy, and strategies to address social determinants of health, and equity in quality of care.The equity framework allows a platform for advancing knowledge and international comparison of the health equity efforts of regional primary health-care organisations.