Reeve Carole, Humphreys John, Wakerman John, Carroll Vicki, Carter Maureen, O'Brien Tim, Erlank Carol, Mansour Rafik, Smith Bec
Aust J Prim Health. 2015;21(4):409-16. doi: 10.1071/PY14073.
The aim of this study was to describe the reorientation of a remote primary health-care service, in the Kimberley region of Australia, its impact on access to services and the factors instrumental in bringing about change. A unique community-initiated health service partnership was developed between a community-controlled Aboriginal health organisation, a government hospital and a population health unit, in order to overcome the challenges of delivering primary health care to a dispersed, highly disadvantaged Aboriginal population in a very remote area. The shared goals and clear delineation of responsibilities achieved through the partnership reoriented an essentially acute hospital-based service to a prevention-focussed comprehensive primary health-care service, with a focus on systematic screening for chronic disease, interdisciplinary follow up, health promotion, community advocacy and primary prevention. This formal partnership enabled the primary health-care service to meet the major challenges of providing a sustainable, prevention-focussed service in a very remote and socially disadvantaged area.
本研究的目的是描述澳大利亚金伯利地区一家偏远基层医疗服务机构的重新定位、其对服务可及性的影响以及促成变革的因素。一个社区控制的原住民健康组织、一家政府医院和一个人群健康单位之间建立了独特的社区发起的健康服务伙伴关系，以克服在非常偏远地区为分散的、极度弱势的原住民人口提供基层医疗服务的挑战。通过伙伴关系实现的共同目标和明确的责任划分，将原本以急性病医院为基础的服务重新定位为以预防为重点的综合基层医疗服务，重点是慢性病的系统筛查、跨学科随访、健康促进、社区宣传和初级预防。这种正式的伙伴关系使基层医疗服务能够应对在非常偏远和社会弱势地区提供可持续的、以预防为重点的服务的重大挑战。
