Search Results for primary-healthcare-systems

Abstract

Primary healthcare institutions are highly important socio-technical systems, where infrastructure, digital technologies, and service delivery processes collaborate to establish service resilience and performance. Digital systems and sustainable infrastructure may not be integrated as well in a limited environment with resources, which may lead to reduced system robustness and efficiency. This paper is a systematic digital systems and infrastructure evaluation of the process of providing primary healthcare in Paschim Bardhaman District, India, through an engineering-based, multi-criteria analysis framework._x000D_ Cross-sectional engineering analysis was carried out on 25 Primary Health Centers (PHCs) chosen based on the rural and semi-urban settings. They have developed a composite system performance index by incorporating five domains of engineering, namely infrastructure robustness, operational workflow efficiency, outcome performance, digital systems readiness (ICT), and environmental sustainability systems. Information was gathered based on formal auditing of facilities, check of readiness of ICT equipment and software, field observation of operations and review of documents. Domain-specific scores were also summed up to create a Composite Quality and Resilience Index (CQRI). Statistical analyses were made to provide measures of description, correlation analysis and comparative testing between rural and semi-urban facilities._x000D_ Findings showed that there was moderate system performance (mean CQRI = 1.21 ± 0.24) and there was high inter-facility difference. The positive correlation of infrastructure robustness and the efficiency of operational workflow were found to be strong with composite system performance (r = 0.67 and r = 0.74, respectively). The readiness to digital systems, and environmental sustainability scored relatively low, which points out to the underutilization of ICT infrastructure, lack of telemedicine adoption, and the integration of renewable energy sources. The composite performance of semi-urban PHCs was much better than that of rural facilities (p < 0.05), which highlights the importance of infrastructure accessibility and digital connectivity to system resilience._x000D_ The results show that integration of digital systems and infrastructure design that is sustainable are important engineering determinants of resilient primary healthcare delivery. The suggested composite assessment framework can be used as a scalable engineering-based tool to estimate and optimize the performance of low-resource healthcare infrastructure in supporting the resilience of the system and its long-term sustainability and efficiency in delivering the services.