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Utilising a collective case study system theory mixed methods approach: a rural health example

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dc.contributor.authorAdams, R.
dc.contributor.authorJones, A.
dc.contributor.authorLefmann, S.
dc.contributor.authorSheppard, L.
dc.date.issued2014
dc.description.abstractBackground: Insight into local health service provision in rural communities is limited in the literature. The dominant workforce focus in the rural health literature, while revealing issues of shortage of maldistribution, does not describe service provision in rural towns. Similarly aggregation of data tends to render local health service provision virtually invisible. This paper describes a methodology to explore specific aspects of rural health service provision with an initial focus on understanding rurality as it pertains to rural physiotherapy service provision. Method: A system theory-case study heuristic combined with a sequential mixed methods approach to provide a framework for both quantitative and qualitative exploration across sites. Stakeholder perspectives were obtained through surveys and in depth interviews. The investigation site was a large area of one Australian state with a mix of rural, regional and remote communities. Results: 39 surveys were received from 11 locations within the investigation site and 19 in depth interviews were conducted. Stakeholder perspectives of rurality and workforce numbers informed the development of six case types relevant to the exploration of rural physiotherapy service provision. Participant perspective of rurality often differed with the geographical classification of their location. The numbers of onsite colleagues and local access to health services contributed to participant perceptions of rurality. Conclusions: The complexity of understanding the concept of rurality was revealed by interview participants when providing their perspectives about rural physiotherapy service provision. Dual measures, such as rurality and workforce numbers, provide more relevant differentiation of sites to explore specific services, such rural physiotherapy service provision, than single measure of rurality as defined by geographic classification. The system theory-case study heuristic supports both qualitative and quantitative exploration in rural health services research.
dc.identifier.citationBMC Medical Research Methodology, 2014; 14(94):1-9
dc.identifier.doi10.1186/1471-2288-14-94
dc.identifier.issn1471-2288
dc.identifier.issn1471-2288
dc.identifier.urihttps://hdl.handle.net/1959.8/159739
dc.language.isoen
dc.publisherBioMed Central
dc.rightsCopyright 2014 The Authors.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver applies to the data made available in this article, unless otherwise stated. (http://creativecommons.org/licenses/by/2.0)
dc.source.urihttps://doi.org/10.1186/1471-2288-14-94
dc.subjectcase study
dc.subjecthealth service
dc.subjectrural
dc.subjectsystems theory
dc.titleUtilising a collective case study system theory mixed methods approach: a rural health example
dc.typeJournal article
pubs.publication-statusPublished
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ror.mmsid9915910029001831

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