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21 results on '"Davy, Carol"'

20. Characteristics of Indigenous primary health care service delivery models: a systematic scoping review

Author

Alex Brown, Alexa McArthur, Ngiare Brown, Carol Davy, Zachary Munn, Stephen Harfield, Harfield, Stephen G., Davy, Carol, McArthur, Alexa, Munn, Zachary, Brown, Alex, and Brown, Ngiare

Subjects
medicine.medical_specialty, Models of care, Service delivery framework, service delivery, Review, Indigenous, American Indian and Alaska Native, 03 medical and health sciences, 0302 clinical medicine, Nursing, medicine, Health Services, Indigenous, Humans, 030212 general & internal medicine, Social determinants of health, Sociology, 10. No inequality, Primary health care, Social policy, Aboriginal and Torres Strait Islander, Service (business), 030505 public health, lcsh:Public aspects of medicine, Health Policy, Public health, Public Health, Environmental and Occupational Health, Health services research, lcsh:RA1-1270, Service delivery, models of care, 3. Good health, primary health care, Health promotion, Models, Organizational, 0305 other medical science
Abstract

Background Indigenous populations have poorer health outcomes compared to their non-Indigenous counterparts. The evolution of Indigenous primary health care services arose from mainstream health services being unable to adequately meet the needs of Indigenous communities and Indigenous peoples often being excluded and marginalised from mainstream health services. Part of the solution has been to establish Indigenous specific primary health care services, for and managed by Indigenous peoples. There are a number of reasons why Indigenous primary health care services are more likely than mainstream services to improve the health of Indigenous communities. Their success is partly due to the fact that they often provide comprehensive programs that incorporate treatment and management, prevention and health promotion, as well as addressing the social determinants of health. However, there are gaps in the evidence base including the characteristics that contribute to the success of Indigenous primary health care services in providing comprehensive primary health care. This systematic scoping review aims to identify the characteristics of Indigenous primary health care service delivery models. Method This systematic scoping review was led by an Aboriginal researcher, using the Joanna Briggs Institute Scoping Review Methodology. All published peer-reviewed and grey literature indexed in PubMed, EBSCO CINAHL, Embase, Informit, Mednar, and Trove databases from September 1978 to May 2015 were reviewed for inclusion. Studies were included if they describe the characteristics of service delivery models implemented within an Indigenous primary health care service. Sixty-two studies met the inclusion criteria. Data were extracted and then thematically analysed to identify the characteristics of Indigenous PHC service delivery models. Results Culture was the most prominent characteristic underpinning all of the other seven characteristics which were identified – accessible health services, community participation, continuous quality improvement, culturally appropriate and skilled workforce, flexible approach to care, holistic health care, and self-determination and empowerment. Conclusion While the eight characteristics were clearly distinguishable within the review, the interdependence between each characteristic was also evident. These findings were used to develop a new Indigenous PHC Service Delivery Model, which clearly demonstrates some of the unique characteristics of Indigenous specific models.

Published
2018

21. Effectiveness of chronic care models: opportunities for improving healthcare practice and health outcomes: a systematic review

Author

Maria Tchan, Jonathan Bleasel, Sharon Ponniah, Hueiming Liu, Carol Davy, Alex Brown, Davy, Carol, Bleasel, Jonathan, Liu, Hueiming, Tchan, Maria, Ponniah, Sharon, and Brown, Alex

Subjects
medicine.medical_specialty, Quality Assurance, Health Care, Health informatics, Chronic disease, chronic care model, Health administration, primary healthcare, 03 medical and health sciences, 0302 clinical medicine, Nursing, Health care, Humans, Medicine, 030212 general & internal medicine, Developing Countries, integrated care, Chronic care, Primary Health Care, business.industry, 030503 health policy & services, Nursing research, Health Policy, Chronic care model, Integrated care, Long-Term Care, Quality Improvement, 3. Good health, Self Care, Long-term care, Treatment Outcome, Systematic review, Models, Organizational, Family medicine, 0305 other medical science, business, Delivery of Health Care, Primary healthcare, chronic disease, Research Article
Abstract

Background The increasing prevalence of chronic disease and even multiple chronic diseases faced by both developed and developing countries is of considerable concern. Many of the interventions to address this within primary healthcare settings are based on a chronic care model first developed by MacColl Institute for Healthcare Innovation at Group Health Cooperative. Methods This systematic literature review aimed to identify and synthesise international evidence on the effectiveness of elements that have been included in a chronic care model for improving healthcare practices and health outcomes within primary healthcare settings. The review broadens the work of other similar reviews by focusing on effectiveness of healthcare practice as well as health outcomes associated with implementing a chronic care model. In addition, relevant case series and case studies were also included. Results Of the 77 papers which met the inclusion criteria, all but two reported improvements to healthcare practice or health outcomes for people living with chronic disease. While the most commonly used elements of a chronic care model were self-management support and delivery system design, there were considerable variations between studies regarding what combination of elements were included as well as the way in which chronic care model elements were implemented. This meant that it was impossible to clearly identify any optimal combination of chronic care model elements that led to the reported improvements. Conclusions While the main argument for excluding papers reporting case studies and case series in systematic literature reviews is that they are not of sufficient quality or generalizability, we found that they provided a more detailed account of how various chronic care models were developed and implemented. In particular, these papers suggested that several factors including supporting reflective healthcare practice, sending clear messages about the importance of chronic disease care and ensuring that leaders support the implementation and sustainability of interventions may have been just as important as a chronic care model’s elements in contributing to the improvements in healthcare practice or health outcomes for people living with chronic disease. Electronic supplementary material The online version of this article (doi:10.1186/s12913-015-0854-8) contains supplementary material, which is available to authorized users.

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