Cargando…

Defining and classifying public health systems: a critical interpretive synthesis

BACKGROUND: The introduction of the determinants of health has caused a shift towards understanding health from a holistic perspective as well as increased recognition of public health’s contributions to the health of the population. Several frameworks exist to conceptualise healthcare systems, high...

Descripción completa

Detalles Bibliográficos
Autores principales: Jarvis, Tamika, Scott, Fran, El-Jardali, Fadi, Alvarez, Elizabeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296190/
https://www.ncbi.nlm.nih.gov/pubmed/32546163
http://dx.doi.org/10.1186/s12961-020-00583-z
_version_ 1783546799587328000
author Jarvis, Tamika
Scott, Fran
El-Jardali, Fadi
Alvarez, Elizabeth
author_facet Jarvis, Tamika
Scott, Fran
El-Jardali, Fadi
Alvarez, Elizabeth
author_sort Jarvis, Tamika
collection PubMed
description BACKGROUND: The introduction of the determinants of health has caused a shift towards understanding health from a holistic perspective as well as increased recognition of public health’s contributions to the health of the population. Several frameworks exist to conceptualise healthcare systems, highlighting the stark contrast of frameworks unique to public health systems. The objectives of this study were to define public health systems and assess differences between healthcare systems and public health systems within established health systems frameworks. METHODS: A critical interpretive synthesis was conducted. Databases searched included EBSCOhost, OVID, Scholars Portal, Web of Science, Cochrane Library and Health Systems Evidence. Data extraction, coding and analysis followed a best-fit framework analysis method. Initial codes were based on a current leading health systems and policy classification scheme – health systems arrangements (governance, financial and delivery arrangements). RESULTS: A total of 5933 unique documents were identified and 67 were included in the analysis. Definitions of public health and public health systems varied significantly as did their roles and functions across jurisdictions. Public health systems arrangements generally followed those of health systems, with the addition of partnerships (community and inter-sectoral) and communication playing a larger role in public health. A public health systems framework and conceptualisation of how public health currently fits within health systems are presented. CONCLUSIONS: Public health systems are unique and vital entities within health systems. In addition to examining how public health and public health systems have been defined within the literature, this review suggests that establishing the scope of public health is crucial to understanding its role within the larger health system and adds to the discourse around the relationship between public health, healthcare and population health. More broadly, this study addresses an important gap in understanding public health systems and provides conceptual and practical contributions as well as areas for future research.
format Online
Article
Text
id pubmed-7296190
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-72961902020-06-16 Defining and classifying public health systems: a critical interpretive synthesis Jarvis, Tamika Scott, Fran El-Jardali, Fadi Alvarez, Elizabeth Health Res Policy Syst Research BACKGROUND: The introduction of the determinants of health has caused a shift towards understanding health from a holistic perspective as well as increased recognition of public health’s contributions to the health of the population. Several frameworks exist to conceptualise healthcare systems, highlighting the stark contrast of frameworks unique to public health systems. The objectives of this study were to define public health systems and assess differences between healthcare systems and public health systems within established health systems frameworks. METHODS: A critical interpretive synthesis was conducted. Databases searched included EBSCOhost, OVID, Scholars Portal, Web of Science, Cochrane Library and Health Systems Evidence. Data extraction, coding and analysis followed a best-fit framework analysis method. Initial codes were based on a current leading health systems and policy classification scheme – health systems arrangements (governance, financial and delivery arrangements). RESULTS: A total of 5933 unique documents were identified and 67 were included in the analysis. Definitions of public health and public health systems varied significantly as did their roles and functions across jurisdictions. Public health systems arrangements generally followed those of health systems, with the addition of partnerships (community and inter-sectoral) and communication playing a larger role in public health. A public health systems framework and conceptualisation of how public health currently fits within health systems are presented. CONCLUSIONS: Public health systems are unique and vital entities within health systems. In addition to examining how public health and public health systems have been defined within the literature, this review suggests that establishing the scope of public health is crucial to understanding its role within the larger health system and adds to the discourse around the relationship between public health, healthcare and population health. More broadly, this study addresses an important gap in understanding public health systems and provides conceptual and practical contributions as well as areas for future research. BioMed Central 2020-06-16 /pmc/articles/PMC7296190/ /pubmed/32546163 http://dx.doi.org/10.1186/s12961-020-00583-z Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Jarvis, Tamika
Scott, Fran
El-Jardali, Fadi
Alvarez, Elizabeth
Defining and classifying public health systems: a critical interpretive synthesis
title Defining and classifying public health systems: a critical interpretive synthesis
title_full Defining and classifying public health systems: a critical interpretive synthesis
title_fullStr Defining and classifying public health systems: a critical interpretive synthesis
title_full_unstemmed Defining and classifying public health systems: a critical interpretive synthesis
title_short Defining and classifying public health systems: a critical interpretive synthesis
title_sort defining and classifying public health systems: a critical interpretive synthesis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296190/
https://www.ncbi.nlm.nih.gov/pubmed/32546163
http://dx.doi.org/10.1186/s12961-020-00583-z
work_keys_str_mv AT jarvistamika definingandclassifyingpublichealthsystemsacriticalinterpretivesynthesis
AT scottfran definingandclassifyingpublichealthsystemsacriticalinterpretivesynthesis
AT eljardalifadi definingandclassifyingpublichealthsystemsacriticalinterpretivesynthesis
AT alvarezelizabeth definingandclassifyingpublichealthsystemsacriticalinterpretivesynthesis