背景:卫生服务提供和卫生干预措施必须满足患者的需求或偏好,与实践相关,可以实施。让那些将在优先级设置中使用或提供医疗保健的人参与进来,可以导致医疗服务的提供和研究更有意义和影响力。这在农村社区尤其重要,在资源有限以及医疗保健和健康结果方面的差异通常更为明显。这项研究的目的是使用区域社区参与方法确定农村社区的健康和医疗保健优先事项。
方法:这项多方法研究是在格兰比地区的五个农村社区进行的,维多利亚西部,澳大利亚。它涉及六个概念映射步骤:(1)准备,(2)生成(头脑风暴陈述和确定评级标准),(3)结构化报表(排序和评级报表),(4)陈述陈述,(5)概念图的解释和(6)利用。社区论坛,在步骤2中使用了与社区成员和卫生专业人员的调查和利益相关者协商。创新的在线群体概念图平台,涉及消费者,在步骤3中使用了卫生专业人员和研究人员。
结果:总体而言,117名社区成员和70名卫生专业人员确定了400个健康和医疗保健问题。六次利益攸关方协商会议(16名社区成员和16名卫生专业人员)确定了优先考虑卫生问题的三个关键价值观:有效性和影响(受影响的人数)。医疗保健服务的可操作优先事项在很大程度上与访问问题有关,比如在医疗保健系统中导航的挑战,特别是对于有精神健康问题的人;缺乏足够的全科医生和其他保健提供者;旅行费用高;互联网覆盖率差往往影响农村地区人们基于技术的干预措施。
结论:本研究从西维多利亚州农村社区医疗服务使用者和提供者的角度确定了可操作的健康和医疗保健优先事项。与访问有关的问题,例如医疗保健成本的不平等,感知到缺乏服务质量和可用性,特别是在心理健康和残疾方面,被确定为优先事项。这些见解可以指导未来的研究,政策制定和资源分配努力,以改善医疗服务,农村社区的质量和公平。
BACKGROUND: It is vital that health service delivery and health interventions address patients\' needs or preferences, are relevant for practice and can be implemented. Involving those who will use or deliver healthcare in priority-setting can lead to health service delivery and research that is more meaningful and impactful. This is particularly crucial in
rural communities, where limited resources and disparities in healthcare and health outcomes are often more pronounced. The aim of this study was to determine the health and healthcare priorities in
rural communities using a region-wide community engagement approach.
METHODS: This multi-methods study was conducted in five
rural communities in the Grampians region, Western Victoria, Australia. It involved six concept mapping steps: (1) preparation, (2) generation (brainstorming statements and identifying rating criteria), (3) structuring statements (sorting and rating statements), (4) representation of statements, (5) interpretation of the concept map and (6) utilization. Community forums, surveys and stakeholder consultations with community members and health professionals were used in Step 2. An innovative online group concept mapping platform, involving consumers, health professionals and researchers was used in Step 3.
RESULTS: Overall, 117 community members and 70 health professionals identified 400 health and healthcare issues. Six stakeholder consultation sessions (with 16 community members and 16 health professionals) identified three key values for prioritizing health issues: equal access for equal need, effectiveness and impact (number of people affected). Actionable priorities for healthcare delivery were largely related to access issues, such as the challenges navigating the healthcare system, particularly for people with mental health issues; the lack of sufficient general practitioners and other health providers; the high travel costs; and poor internet coverage often impacting technology-based interventions for people in rural areas.
CONCLUSIONS: This study identified actionable health and healthcare priorities from the perspective of healthcare service users and providers in
rural communities in Western Victoria. Issues related to access, such as the inequities in healthcare costs, the perceived lack of quality and availability of services, particularly in mental health and disability, were identified as priorities. These insights can guide future research, policy-making and resource allocation efforts to improve healthcare access, quality and equity in
rural communities.