A comprehensive health service evaluation and monitoring framework.
OBJECTIVE
To develop a framework for evaluating and monitoring a primary health care service, integrating hospital and community services.


METHODS
A targeted literature review of primary health service evaluation frameworks was performed to inform the development of the framework specifically for remote communities. Key principles underlying primary health care evaluation were determined and sentinel indicators developed to operationalise the evaluation framework. This framework was then validated with key stakeholders.


RESULTS
The framework includes Donabedian's three seminal domains of structure, process and outcomes to determine health service performance. These in turn are dependent on sustainability, quality of patient care and the determinants of health to provide a comprehensive health service evaluation framework. The principles underpinning primary health service evaluation were pertinent to health services in remote contexts. Sentinel indicators were developed to fit the demographic characteristics and health needs of the population. Consultation with key stakeholders confirmed that the evaluation framework was applicable.


CONCLUSIONS
Data collected routinely by health services can be used to operationalise the proposed health service evaluation framework. Use of an evaluation framework which links policy and health service performance to health outcomes will assist health services to improve performance as part of a continuous quality improvement cycle.
Centre for Remote Health, Flinders University & Charles Darwin University, PO Box 4066, Alice Springs 0871, NT, Australia; Western Australian Country Health Services, Kimberley Population Health Unit, Locked Bag 4011, Broome 6725, WA, Australia. Electronic address: carole.reeve@flinders.edu.au.
Carole
C
Reeve
Centre of Research Excellence in Rural and Remote Primary Care, Monash University School of Rural Health, Bendigo 3552, VIC, Australia.
John
J
Humphreys
Centre for Remote Health, Flinders University & Charles Darwin University, PO Box 4066, Alice Springs 0871, NT, Australia.
John
J
Wakerman
D001315:Australia; D003153:Community Health Services / Q000458:organization & administration; D003191:Comprehensive Health Care / Q000458:organization & administration*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000458:organization & administration*; D011787:Quality of Health Care; D019114:Remote Consultation; D012423:Rural Health
Community; Indigenous; Performance; Primary health care; Rural and remote; Sustainability