The population health role of academic health centres: a multiple-case exploratory study in Australia and England.
Academic health centre
Health systems
Impact
Innovation
Population health
Translation
Journal
Health policy (Amsterdam, Netherlands)
ISSN: 1872-6054
Titre abrégé: Health Policy
Pays: Ireland
ID NLM: 8409431
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
received:
25
03
2022
revised:
31
07
2022
accepted:
14
08
2022
pubmed:
29
8
2022
medline:
9
9
2022
entrez:
28
8
2022
Statut:
ppublish
Résumé
Academic health centres (AHCs) are organisations that aim to mobilise knowledge into practice by improving the responsiveness of health systems to emerging evidence. This study aims to explore the population health role of AHCs in Australia and England, where AHCs represent novel organisational forms. A multiple-case study design using qualitative methods was used to explore population health goals and activities in four discrete AHCs in both countries during 2017 and 2018. Data from 85 interviews with AHC leaders, clinicians and researchers, direct observation, and documentation were analysed within and across the cases. Comparison across cases produced four cross-case themes: health care rather than population health; incremental rather than major health system change; different conceptions of "translation" and "innovation"; and unclear pathways to impact. The ability of the AHCs to define and enact a population health role was hindered during the study period by gaps in knowledge mobilisation strategies at a health system and policy level, the biomedical orientation of government designation schemes for AHCs in Australia and England, and competing expectations of the sovereign partner organisations in AHCs against a backdrop of limited operational resources. The study identifies several institutional elements that are likely to be needed for AHCs in Australia and England to deliver on both internal and external expectations of their population health role.
Sections du résumé
BACKGROUND
Academic health centres (AHCs) are organisations that aim to mobilise knowledge into practice by improving the responsiveness of health systems to emerging evidence. This study aims to explore the population health role of AHCs in Australia and England, where AHCs represent novel organisational forms.
METHODS
A multiple-case study design using qualitative methods was used to explore population health goals and activities in four discrete AHCs in both countries during 2017 and 2018. Data from 85 interviews with AHC leaders, clinicians and researchers, direct observation, and documentation were analysed within and across the cases.
RESULTS
Comparison across cases produced four cross-case themes: health care rather than population health; incremental rather than major health system change; different conceptions of "translation" and "innovation"; and unclear pathways to impact. The ability of the AHCs to define and enact a population health role was hindered during the study period by gaps in knowledge mobilisation strategies at a health system and policy level, the biomedical orientation of government designation schemes for AHCs in Australia and England, and competing expectations of the sovereign partner organisations in AHCs against a backdrop of limited operational resources.
DISCUSSION
The study identifies several institutional elements that are likely to be needed for AHCs in Australia and England to deliver on both internal and external expectations of their population health role.
Identifiants
pubmed: 36031466
pii: S0168-8510(22)00225-1
doi: 10.1016/j.healthpol.2022.08.008
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
1051-1061Informations de copyright
Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The material in this manuscript is based on doctoral work conducted at James Cook University by the first author. The co-authors are the members of the first author's advisory panel. The work was supported by an Australian Postgraduate Award Stipend; and Higher Degree by Research Enhancement Scheme funding from James Cook University, Australia. These resources were used to support some travel for data collection, conference presentations and publications.