Factors shaping intersectoral action in primary health care services
Factors shaping intersectoral action in primary health care services
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DOI：
10.1111/1753-6405.12284
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发表时间：
2014-12-01
影响因子：
3.5
通讯作者：
Bentley, Michael
中科院分区：
文献类型：
--
作者：
Anaf, Julia;Baum, Fran;Bentley, Michael
目的：在南澳大利亚州和北领地的6个地点考察作为评估综合初级卫生保健的一部分的跨部门卫生行动的良好做法的案例研究。方法：访谈初级卫生保健工作者、协作机构工作人员和服务使用者(总计33人)；补充来自服务机构和合作伙伴的相关文件。结果：跨部门卫生行动的价值和伙伴关系对初级卫生保健服务的重要性都得到了强烈的肯定。促进部门间行动的因素包括充足的人力和财政资源、不同的背景和技能以及维持承诺的个人奖励。关键的制约因素是财政和时间限制，以及不太支持跨部门行动的政治和政策背景；包括初级卫生保健的变化。结论：虽然跨部门行动是初级卫生保健服务解决健康的社会决定因素的有效方式，但对社会正义和采用社会健康观点的承诺受到更广泛的卫生服务的制约，目前在很大程度上加强了生物医学模式。影响：需要有效的组织做法和政策，以解决初级卫生保健中健康的社会决定因素，并为从事跨部门行动的工作人员提供支持性环境。
Objective: To examine case studies of good practice in intersectoral action for health as one part of evaluating comprehensive primary health care in six sites in South Australia and the Northern Territory.Methods: Interviews with primary health care workers, collaborating agency staff and service users (Total N=33); augmented by relevant documents from the services and collaborating partners.Results: The value of intersectoral action for health and the importance of partner relationships to primary health care services were both strongly endorsed. Factors facilitating intersectoral action included sufficient human and financial resources, diverse backgrounds and skills and the personal rewards that sustain commitment. Key constraining factors were financial and time limitations, and a political and policy context which has become less supportive of intersectoral action; including changes to primary health care.Conclusions: While intersectoral action is an effective way for primary health care services to address social determinants of health, commitment to social justice and to adopting a social view of health are constrained by a broader health service now largely reinforcing a biomedical model. Implications: Effective organisational practices and policies are needed to address social determinants of health in primary health care and to provide a supportive context for workers engaging in intersectoral action.