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How institutional forces, ideas and actors shaped population health planning in Australian regional primary health care organisations

Overview of attention for article published in BMC Public Health, March 2018
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (86th percentile)
  • Good Attention Score compared to outputs of the same age and source (75th percentile)

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Title
How institutional forces, ideas and actors shaped population health planning in Australian regional primary health care organisations
Published in
BMC Public Health, March 2018
DOI 10.1186/s12889-018-5273-4
Pubmed ID
Authors

Sara Javanparast, Toby Freeman, Fran Baum, Ronald Labonté, Anna Ziersch, Tamara Mackean, Richard Reed, David Sanders

Abstract

Worldwide, there are competing norms driving health system changes and reorganisation. One such norm is that of health systems' responsibilities for population health as distinct from a focus on clinical services. In this paper we report on a case study of population health planning in Australian primary health care (PHC) organisations (Medicare Locals, 2011-2015). Drawing on institutional theory, we describe how institutional forces, ideas and actors shaped such planning. We reviewed the planning documents of the 61 Medicare Locals and rated population health activities in each Medicare Local. We also conducted an online survey and 50 interviews with Medicare Local senior staff, and an interview and focus group with Federal Department of Health staff. Despite policy emphasis on population health, Medicare Locals reported higher levels of effort and capacity in providing clinical services. Health promotion and social determinants of health activities were undertaken on an ad hoc basis. Regulatory conditions imposed by the federal government including funding priorities and time schedules, were the predominant forces constraining population health planning. In some Medicare Locals, this was in conflict with the normative values and what Medicare Locals felt ought to be done. The alignment between the governmental and the cultural-cognitive forces of a narrow biomedical approach privileged clinical practice and ascribed less legitimacy to action on social determinants of health. Our study also shed light on the range of PHC actors and how their agency influenced Medicare Locals' performance in population health. The presence of senior staff or community boards with a strong commitment to population health were important in directing action towards population health and equity. There are numerous institutional, normative and cultural factors influencing population health planning. The experience of Australian Medicare Locals highlights the difficulties of planning in such a way that the impact of the social determinants on health and health equity are taken into account. The policy environment favours a focus on clinical services to the detriment of health promotion informed by a social determinants focus.

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X Demographics

The data shown below were collected from the profiles of 12 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 93 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 93 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 12 13%
Student > Master 10 11%
Researcher 9 10%
Student > Doctoral Student 7 8%
Unspecified 6 6%
Other 13 14%
Unknown 36 39%
Readers by discipline Count As %
Nursing and Health Professions 13 14%
Medicine and Dentistry 13 14%
Social Sciences 10 11%
Unspecified 6 6%
Psychology 4 4%
Other 10 11%
Unknown 37 40%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 16. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 March 2018.
All research outputs
#2,049,197
of 23,577,654 outputs
Outputs from BMC Public Health
#2,248
of 15,294 outputs
Outputs of similar age
#46,174
of 333,638 outputs
Outputs of similar age from BMC Public Health
#77
of 317 outputs
Altmetric has tracked 23,577,654 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 91st percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 15,294 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.1. This one has done well, scoring higher than 85% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 333,638 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 86% of its contemporaries.
We're also able to compare this research output to 317 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 75% of its contemporaries.