SURGICAL SERVICES IN RURAL HOSPITALS
Introduction
This report investigates the impact of New Zealand's current health reforms on the surgical services provided in rural hospitals. In particular it focuses on the use of the New South Wales guidelines for evaluating hospital services. It is based primarily on information drawn from relevant literature, augmented by discussions with individuals familiar with the use of the NSW guidelines.
However, there are many forces influencing the nature and level of services provided by rural hospitals, and these other factors are also discussed in order to put the use of the guidelines in context.
The paper begins by discussing the NSW guidelines - their background, their strengths and shortcomings, and some examples of how they are being used.
There are a number of aspects of service delivery not addressed by these guidelines, such as cost, efficiency, access, and community acceptability. Such issues are the focus of the health sector monitoring process, and this then forms the second topic of discussion in this paper, with particular emphasis on CHE operation performance measures.
Moving from health providers to health service purchasers, the paper looks at the decisions being made by the Minister of Health, the Core Services Committee and the Regional Health Authorities (RHAs) about what services will be purchased, and how this will affect the smaller hospitals.
The final section of paper draws together the earlier discussions to summarise where the reform process is leading rural hospitals in New Zealand, and compares this to the pressures being faced by rural hospitals in other countries. Drawing upon the experience of other countries, the paper concludes by examining key issues and options for future rural health services.
Contact for Enquiries
Rural Affairs Coordinator
Sector Performance Policy
MAF Policy
Ministry of Agriculture and Forestry
PO Box 2526
Wellington
NEW ZEALAND
Phone: +64 4 894 0675
Fax: +64 4 4 894 0745
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