رسالة جامعية

Working towards primary care and aged residential care integration

التفاصيل البيبلوغرافية
العنوان: Working towards primary care and aged residential care integration
المؤلفون: Howard-Brown, Christine
المساهمون: Perera, Gail Antonia Roshan, Keeling, Sally
بيانات النشر: University of Otago
سنة النشر: 2018
المجموعة: University of Otago: Research Archive (OUR Archive)
مصطلحات موضوعية: Integration, Aged residential care, Primary care, Primary healthcare, General Practice, rest home, Integrated care
الوصف: Background Overuse of secondary care services and insufficient access to primary care in aged residential care (ARC) are topical issues. There is limited policy guidance or research evidence promoting effective, efficient and sustainable models of primary care in ARC as part of an integrated healthcare system. Aim This thesis aims to understand and delineate the existing relationship between primary care and ARC in New Zealand (NZ), and to propose a model or models of care designed to improve the capacity for integration between primary care and ARC services. The research specifically investigates the current state of primary care in the ARC sector from a policy and practice perspective, to identify features of a model or models that could offer quality and sustainable improvements in the delivery of primary care in ARC. Methods 1) An integrative review of international research literature was completed to identify primary care models in ARC. 2) A predominantly qualitative mixed methods approach was used to identify and describe NZ models within their relevant policy context. This entailed a narrative review of grey literature, 34 in-depth interviews with purposively sampled key informants, and four case studies with either a practice or a policy focus. 3) Factors for integrated delivery of primary care in ARC were identified, and models of care critiqued and compared using thematic analysis and general inductive principles. Results The research identified well-defined existing issues in the delivery of primary care in ARC. Proposed solutions were seldom found to address underlying causes. Multiple models of care that have an impact on the primary care and ARC interface were identified: eighteen from international literature (including three NZ models) and eleven from key informant interviews. Models often operate in parallel and few represented an integrated approach. The persistent use of historic models by ARC undermines the integrity and sustainability of newer more integrated models. Policy guidance was ...
نوع الوثيقة: thesis
اللغة: English
العلاقة: http://hdl.handle.net/10523/8479Test
الإتاحة: http://hdl.handle.net/10523/8479Test
حقوق: All items in OUR Archive are provided for private study and research purposes and are protected by copyright with all rights reserved unless otherwise indicated.
رقم الانضمام: edsbas.C429E0A
قاعدة البيانات: BASE