In many decentralized health systems the district level has been found to be particularly weak [ 8], despite being the essential service structure for the provision and coordination of hospital level services.
The current service schedule structure (structure 1 in Table 8) is preferred among MDs in the study PICU because, among candidate schedules with the 7-day preferred service structure for attending MDs, it has the fewest night call shifts without an on-service MD associated with the highest HCS.
The framework describes the means to deliver mental illness prevention that the literature indicates is achievable, and is the basis of an ongoing project to model the workforce and service structures required for mental illness prevention.
Building on an aetiological model of adult mental illness that emphasizes the importance of intervening during infancy, childhood, adolescence and youth, we adapted a workforce and service planning framework, originally applied to diabetes care, to the analysis of the workforce and service structures required for best-practice prevention of mental illness.
The goal of needs-based workforce modelling in mental illness prevention is to estimate the workforce and service structures required for a given regional population to effectively address core risk factors in infancy, childhood, adolescence and youth ('young people') that are implicated in the development of mental illness in adults.
While public education strategies about stroke did not differ across the two regions at the time of the survey, service structures differ – for instance there are many more stroke units in hospitals in Northern Ireland [ 23], with consequent better access to post-stroke rehabilitation.
The health services structure for adolescents and young adults with substance related problems in Germany, is multifaceted, because different communal, medical and judicial agencies are involved.
However, they saw the potential of using existing traditional, administrative and local service structures to lobby for support.
For example, existing service structures emphasize family caregivers and dying-in-place (i.e., the home) [ 31, 32].
Likewise, efforts need to be made to integrate GE-related methodology into the local pre-service and in-service training structures for both student teachers and teachers already in service.
