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Question: Discuss About The Association Mining Clinical Observations? Answer: Introduction: Evaluation of any program, be it a health program or any other public service program, is important for checking how perfectly the program fits for the public of a particular place (Issel and Wells, 2017). Most of the countries have evaluation programs, which are done by various governmental and non-governmental officials that are directed by governmental officials of the particular region. The most important programs for evaluation are the health programs as the wellness of the citizens of a country decides its gross productivity. It also is important to have a healthy population (Sonifield, Hasstedt and Gold, 2014). The report discusses about the studies on the health programs, done by Pawson and Tilley in the year of 1997 and 2004. The points that have to be kept in mind before evaluation of any health program as assisted by the above mentioned researchers are also going to be elaborated. It also emphasizes on the similarities and differences between the Pawson, Tilley evaluation study with that of the model designed by the Researcher Michell Issel. The report will also discuss about evaluation of an already existing evaluation of the program Medicare Australia by the government of Australia. It also highlights the pros and cons of the earlier evaluator program done on the Medicare Australia and gives an insight of the present situation of such initiatives. The discussion also focuses on designing a model of evaluation for the existing public health program of Medicare Australia. It elaborates the points under focus of the project and the points, which have to be taken into consideration to improve the existing program. The realist evaluation studies of Pawson and Tilley: The above mentioned Researchers define the realistic evaluation as a type of evaluation, done based on certain available theories on the subject or program taken into consideration (Pawson, 2013). It is a distinctive account of the nature of different health programs and the way in which they work. The study done by the Researchers emphasizes on the importance of evaluating programs, based on the scenario of the place, that is the evaluation should focus on the lifestyle of the people of the region and the environmental aspects of the place. The study should never be generalized for all people around the world as the cultures, climate and behavior of the habitants vastly differ from region to region. The model made by the Researchers, also highlights on the importance of personalized approach of the health programs that is different people need different kind of care giving. Programs should also have an approach to consider every individuals needs. The study also designs a methodology, which to an extent depends on the hypothesis about the program under consideration. The first stage of the evaluation begins with researching in various sources. The sources for evaluation can be library searches, interviews and documentary analysis. The second stage is to edit the data that are collected from the sources, the third step is to subject the chosen program under the hypothetical scenario. The fourth and the final step, needs an evaluator to assess and interpret the analysis done on the program. Similarities and Differences between the evaluation model of Pawson and Tilley with that of Michelle Issel: Both the approaches of the evaluation of health programs had the aim of improving the system of health programs available, to deal with the health of the public. Both the studies in contrast to the other existing evaluations have emphasized on the importance of health programs highlighting the health of people as individuals. Both the research projects put an abstract of the importance of the interaction between the stakeholders and the evaluators of the program. They also give an importance to remodel the programs in accordance to the needs of the public or customers with time. Both the studies highlight the need of examining the social and ecological ranges of different locations their program is spread. They focus on the different levels of population because the determinants of health problems vary in different levels. Both the research works also examine the efficiency of the social workers associated with the health program, this is a chief step because without the presence of an efficient social worker, the surveys conducted by the program do not have accuracy. Surveys are the primary projects of any program to design the procedure of their work, so, their conductance should be appropriate. Differences: The research done by Pawson and Tilley as described in the above paragraph, deals with realistic evaluation of a program, whereas, the model prepared by the Researcher Michele Issel direct practical approach of the Researcher to evaluate the procedures the programs apply for the sake of the public or their customers. Michelle Iselles evaluation is based on the quality management and improvement of the tools applied in the program. The study also involves the presence of many health professionals who are engaged in the operation of several health related programs. On the other hand, Pawson and Tilleys approach is theory based and it does not require a number of health personnel for the theoretical evaluation. Michelles work requires the presence of the public and the personnel from the health organization as sources, it gives a clearer knowledge of the position of the program. The study of Pawson and Tilley lacks the practical approach, which Michelles study includes, it takes only th e documentary films, library searching and other theoretical approaches as sources. The Pawson and Tilleys research work is purely hypothetical lacking the accurate scenario study unlike the work done by Michelle Issle. The study by Issel has considered a unique comparison of theory and practical examination of the programs, it also builds a relation between these two aspects of research works and gives an insight of the importance of relating the two types of studies. Pawson and Tilleys study does not approach to the practicality of the programs at all. The study by Michelle Issle, basically is done to help the students of evaluation studies to understand the process better, Pawson Tilley addressed their work for the public as a whole. From the comparison of the two studies, it can be inferred that the study done by Michelle Issle considers many more criteria for judgment of the health programs than the study done by Pawson and Tilley. The Medicare program of Australia: The Medicare Australia program is an initiative taken by the government of Australia, Department of Human health service (DHS). The program started on first of October in the year 2005. This program was previously known as the Health Insurance Commission (HIC). It is interlinked with the Department of Human Service. The Head Quarters of the organization is in Canberra (Health.gov.au, 2017). This program is one of the most popular in Australia because it covers a numerous health related issues under its policies (Rashid, Hoque and Sattar, 2014). The program was made to reduce the cost of medical expenses, and to minimize the time taken for admission in hospitals during emergencies and to govern the process of health promotion in a well- managed way. The organization also administers different programs in association with the Department of Health and Ageing. The program is nominally funded, that is the surcharge of income tax is minimally Some of the programs under the vast program of Medicare Australia are Pharmaceutical Benefit Scheme, Special Assistance scheme, Medical indemnity, Doctor connect, Aged care and Indigenious Health. Evaluation of the Medicare Australia program by the Practitioners review program: According to the evaluation done by the Practitioner review programs of Australia, the program Medicare Australia has a proper framework that delivers a health system to the citizens. Studies done by Practitioner review programs also highlighted that the program helps millions of people of Australia with minimum wastage of resources (Mason, 2013). It also maintains the records of the people they served. The organization also has an online portal to serve the people and communities, registered under their program. The website also keeps a record of the identifications of their customers. The identification column also comprises of the reviews of the practitioners they are under treatment of, this feature reduces the risk of misplacing hard copies of the records and keeps the inappropriate costing of treatments in check. The examiners also sent their officials to the field -work sessions organized by the Medicare team to ensure the health of the rural people. The examination shows that the Medicare personnel do a thorough examination of the population by monitoring the health status of each individual of the village. The program does not emphasize on the different policies of cost cutting related to different diseases, it briefly discusses about the lineage of cost cutting in totality. Review of the evaluation done on Medicare Australia by the Practitioners Review program: The evaluation study of the Practitioners review programs gives importance mostly to the positive outcomes of the Medicare program of Australia (Panter-Brick et al, 2014). It minimally gives an account of the drawbacks of the program. An evaluation should be structured in such a way that the program can be worked upon and improved. The insight given by the Practitioners review programs, does not suggest points that can be improved. The vast program of Medicare Australia is examined but the sub- programs within the Medicare Australia are not discussed in the evaluation elaborately, this makes the study fragile because the process in which the sub-programs work, majorly impact the vast program as a whole (Cater et al, 2012). The environmental factors of the premises should also be under examination, but the Practitioners program omitted this factor. The positive points of the evaluation are that the program thoroughly investigated on the official activities of the Program. It examined the online availability of the customer care services they include to make certain that their care is par excellence, it also investigated the archives they have preserved of their customers and its genuineness. Field works are crucial to such health care programs as the people of remote areas are devoid of much communications from the city (Edward, 2012). The main aim of the field -work is to promote their program and assist the rural people with getting their policies done for economic as well as health benefits. The program also incorporated their officials during the health programs field works to remote places, in order to check the process the people of such places are handled by the officials of the program. An evaluation process to improve the Medicare Australia program by the Practitioners review program: Evaluation of the health care programs is important as the programs at present have a complex way of doing their tasks (Eldredge et al, 2016). The programs work immensely well at one place but fail to show such impressive results in the other because of the socioeconomic, fiscal, demographic, inter- organizational and interpersonal settings in which they are set up (Runciman et al, 2012). The evaluation of health programs should be done systematically (Drummond et al, 2015). The examination should be for the particular region the program is made to cover. The objectives should primarily consists of the following steps: firstly the operation as whole of the organization should be under evaluation, secondly the activities that are considered by the program should be checked, thirdly the operation in-charge should be noted and finally the number of people that is approached reached by the organization should be tracked (Luce and Elixhauser, 2012). The Medicare Australia program is a large program, which has sub- programs associated with it (Australia, 2015). This program hence needs evaluation of the sub-programs as well. The evaluation should be done primarily as mentioned in the above paragraph. The evaluation should be both realistic based as well as practical based. The study of previously available documents on the program, gives an idea of the ways in which it used to work, so that the degree of improvement can be accessed during the evaluation (Street, Gold and Manning, 2013). The theoretical analysis also establishes an understanding of the ways the organization operates in general (Pyrczak, 2016). Physical evaluation of a program, requires the presence of the evaluator in the site at which the program operates. Such evaluation gives a clearer insight of the scenario of the steps that the programs practices (Diamond, Horn and Uttal, 2016). The Medicare Australia program operation is appreciable as a whole, but certain areas need improvement. The program has a good online appearance but theoretical evaluation shows that it lacks the discussion of the sub-programs it conducts on the website. The management should upload information about the areas, which are taken care by the program, so that the customers have a clear idea about them. Medicare covers health cost for many diseases and surgeries (Harrison et al, 2015). In the present day occurrence of some of the diseases and ailments are increasing like the degenerative disorder of eyes named keratoconus. These disorders are not covered under the program as most of the patients need implantation (Britt et al, 2013). Such ailments should be taken under coverage policies so that the expenditure of the patients due to those diseases, reduce to some extent. The environmental factors of the premises in, which the program generally work needs proper assessment on a regular bas is (Kim, 2014). The cleanliness of the work place, a healthy surrounding atmosphere, a properly managed working system altogether makes an ideal program (Thakur et al, 2012). The evaluation needs to judge these factors too, for carrying a proper evaluation process. Conclusion: Therefore, it can be concluded that evaluation of public programs help in the improvement process. Health programs should be evaluated in first hand because health is the primary necessity for the growth of any nation. The two evaluation strategies discussed gives an insight of the ways the programs can be evaluated. The differences between the two strategic models designed by the respective Researchers, the theoretical model and the practical model, show how the two have their own pros and cons. The study done by Michelle Issle, covers a wide range of aspects unlike the study done by Pawson and Tilley program. Evaluation is going to be clearer according to the Michelle Issle model. The evaluation of the review done on the Medicare Australia by the Practitioners review program provides us with a gist of the process. Through such review studies, the others evaluators can get an insight of the process of examination. The program that was evaluated in the discussion, that is the Medicar e Australia program, is one of the most popular health programs of the country of Australia, the discussion about the improvements that can be done, helps to get an overview of the evaluation process of the health care programs. The discussion also sums up about the points that are to be considered for enhancement of the Practitoners review program on a regular basis. Evaluation of the health programs should be frequently done for the reasons mentioned in the discussion. Higher the rate of conduction of evaluation, better the quality of the health care programs. References: Australia, M., 2015. Medicare statistics.Canberra: Medicare Australia. Britt, H., Miller, G.C., Henderson, J., Bayram, C., Valenti, L., Harrison, C., Charles, J., Pan, Y., Zhang, C., Pollack, A.J. and O'Halloran, J., 2013.General Practice Activity in Australia 2012-13: BEACH: Bettering the Evaluation and Care of Health(No. 33). Sydney University Press. Carter, S.R., Moles, R., White, L. and Chen, T.F., 2012. Exploring patients motivation to participate in Australias Home Medicines Review program.International journal of clinical pharmacy,34(4), pp.658-666. 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