Addressing the problem of rural community engagement in healthcare service design

Nimegeer, Amy; Farmer, Jane; West, Christina; Currie, Margaret

doi:10.1016/j.healthplace.2011.04.013

Cited by 23 publications

(31 citation statements)

References 9 publications

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“…Particular challenges of community participation in rural health care have been noted elsewhere. 185,193 Our analysis starts to address some of the highlighted gaps in knowledge around the role of community hospitals and points to factors that will be important to consider, at a local and national level, in the future development of models. There are, however, a number of limitations.…”

Section: Discussionmentioning

confidence: 99%

Community hospitals and their services in the NHS: identifying transferable learning from international developments – scoping review, systematic review, country reports and case studies

Pitchforth

Nolte

Corbett

et al. 2017

Health Serv Deliv Res

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BackgroundThe notion of a community hospital in England is evolving from the traditional model of a local hospital staffed by general practitioners and nurses and serving mainly rural populations. Along with the diversification of models, there is a renewed policy interest in community hospitals and their potential to deliver integrated care. However, there is a need to better understand the role of different models of community hospitals within the wider health economy and an opportunity to learn from experiences of other countries to inform this potential.ObjectivesThis study sought to (1) define the nature and scope of service provision models that fit under the umbrella term ‘community hospital’ in the UK and other high-income countries, (2) analyse evidence of their effectiveness and efficiency, (3) explore the wider role and impact of community engagement in community hospitals, (4) understand how models in other countries operate and asses their role within the wider health-care system, and (5) identify the potential for community hospitals to perform an integrative role in the delivery of health and social care.MethodsA multimethod study including a scoping review of community hospital models, a linked systematic review of their effectiveness and efficiency, an analysis of experiences in Australia, Finland, Italy, Norway and Scotland, and case studies of four community hospitals in Finland, Italy and Scotland.ResultsThe evidence reviews found that community hospitals provide a diverse range of services, spanning primary, secondary and long-term care in geographical and health system contexts. They can offer an effective and efficient alternative to acute hospitals. Patient experience was frequently reported to be better at community hospitals, and the cost-effectiveness of some models was found to be similar to that of general hospitals, although evidence was limited. Evidence from other countries showed that community hospitals provide a wide spectrum of health services that lie on a continuum between serving a ‘geographic purpose’ and having a specific population focus, mainly older people. Structures continue to evolve as countries embark on major reforms to integrate health and social care. Case studies highlighted that it is important to consider local and national contexts when looking at how to transfer models across settings, how to overcome barriers to integration beyond location and how the community should be best represented.LimitationsThe use of a restricted definition may have excluded some relevant community hospital models, and the small number of countries and case studies included for comparison may limit the transferability of findings for England. Although this research provides detailed insights into community hospitals in five countries, it was not in its scope to include the perspective of patients in any depth.ConclusionsAt a time when emphasis is being placed on integrated and community-based care, community hospitals have the potential to assume a more strategic role in health-care delivery locally, providing care closer to people’s homes. There is a need for more research into the effectiveness and cost-effectiveness of community hospitals, the role of the community and optimal staff profile(s).FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Discussionmentioning

confidence: 99%

Community hospitals and their services in the NHS: identifying transferable learning from international developments – scoping review, systematic review, country reports and case studies

Pitchforth

Nolte

Corbett

et al. 2017

Health Serv Deliv Res

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“…When adopted in an appropriate setting the value to patients and potential cost savings of eHealth technologies is demonstrable and the potential to save money, however slim, enhances their attractiveness, particularly in the current financial climate. As is common when any established model of care undergoes reform (Nimegeer et al 2011), concerns have also been expressed that eHealth rollout may bring about negative effects, in particular the loss of opportunities for in-person social interaction between older patients and their care professionals. This has implications for wider well-being and should be considered alongside financial aspects of changes to care models.…”

Section: Introductionmentioning

confidence: 99%

Technology for Older Adults: Maximising Personal and Social Interaction: Exploring Opportunities for eHealth to Support the Older Rural Population with Chronic Pain

Philip

Roberts

Currie

et al. 2015

Scottish Geographical Journal

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eHealth technologies are being promoted by government as an integral part of the future delivery of health and social care services. Demographic ageing is most pronounced in rural areas and eHealth technologies could support care models designed to help the growing number of rural older people living independently in their own homes. Successful deployment of eHealth technologies will depend on a number of factors, including older adults' receptiveness to and ability to use new technologies. Using a mixed-methods approach we report findings from a survey of Pain Association Scotland members, home visit observations, qualitative interviews with rural older adults with chronic pain and their health and social care providers. We report that rural older adults with chronic pain are receptive to eHealth technologies but caution that these technologies need to be designed and deployed with the needs of specific patient groups in mind. Patients and professionals do not think that opportunities for in-person interaction should be replaced by technology. We suggest that care needs to be taken to ensure that an appropriate balance between the use of eHealth technologies and in-person care is struck.

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“…The importance of a closed feedback loop to successful consumer engagement cannot be overstated (McCabe et al 2006;Oliver et al 2008;Nimegeer et al 2011) and was a key learning for GCPHN from the online forum experience. Care was taken to create realistic expectations among CAC members by clearly explaining the scope of influence they would have on different issues.…”

Section: What Does This Paper Add?mentioning

confidence: 99%

Not just tea and biscuits; the Gold Coast Primary Health Network process of designing, implementing and operating a Community Advisory Council

McClean

Trigger

2017

Aust. J. Prim. Health

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Abstract. Consumers are fast being acknowledged as a critical voice in the creation of sustainable health systems, and their ability and willingness to participate must be kept in mind by those eager to engage them. Federal health reform in Australia has mandated the formal involvement of communities in primary care through advisory committees in the newly established Primary Health Networks. Although there is clear progression towards increased consumer participation in Australia's health services, scope exists to improve the evidence base around identifying and implementing the most appropriate approach in different settings. Gold Coast Primary Health Network has drawn on the principles of deliberative participation to design, implement and operate their Community Advisory Council. Although functioning well, further work is required to evaluate the efficiency of this approach.

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Addressing the problem of rural community engagement in healthcare service design

Cited by 23 publications

References 9 publications

Community hospitals and their services in the NHS: identifying transferable learning from international developments – scoping review, systematic review, country reports and case studies

Community hospitals and their services in the NHS: identifying transferable learning from international developments – scoping review, systematic review, country reports and case studies

Technology for Older Adults: Maximising Personal and Social Interaction: Exploring Opportunities for eHealth to Support the Older Rural Population with Chronic Pain

Not just tea and biscuits; the Gold Coast Primary Health Network process of designing, implementing and operating a Community Advisory Council

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