Government Funding Policies Research Articles

Using Learning Health System Principles to Embed Patient Experience Data in Primary Care: A Qualitative Investigation.

Though an important component of high-quality healthcare, the routine collection of patient experience data is limited in primary care, as is the evidence for how this data is being used for quality improvement. This study used a learning health system (LHS) framework to describe how a university-affiliated community general practice is integrating patient experience data into service and quality improvement efforts, and to identify barriers and facilitators. A co-designed qualitative case study was conducted with academic researchers and staff from a university-affiliated general practice in Australia. Semi-structured interviews were conducted in April 2024 with practice staff, and transcripts were deductively coded according to a five-domain learning health systems framework, and with additional codes capturing barriers and facilitators. Eighteen (53%) practice staff were interviewed, including general practitioners (n=11), a practice nurse (n=1), and administrative staff (n=6). Participants identified multiple methods through which the practice captured the patient experience that spanned all domains of the LHS framework. However, there was less evidence of a coherent quality improvement strategy being employed, with associated barriers identified around staff workloads, training, and existing government funding policies. Key facilitators to the use of patient experience data included: membership of a larger health organisation and university; key dedicated administrative and clinical roles; and effective leadership, governance structures and policies to support continuous learning and drive service improvement. This study presents a case example of how patient experience data is being integrated into general practice and identifies key barriers and facilitators to initiating and translating this data for continuous healthcare improvement. By mapping the use of patient experience data to a LHS framework, this study shows how LHS principles can be applied to primary care to facilitate the capture and use of patient experience data on an ongoing basis.

Challenges And Strategies For Implementing Performance-Based Capitation In Indonesian Community Health Center : A Scoping Review

This study examines the implementation and challenges of performance-based capitation (KBK) at Community Health Centers (Puskesmas) in Indonesia, as a part of the National Health Insurance Program, aiming to improve the efficiency and quality of primary health services. Despite its potential, the implementation of KBK faces various challenges including inadequate human resources, limited infrastructure, and insufficient monitoring systems. The study uses a scoping review framework based on the Public Health Care Monitoring Conceptual Framework by WHO, analyzing 11 selected studies from 2021 to 2024. Findings indicate that internal factors such as management capacity, health worker competence, and organizational culture significantly impact the effectiveness of KBK. External factors like local government support, funding policies, and infrastructure availability also play crucial roles. Technological barriers, particularly in remote areas, hinder optimal policy implementation. The study emphasizes the need for clear regulations, consistent policy dissemination, and effective monitoring to ensure successful KBK implementation. Recommendations include strengthening leadership, training health workers, improving infrastructure, and enhancing digital health technology utilization. These strategies aim to optimize resource allocation, enhance service access, and improve patient satisfaction in Indonesia’s primary health care system.

Barriers and enablers to accessing perinatal health services for rural Australian women: A qualitative exploration of rural health care providers perspectives.

To identify perceived barriers and enablers for rural women in accessing perinatal care within their own community from the perspective of perinatal health care providers. A qualitative descriptive study design utilising reflexive thematic analysis, using the socioecological framework to organise and articulate findings. Victoria, Australia. Semi-structured interviews were conducted with nine perinatal health care providers who provide care to pregnant women or new mothers in rural communities. Participants were recruited across Victoria in 2023. Providers reported multi-level barriers and enablers that exist for rural women in accessing perinatal care within their communities. Barriers included women's personal circumstances, challenging professional relationships, inequitable service provision, ineffective collaboration between services and clinicians and government funding models and policies. Enablers included strength and resilience of rural women, social capital within rural communities, flexible care delivery and innovative practice, rural culture and continuity of care models. Rural perinatal health care providers perceived that rural women face multiple barriers that are created or sustained by complex interpersonal, organisational, community and policy factors that are intrinsic to rural health care delivery. Several addressable factors were identified that create unnecessary barriers for rural women in engaging with perinatal care. These included education regarding health systems, rights and expectations, equitable distribution of perinatal services, improved interprofessional relationships and collaborative approaches to care and equity-based funding models for perinatal services regardless of geographical location.

Exploring occupational therapy practice in Australian residential aged care facilities: A cross-sectional survey.

Occupational therapy in residential aged care facilities (RACFs) can enhance residents' occupational engagement and wellbeing. However, industry reports suggest that occupational therapists in Australian RACFs have mostly provided physical therapies such as pain management via massage and not addressed residents' occupations. There is limited literature on what constitutes occupational therapists' practice in RACFs to inform policy and practice. The aim of this cross-sectional survey was to explore practice patterns of occupational therapists working in Australian RACFs and influences on their practice. Occupational therapists working in Australian RACFs were invited from July 2019 to March 2020 to complete a self-report online questionnaire via email and advertisements on industry websites, newsletters, and social media. The questionnaire asked therapists about their caseload, referrals, assessments, and interventions. Data were analysed descriptively and presented as frequencies and percentages. A total of 214 occupational therapists completed the survey. Occupational therapists' daily practice largely focussed on pain management; other areas of practice included falls prevention, pressure care, and mobility. The Aged Care Funding Instrument in place at the time of the survey was identified as the leading factor influencing therapists' choice of assessments and interventions. Organisational policies and procedures were also perceived as key factors influencing occupational therapy practice. This paper highlights the influence of government funding and organisational policies in limiting occupational therapists' scope of practice and their ability to fully address the occupational needs of residents. Occupational therapists and the profession in general should be aware of factors in aged care funding models, and their application, that restrict occupational therapy practice and inhibit residents' function and advocate for change where needed. With the introduction of the Australian National Aged Care Classification funding model replacing Aged Care Funding Instrument, future research should explore potential changes to therapists practice following the implementation of the new funding model.

An IoT-Based Road Bridge Health Monitoring and Warning System.

Recent earthquakes worldwide have led to significant loss of life and structural damage to infrastructure, especially road bridges. Existing bridge monitoring systems have limitations, including restricted detection capabilities, subjectivity, human error, labor-intensive inspections, limited access to remote areas, and high costs. Aging infrastructures pose a critical concern for organizations and government funding policies, showing signs of decay and impending structural failure. To address these challenges, this research proposes an IoT-based bridge health status monitoring and warning system that is wireless, low-cost, durable, and user-friendly. The proposed system builds upon engineering standards and guidelines to classify bridge health status into categories ranging from excellent to collapse condition. It incorporates deflection, vibration, temperature, humidity, and infrared sensors, combined with IoT and a fuzzy logic algorithm. The primary objective is to reduce bridge maintenance costs, extend lifespans, and enhance transportation safety through an early warning system via a mobile application. Additionally, a Google Maps interface has been developed to display bridge conditions along with real-time traffic video. To validate the proposed system, a 3-D prototype model was constructed and tested. Practical testing of the fuzzy logic algorithm aligned with the simulation outcomes, demonstrating expected accuracy in determining bridge health status.

The Impacts of Economic and Political Drivers on the Performance of the Chinese Fintech Sector: The Mediating Role of Blockchain Developments

The emergence of finance technologies (fintech) has revolutionised traditional financial services and delivery processes, the advancement of blockchain technologies has aided the transition of fintech services with optimized efficiency and added values for modern customers. This study critically explored the impacts of macroeconomic environment factors and policy interventions in China on the developments of blockchain across the period of 2017 to 2021, examining how blockchain developments (BDI) mediate the relationship between economic driver influence (EDI), political driver influence (PDI) and Chinese fintech market performance (CFMP). This study contributed to literature gap and utilised empirical knowledge on the measurement of macroeconomic and political factors toward technological development, forming designated proxies and latent variables to offer new parameters to measure the influence of these factors in unified manners. This study measured economic driver influence under GDP per capita (GDP), gross national income (GNI), government borrowing and debt (GBD), gross domestic expenditure on R&D per capita (GERD) and labour cost index (LCI), political factor influence is measured under government funding (GF), pilot zones (PZ), incubators (IC), national champions (NC) and supportive policies by engaged province ratio (SP). Blockchain development is measured by the number of blockchain company registrations (BCR), blockchain patents (NBP), venture capital investment volume (VCI) and revenue of blockchain companies (RBC). The results reveal that both EDI and PDI have highly statistically significant relationships with BDI, positively impacting the growth of the overall Chinese fintech market sector and across 4 key fintech segments of alternative finance, digital assets/ investments and payments.

Towards developing a knowledge base for small business survival techniques during COVID-19 and sustainable growth strategies for the post-pandemic era

Small and Medium-scale Enterprises (SMEs) often face severe challenges during most global crises. This study utilizes metadata from 694 publications generated through a literature survey on SCOPUS to undertake science mapping, thematic structure analysis, and text analytics to identify, evaluate, and initiate a knowledge base of COVID-19 survival techniques and post-pandemic sustainable growth strategies. The results highlight several streams of strategies. First, the firm’s internal resources and situational leadership abilities, including crisis management techniques and dynamic capabilities, provide the initial resilience against the pandemic challenges, supported by government funding and public policy. Second, adopting digital technologies, modifying business models, and process innovation not only aids survival but enhances internal operations. SMEs can turn challenges into opportunities through product innovation, achieving competitiveness and improved performance. Third, securing funding for SMEs’ digitization or digital transformation can be challenging but offers enormous survival opportunities during crises and sustainable growth in the post-pandemic era. SMEs can explore non-traditional financing options, including crowdsourcing and digital financing. Fourth, readily available virtual technologies (virtual meeting platforms) provide immediate relief to businesses and become a significant part of future business practices in the post-pandemic era. Finally, social entrepreneurship blossomed during COVID-19, ignited particularly by the community lockdown, travel restrictions, self-isolations, and quarantine of entrepreneurs and workers. Although scientists cannot stop the outbreak of pandemics, adequate preparation and understanding of effective strategic responses can cushion negative impacts. Further studies can contribute more survival and sustainable growth strategies against potential crises.

Research on Industry Transformation Models and Influencing Factors of Hot Spring Villages from the Perspective of Sustainable Development: A Case Study of Fujian, China

The industrial transformation of hot spring villages is an important means to promote the sustainable development of the rural economy and achieve common prosperity. This study aims to explore the models of hot spring industrial transformation and reveal the influencing mechanisms in hot spring villages. Based on the theory of rural industrial transformation, an evaluation index system was constructed to measure rural industrial development by using the attribute data of enterprises in hot spring villages. Taking 19 typical hot spring villages in Fujian Province of China as examples, this study explores the process, models and influencing factors of the industrial transformation of hot spring villages from a sustainable perspective. Research results show that (1) the industrial transformation of the hot spring village includes the initial development stage and the rapid development stage, with the leading industries being transformed into service industries. (2) The industrial transformation of the hot spring village presents a gradual transformation model from hot spring aquaculture to hot spring processing and hot spring services, which not only reflects the transformation process of the hot spring village from the development of its primary industry to that of its secondary and tertiary industries, but also reveals the transformation trend of specialization and the high-end productive service industry and the convenient and high-quality transformation process of the living service industry. (3) The influencing factors of the industrial transformation of the hot spring village mainly include location conditions, the demand of the rural hot spring tourism market, government funding policy support and the choices of local villagers. This study not only enriches the theory of industrial transformation in resource-based rural areas, but also provides decision-making references for the sustainable development of hot spring villages in practice.

An evaluation of Lean deployment in Irish micro-enterprises

This study investigates the reasons for Lean deployment in Micro Enterprises, the types of tools used, the challenges involved and the results obtained in Micro Enterprises in Ireland. Qualitative interviews were conducted with 22 Micro Enterprises in Ireland that have started Lean implementation over the last three years. Lean offers many benefits to Micro Enterprises similar to those observed in larger-sized enterprises, including improved productivity, quality and reduced costs. In addition, leadership support for Lean in Micro Enterprises is not a challenge for Lean deployment as many Micro Enterprises are owner-managers and thus embrace and facilitate the deployment of Lean in organisations. Furthermore, a Critical success factor for Lean in Micro Enterprises is government support and availability of Lean mentorship. Further longitudinal studies on Micro Enterprises would help study how Lean evolves in these organisations over time especially in enterprises who have employed Lean for several Leans. This is one of the first studies specific to the practical application of Lean in ME’s in Ireland and globally. For academics and practitioners and informing government funding policy, this study demonstrates that Lean can successfully be deployed in Micro Enterprises. This study demonstrates that government supports can aid Lean and enhance economic competitiveness.

Cushioning the economic burden of chronic kidney disease for patients in LMICs: The heightened need for a government-driven financial support policy

The increasing chronic kidney disease (CKD) burden and the exorbitant cost of treatment are mainly responsible for the alarming morbidity and mortality associated with the disease in low- and middle-income countries (LMICs). In most LMICs, health insurance coverage is low or inefficient, or nonexistent. However, the lack of government-driven financial support for CKD care has led to out-of-pocket payment for medications, dialysis, and renal transplantation by patients and their family members which cause catastrophic health expenditure and worsening poverty. Thus, poverty is a great constraint to effective CKD care with attendant consequences of increased morbidity and mortality in LMICs. Therefore, the purpose of this paper is to highlight the need for government funding policy for CKD management in order to mitigate the adverse health outcomes of poorly managed CKD.

Assessment of training methods and techniques in government craft development centres in rivers state, Nigeria : A case study of government craft development centre, port harcourt Rivers state, Nigeria

This study examined the assessment of training methods and techniques of Government Craft Development Centres, with Government Craft Development Centre, Port Harcourt, Rivers State, Nigeria as a case study. The population of the study consisted of all the vocational training programmes teachers and students of Government Craft Development Centres in Rivers State, Nigeria. A survey design was used for the study. The random sampling technique was employed for the study with 156 respondents. The research instrument used for the study was a questionnaire with 20 structured items was the major tool for data collection, aimed at eliciting information to answer the research questions. Mean and grand mean was used as a statistical tool to answer the research questions. T-test statistics at 0.05 level of significance was used to test the hypotheses. The results of the findings among others show that the application of the various training methods and techniques do not relate to the needs of the students. And this is as a result of several factors which include lack of relevant qualifications and experience of the teachers, inadequate motivation and remuneration of teachers, inadequate facilities for learning, as well as poor government funding policies for vocational training programmes. Based on the findings, some recommendations were made towards making the application of the various training methods and techniques relate to the needs of the students.

Critical reflections of early childhood care and education in Singapore to build an inclusive society

The early childhood years are pivotal as they mark the beginning of a young child’s life journey into education. This paper offers critical reflections of the early childhood care and education landscape in Singapore as it has evolved over the last decade. The discussion will draw on findings of the study Vital Voices for Vital Years 2 (2019) to explicate the issues, debates and challenges facing the early childhood care and education sector. It argues that recent developments in the sector with stepped increases in government funding and strategic policy development, augmented by the establishment of national agencies committed to improving the quality of care and education, have achieved significant milestones in the country. However, a more critical perspective of the role of early childhood in policy and practice to meet the diverse needs of young children and families is necessary for envisioning education as a pathway to inclusion and social equality, and for building a truly inclusive society.

The non-medical surgical assistant and inequity in the Australian healthcare system

Objectives: The objective of this discussion paper is two-fold. The first is to quantify if the non-medical surgical assistant increases access to surgery by investigating what percentages of cases these clinicians undertake in the private sector surgical units where they work. The second is to examine procedural and distributive justice and how they impact on private sector surgical care. Aim: The aim of this paper is to investigate if the non-medical surgical assistant increases equity via access, for the patient, to private sector surgical care; and if government policy has an impact on equity in the form of access. Background: The private healthcare sector completes approximately two-thirds of all elective surgery in Australia; without this contribution, there would be more pressure on the public healthcare sector. In the private sector, recognition and federal funding of the surgical assistant differs depending on whether this clinician has a medical or non-medical, eg. nursing, qualification. The role of the non-medical surgical assistant is well established internationally and this role has been practiced in Australia for more than 20 years. Discussion: Inequity; as a result of the procedural injustice of government funding policy, impacts the private sector surgical patient causing distributive injustice. This distributive injustice results in an out-of-pocket expense to the patient. Rising outof-pocket expenses has started a trend of patients moving away from private health insurance and into the public sector. The registered nurse and nurse practitioner are qualified to practise as a non-medical surgical assistant and provide increased access to care, and effective care compared to the medical surgical assistant. The nurse practitioner is an eligible provider of Medical Benefits Schedule services but restricted from accessing the intraoperative assisting item numbers. Conclusion: The non-medical surgical assistant; or at least the nurse practitioner as non-medical surgical assistant; require access to the Medical Benefits Schedule intraoperative item numbers. Access would alleviate the out-of-pocket expense incurred by Australian patients when a non-medical surgical assistant assists with their surgery. Lack of access to these item numbers means patients may have their surgery delayed until an appropriately skilled medical surgical assistant is available, or the public healthcare sector can accommodate them. Implications for research, policy and practice: This paper illustrates a need for change in Australian government policy to reflect contemporary, evidencebased practice. What is already known about the topic? • The international literature reports that advanced practice nursing roles increase access to healthcare. • The nurse practitioner role in Australia is now well established, and the Australian literature illustrates increased access to care. • The Medical Benefits Schedule Review Taskforce was formed to investigate a system that is not consistent with contemporary, evidence-based healthcare. What this paper adds: • The nurse practitioner and registered nurse, in the role of non-medical surgical assistant, increase access to private sector surgical care. • Australian government policy limits access to private sector surgical care through its inequitable policies that contravene the spirit of fair trade. • According to peak professional bodies’ policy and position statements, the nurse practitioner and registered nurse are legitimate providers of surgical assisting services.

Geographies of local government

Geographies of local government

Selling medical education to international students: time for review.

Over 600 international medical students commence training in Australian medical schools each year. Government funding policies are driving medical schools to recruit more international students. The need to lobby for intern positions for domestic graduates and for international students has placed Australia's medical schools in conflicted positions. It is time for a thorough re-examination of all aspects of medical education in Australia.

Government regulation of the market for higher education

This paper presents a model of strategic competition between universities that accounts for the existence of positive spillover effect from education (peer effect). It was demonstrated that in the presence of peer effect strategic competition results in inefficient student allocation between the two universities (biased to the high-quality university) and excessive quality differentiation. The model is used to analyze the implications of government funding policies as well as admission and quality regulation. It was demonstrated that traditional schemes of institutional funding and students’ financial aid programs like tuition fee subsidy, quality investment subsidy, or total cost subsidy reduce social welfare. At the same time, an introduction of provision of tuition-free education for the best students combined with a per-student grant provided to the university improves both students’ and social welfare. It was also demonstrated that tight admission regulation is not socially desirable while the introduction of minimum quality standards makes society better off.

Responding to the Demands of the STEM Education Agenda: The Experiences of Primary and Secondary Teachers from Rural, Regional and Remote Australia


 
 
 In recent years STEM education has been the focus of Australian government funding initiatives, policy and curriculum development at the national and state levels and a key driver of school innovation. Principals, teachers and students have been called upon to develop their capability and interest in the individual STEM discipline subjects or to engage in interdisciplinary STEM activities. Much of the focus on STEM has been driven by a national agenda informed by the needs of industry, and research that indicates that the students graduating from schools and universities today with STEM qualifications will not be sufficient for society’s needs. While the agenda encompasses more than individual teachers or schools, it is teachers who are at the forefront of its implementation in classrooms. In this paper we report on the perceptions of teachers about issues impacting on the effective teaching of STEM in rural, regional and remote Australia, and strategies they use to overcome issues/barriers and building the confidence and capacity of STEM teachers. Based on these, the paper reports some potential solutions to the issues faced by schools in rural, regional and remote Australia addressing the demands of the STEM Education focus.
 
 

Enhancing Parenting Effectiveness, Fathers' Involvement, Couple Relationship Quality, and Children's Development: Breaking Down Silos in Family Policy Making and Service Delivery

In this article, we examine family‐based interventions designed to increase parenting effectiveness, fathers' positive involvement, and couple relationship quality, all with the goal of enhancing children's development. We focus on the fact that government funding policies, service delivery systems, and research evaluations of interventions to benefit children and families typically operate in separate silos. We provide a theoretical model, along with empirical evidence, to argue that a more integrated, collaborative perspective is likely to produce more optimal outcomes for parents and children than current siloed attempts to improve child and family well‐being. We discuss some of the obstacles to using evidence to guide policy decisions. We offer suggestions for policy makers and service providers in an attempt to describe a more integrated approach to supporting family well‐being, and to encourage the increased use of systematic data in making decisions about how to allocate scarce resources for family support.

Organizational Antecedents of Nonprofit Engagement in Policy Advocacy: A Meta-Analytical Review

Policy advocacy by nonprofits has attracted substantial scholarly interest in recent years. Although considerable empirical studies have examined factors influencing nonprofit participation in policy advocacy, the existing evidence remains inconsistent as to what factors influence nonprofits to engage in policy advocacy and to what extent. The present study conducts a meta-analysis to quantitatively synthesize existing studies on the organizational antecedents of nonprofit advocacy engagement. Through systematically reviewing 46 studies and aggregating 559 effect sizes on 17 organizational predictors, the study finds organizational size, professionalization, board support, constituent involvement, knowledge about laws, government funding, private donations, foundation funding, collaboration, and negative policy environment have positive and significant relationships with a nonprofit’s level of advocacy engagement. The study contributes a clear knowledge base to guide future nonprofit advocacy research and practice.

Silent policymakers in Aotearoa New Zealand: reflections on research of early childhood teacher views on policy, practicum and partnership

ABSTRACTThis paper reports on the importance of the stories and perspectives of early childhood education Associate Teachers (ATs) at a time when there is considerable flux being experienced in the Aotearoa New Zealand early childhood sector, due in particular to the ongoing impact of changes in government funding policy, ongoing debates about pathways into the teaching profession, and an updated curriculum framework. The paper developed out of a research project that asked Associate Teachers (AT) about their views on the impact of recent national education policy changes. The views of ATs provide an influential voice for the sector, and particularly for teacher education providers through the student teacher practicum experience. Evidence and analysis of AT views provides insight into how the triadic of student, lecturer and practitioner can work together to support student teachers with their practicum experience in relation to the recent policy changes. A very small return rate for online questionnaire...