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"Hospitals respond to demand. Public health needs to respond to risk": health system lessons from a case study of northern Queensland's COVID-19 surveillance and response.

Authors :
Edelman, Alexandra
Allen, Tammy
Devine, Susan
Horwood, Paul F.
McBryde, Emma S.
Mudd, Julie
Warner, Jeffrey
Topp, Stephanie M
Source :
BMC Health Services Research. 1/18/2024, Vol. 24 Issue 1, p1-11. 11p.
Publication Year :
2024

Abstract

Background: The vast region of northern Queensland (NQ) in Australia experiences poorer health outcomes and a disproportionate burden of communicable diseases compared with urban populations in Australia. This study examined the governance of COVID-19 surveillance and response in NQ to identify strengths and opportunities for improvement. Methods: The manuscript presents an analysis of one case-unit within a broader case study project examining systems for surveillance and response for COVID-19 in NQ. Data were collected between October 2020–December 2021 comprising 47 interviews with clinical and public health staff, document review, and observation in organisational settings. Thematic analysis produced five key themes. Results: Study findings highlight key strengths of the COVID-19 response, including rapid implementation of response measures, and the relative autonomy of NQ's Public Health Units to lead logistical decision-making. However, findings also highlight limitations and fragility of the public health system more generally, including unclear accountabilities, constraints on local community engagement, and workforce and other resourcing shortfalls. These were framed by state-wide regulatory and organisational incentives that prioritise clinical health care rather than disease prevention, health protection, and health promotion. Although NQ mobilised an effective COVID-19 response, findings suggest that NQ public health systems are marked by fragility, calling into question the region's preparedness for future pandemic events and other public health crises. Conclusions: Study findings highlight an urgent need to improve governance, resourcing, and political priority of public health in NQ to address unmet needs and ongoing threats. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
14726963
Volume :
24
Issue :
1
Database :
Academic Search Index
Journal :
BMC Health Services Research
Publication Type :
Academic Journal
Accession number :
174875771
Full Text :
https://doi.org/10.1186/s12913-023-10502-x