Attempts to improve outcomes for all form a major part of recent health and social care policies in Australia and globally. In Australia, policies have largely focused on reducing geographical inequalities in provision of services and to a lesser extent aimed at targeting marginalised people within society. Marginalised people may include children and families who are culturally and socially stigmatised and those with economic disadvantage. For example, those who have a disability, are in the prison and corrections systems, who have mental health issues, are long-term unemployed or homeless. This topic is requires an understanding of the human right to health and the principle of equity. Addressing geographic (rural, remote or simply place-based), cultural and social inequities present significant challenges for health and social care systems. (It is important to be clear about the concepts of inequality and inequity. Simply, inequities are avoidable as they arise from unfair distribution of resources. World Health Organization provides the following guidance).
Health inequalities can be defined as differences in health status or in the distribution of health determinants between different population groups. For example, differences in mobility between elderly people and younger populations or differences in mortality rates between people from different social classes. It is important to distinguish between inequality in health and inequity. Some health inequalities are attributable to biological variations or free choice and others are attributable to the external environment and conditions mainly outside the control of the individuals concerned. In the first case it may be impossible or ethically or ideologically unacceptable to change the health determinants and so the health inequalities are unavoidable. In the second, the uneven distribution may be unnecessary and avoidable as well as unjust and unfair, so that the resulting health inequalities also lead to inequity in health. (https://www.who.int/hia/about/glos/en/index1.html )
Review the WHO definition of ‘universal’ healthcare. Using this definition, critically discuss your chosen international health systems success, or otherwise, in the provision of universal healthcare.
Part 2: Word limit = 250 words
Introduction
The world’s population is growing—and aging. Health care expenditure rises as people get older. However, it is not age itself that drives up the costs but the greater prevalence of chronic diseases, frailty and dementia in the aged population. For it is these health issues that require frequent medical attention, pharmaceuticals and nursing care and support in residential aged care facilities or the home.
Ageing populations
Australia’s older generation are generally classified as people aged 65 and over; that is, people born before 1952. They are commonly called the ‘baby boomer generation’ or ‘baby boomers’. The expectations of baby boomers about the type of aged care they want, and their right to choose, are changing, with many preferring to remain in their home for longer (Productivity Commission 2011). In 2017, there were an estimated 3.8 million older Australians (equivalent to 15% of the population), an increase from 2.2 million people (13% of the population) 10 years earlier (ABS 2013, 2014). Very old Australians (aged 85 and over) accounted for 2.0% of the population in 2017, with this proportion projected to increase to 4.4% by 2057 (ABS 2013). The increasing number of older people and the changing characteristics of the ageing population are associated with a range of issues. These include the implications for high-level aged care; a need for policies and services that respond to the needs of this population and support healthy, positive ageing; and the potential for social isolation and elder abuse.
https://www.youtube.com/channel/UCsooa4yRKGN_zEE8iknghZA
DUCKETT, S. & WILLCOX, S. (eds.) 2015. The Australian Health Care System, South Melbourne: Oxford University Press. 334-346
Review the WHO definition of ‘universal’ healthcare. Using this definition, critically discuss your chosen international health systems success, or otherwise, in the provision of universal healthcare.
Part 3: Word limit = 250 words
For hard core experimental evaluators, the principles that underpin developmental evaluation are often a source of cognitive dissonance (i.e. discomfort caused by a clash of ideas/ideals), in part because evaluation can occur during a intervention design process and also influence the intervention (that which is being evaluated). Read the descriptions of developmental evaluation at the web-links below and based on your readings, respond to the discussion board question that follows.
Check out Spark Institute Developmental Evaluation
http://tools.sparkpolicy.com/developmental-evaluation/
Check out: Developmental evaluation
https://www.betterevaluation.org/en/plan/approach/developmental_evaluation
After reading up on the developmental evaluation approach, reflect on my claim that “for hard core experimental evaluators, the principles that underpin developmental evaluation are often a source of cognitive dissonance”.
Comment on why (or why not) this dissonance may occur.
Part 4: Word limit = 250 words
Realist evaluation is a member of a family of theory-based evaluation approaches which begins by clarifying the intervention theory/logic model and focuses on three main queries:
the mechanisms that are likely to operate,
the contexts in which they might operate and
the outcomes that will be observed if they operate as expected.
Realist approaches assume that nothing works everywhere for everyone: context makes a big difference to outcomes.
A realist evaluation asks not ‘what works?’ but ‘how or why does this work, for whom, in what circumstances?’
Realist impact evaluation is most appropriate for
evaluating new interventions that seem to work but where ‘how and for whom’ is not yet understood;
interventions that have previously demonstrated mixed patterns of outcomes; and
those interventions that will be scaled up, to understand how to adapt the intervention to new contexts.
Read the ODI Methods Lab summary of Realist evaluations, accessed at : Realist evaluation https://www.odi.org/sites/odi.org.uk/files/odi-assets/publications-opinion-files/9138.pdf
See the following paper as a example of a realist evaluation : Realist Evaluation of intensive home care
After reading about Realist evaluation, reflect on and post a short summary of what you perceive as the limitations of Realist Evaluation as an approach in the health context.
Part 5: Word limit = 250 words
Module 8: Evaluation designs- descriptions and drawings
Introduction
Evaluation in health practice contexts is a mix or art and science. So far in this unit we have emphasised the empirical, /analytical/scientific bent of evaluation, being about measurement, experimentation and gathering data to test evaluation hypotheses. It can be argued that there is also an art to evaluation, in that stakeholder consultation and co-design approaches in evaluation practice require approaches and skills often more aligned to the humanities.
Sample Solution
