Journal articles on the topic 'Rural health services Standards Australia'
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Rao, Hamna. "Reforms Needed in Aged Patient’s Care." International Journal of Frontier Sciences 2, no. 1 (January 1, 2018): 56–64. http://dx.doi.org/10.37978/tijfs.v2i1.34.
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Today’s health workforce is constantly engaged to enhance the standards of healthcare services and ensuring comprehensive healthcare standards to the community. Queensland’s health workforce is Australia’s second largest health workforce (1) and serving proportionately in all areas of QLD, making efforts to make health better by making research, surveys and developmental planning in rural and regional areas. Aged Care is currently the most concerned health issue among OECD countries (2) as aged population continues to grow and it’s challenging for Australian health sector to meet the standards of quality care in provision of aged care health services. As per Australian Institute of Health and Welfare statistics it is projected that Australia will constitute 22% of aged population in next 30 years (AIHW).
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MacDermott, Sean, Rebecca McKechnie, Dina LoGiudice, Debra Morgan, and Irene Blackberry. "Barriers and Facilitators to Screening for Cognitive Impairment in Australian Rural Health Services: A Pilot Study." Geriatrics 7, no. 2 (March 22, 2022): 35. http://dx.doi.org/10.3390/geriatrics7020035.
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Australian National standards recommend routine screening for all adults over 65 years by health organisations that provide care for patients with cognitive impairment. Despite this, screening rates are low and, when implemented, screening is often not done well. This qualitative pilot study investigates barriers and facilitators to cognitive screening for older people in rural and regional Victoria, Australia. Focus groups and interviews were undertaken with staff across two health services. Data were analysed via thematic analysis and contextualized within the i-PARIHS framework. Key facilitators of screening included legislation, staff buy-in, clinical experience, appropriate training, and interorganisational relationships. Collaborative implementation processes, time, and workloads were considerations in a recently accredited tertiary care setting. Lack of specialist services, familiarity with patients, and infrastructural issues may be barriers exacerbated in rural settings. In lieu of rural specialist services, interorganisational relationships should be leveraged to facilitate referring ‘outwards’ rather than ‘upwards’.
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van Spijker, Bregje A., Jose A. Salinas-Perez, John Mendoza, Tanya Bell, Nasser Bagheri, Mary Anne Furst, Julia Reynolds, et al. "Service availability and capacity in rural mental health in Australia: Analysing gaps using an Integrated Mental Health Atlas." Australian & New Zealand Journal of Psychiatry 53, no. 10 (June 28, 2019): 1000–1012. http://dx.doi.org/10.1177/0004867419857809.
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Objective: Access to services and workforce shortages are major challenges in rural areas worldwide. In order to improve access to mental health care, it is imperative to understand what services are available, what their capacity is and where existing funds might be spent to increase availability and accessibility. The aim of this study is to investigate mental health service provision in a selection of rural and remote areas across Australia by analysing service availability, placement capacity and diversity. Method: This research studies the health regions of Western New South Wales and Country Western Australia and their nine health areas. Service provision was analysed using the DESDE-LTC system for long-term care service description and classification that allows international comparison. Rates per 100,000 inhabitants were calculated to compare the care availability and placement capacity for children and adolescents, adults and older adults. Results: The lowest diversity was found in northern Western Australia. Overall, Western New South Wales had a higher availability of non-acute outpatient services for adults, but hardly any acute outpatient services. In Country Western Australia, substantially fewer non-acute outpatient services were found, while acute services were much more common. Acute inpatient care services were more common in Western New South Wales, while sub-acute inpatient services and non-acute day care services were only found in Western New South Wales. Conclusion: The number and span of services in the two regions showed discrepancies both within and between regions, raising issues on the equity of access to mental health care in Australia. The standard description of the local pattern of rural mental health care and its comparison across jurisdictions is critical for evidence-informed policy planning and resource allocation.
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Pilbeam, Victoria, Lee Ridoutt, and Tony Badrick. "Best Practice Pathology Collection in Australia." Asia Pacific Journal of Health Management 11, no. 1 (December 16, 2018): 50–55. http://dx.doi.org/10.24083/apjhm.v11i1.243.
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Objectives: The specific objectives of the study were to (a) identify current best practice in pathology specimen collection and assess the extent to which Australian pathology services currently satisfy best practice standards; and (b) identify training and other strategies that would mitigate any gaps between current and best practice.
Methods: A total of 22 case studies were undertaken with pathology collector employers from public, not for profit and private pathology organisations andacross urban and rural locations and eight focus groups with pathology collection services consumers were conducted in December 2012 in four different cities.
Results: The preferred minimum qualification of the majority of case study employers for pathology collectors is the nationally recognised Certificate III in Pathology. This qualification maps well to an accepted international best practice guideline for pathology collection competency standards but has some noted deficiencies identified which need to be rectified. These particularly include competencies related to communicating with consumers. The preferred way of training for this qualification is largely through structured and supervised on the job learning experiences supported by theoretical classroom instruction delivered in-house or in off the job settings. The study found a need to ensure a greater proportion of the pathology collection workforce is appropriately qualified.
Conclusion: The most effective pathway to best practice pathology collection requires strong policies that define how pathology samples are to be collected, stored and transported and a pathology collection workforce that is competent and presents to consumers with a credible qualification and in a professional manner.
Abbreviations: CHF – Consumer Health Forum of Australia; KIMMS – Key Incident Monitoring and Management Systems; NAACLS – National Accrediting Agency for Clinical Laboratory Sciences; NACCHO – National Aboriginal Community Controlled Health Organisation; NPAAC – National Pathology Accreditation Advisory Council; RCPA – Royal College of Pathology Australasia; RTO – Registered Training Organisation.
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Jones, Debra, Lindy McAllister, and David Lyle. "Stepping out of the shadows: Allied health student and academic perceptions of the impact of a service-learning experience on student's work-readiness and employability." Journal of Teaching and Learning for Graduate Employability 6, no. 1 (November 4, 2015): 66–87. http://dx.doi.org/10.21153/jtlge2015vol6no1art574.
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Universities, health services and health students have a vested interest in the development of work-ready graduates to improve employment prospects, standards of practice and healthcare outcomes. Work integrated learning supports the transition of theoretical knowledge into professional practice, thus preparing students for their work following graduation. The positive impact of practice experiences on work-readiness and employability is largely assumed. This paper describes the impact of participation in a rural Australian service-learning program on student and academic perceptions of work-readiness and future employability. Qualitative data was gathered from allied health students who participated in inter-professional focus groups and allied health academics who participated in individual interviews. The findings indicate that students were challenged in transitioning from being observational or highly directed learners, described as [being in the] 'shadows' or 'shadowing', to semi-autonomous healthcare providers. Participants reported enhanced perceptions of future employability through 'real work' experiences and identified broader program implications for universities and students. Based on participant experiences, service-learning, a relatively new educational pedagogy in rural health education in Australia, may provide universities, health services, and students with an alternative to acute hospital placements in the development of work-ready attributes for new graduate allied health practitioners.
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Guzys, Diana, Guinever Threlkeld, Virginia Dickson-Swift, and Amanda Kenny. "Rural and regional community health service boards: perceptions of community health – a Delphi study." Australian Journal of Primary Health 23, no. 6 (2017): 543. http://dx.doi.org/10.1071/py16123.
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Much has been written about the composition of health service boards and the importance of recruiting people with skills appropriate for effective and accountable governance of health services. Governance training aims to educate directors on their governance responsibilities; however, the way in which these responsibilities are discharged is informed by board members’ understanding of health within their communities. The aim of this study was to identify how those engaged in determining the strategic direction of local regional or rural community health services in Victoria, Australia, perceived the health and health improvement needs of their community. The Delphi technique was employed to facilitate communication between participants from difference geographic locations. The findings of the study highlight the different ways that participants view the health of their community. Participants prioritised indicators of community health that do not align with standard measures used by government to plan for, fund or report on health. Devolved governance of healthcare services aims to improve local healthcare responsiveness. Yet, if not accompanied with the redistribution of resources and power, policy claimed to promote localised decision-making is simply tokenistic.
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Casey, Mavourneen G., Michael David, and Diann Eley. "Diversity and consistency: a case study of regionalised clinical placements for medical students." Australian Health Review 39, no. 1 (2015): 95. http://dx.doi.org/10.1071/ah14033.
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Objective A major challenge for medical schools is the provision of clinical skills training for increasing student numbers. This case study describes the expansion of the clinical school network at The University of Queensland (UQ). The purpose of the study was to investigate consistency in medical education standards across a regional clinical teaching network, as measured by academic performance. Methods A retrospective analysis of academic records for UQ medical students (n = 1514) completing clinical rotations (2009–2012) was performed using analysis of covariance (ANCOVA) for comparisons between clinical school cohorts and linear mixed-effects modelling (LEM) to assess predictors of academic performance. Results In all, 13 036 individual clinical rotations were completed between 2009 and 2012. ANCOVA found no significant differences in rotation grades between the clinical schools except that Rural Clinical School (RCS) cohorts achieved marginally higher results than non-RCSs in the general practice rotation (5.22 vs 5.10–5.18; P = 0.03) and on the final clinical examination (objective structured clinical examination; 5.27 vs 5.01–5.09; P < 0.01). LEM indicated that the strongest predictor of academic performance on clinical rotations was academic performance in the preclinical years of medical school (β = 0.38; 95% confidence interval 0.35–0.41; P < 0.001). Conclusions The decentralised UQ clinical schools deliver a consistent standard of clinical training for medical students in all core clinical rotations across a range of urban, regional and rural clinical settings. Further research is required to monitor the costs versus benefits of regionalised clinical schools for students, local communities and regional healthcare services. What is known about the topic? To help meet the demand of increasing numbers of students, Australian medical schools locate clinical training outside the traditional tertiary hospitals. However the viability of maintaining teaching standards across regional and rural locations is uncertain. What does this paper add? Maintaining teaching standards outside established urban teaching hospitals and across a diverse range of urban, regional and rural clinical settings is viable. What are the implications for practitioners? Decentralised clinical teaching networks provide consistent quality of clinical placements while diversifying exposure to different patient populations and clinical environments. These important outcomes may not only alleviate the strain on clinical teaching resources, but also help address the maldistribution of doctors in Australia.
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Wade, Victoria, Jeffrey Soar, and Len Gray. "Uptake of telehealth services funded by Medicare in Australia." Australian Health Review 38, no. 5 (2014): 528. http://dx.doi.org/10.1071/ah14090.
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Objective The aim of this study is to identify the extent to which the Medicare item numbers and incentives, introduced in July 2011, have been effective in stimulating telehealth activity in Australia. Methods A retrospective descriptive study utilising data on the uptake of telehealth item numbers and associated in-person services, from July 2011 to April 2014, were obtained from Medicare Australia. The main outcome measures were number of telehealth services over time, plus uptake proportionate to in-person services, by jurisdiction, by speciality, and by patient gender. Results Specialist consultations delivered by video communication and rebated by Medicare rose to 6000 per month, which is 0.24% of the total number of specialist consultations. The highest proportional uptake was in geriatrics and psychiatry. In 52% per cent of video consultations the patient was supported by an on-site healthcare provider, most commonly a general practitioner. There were substantial jurisdictional differences. A significantly lower percentage of female patients were rebated for item 99, which is primarily used by surgeons. Conclusions Medicare rebates and incentives, which are generous by world standards, have resulted in specialist video consultations being provided to underserved areas, although gaps still remain that need new models of care to be developed. What is known about the topic? Video consultations have been rebated by Medicare since July 2011 as a means of increasing access to specialist care in rural areas, aged care facilities and Aboriginal health services. What does this paper add? The uptake of this telehealth initiative has grown over time, but still remains low. For half the video consultations the patient was supported by an on-site healthcare provider, most commonly a general practitioner. Geriatrics and psychiatry are the specialties with the highest proportional uptake. What are the implications for practitioners? New models of care with a greater focus on consultation-liaison with primary care providers need to be developed to realise the potential of this initiative and to fill continuing gaps in services.
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Iansek, Robert, and Mary Danoudis. "Patients’ Perspective of Comprehensive Parkinson Care in Rural Victoria." Parkinson's Disease 2020 (March 31, 2020): 1–7. http://dx.doi.org/10.1155/2020/2679501.
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Introduction. There is a higher prevalence of Parkinson’s disease (PD) in rural Australia and a poorer perceived quality of life of rural Australians with PD. Coordinated multidisciplinary teams specialised and experienced in the treatment of PD are recommended as the preferred model of care best able to manage the complexities of this disorder. There remains a lack of team-based specialised PD services in rural Australia available to people living with PD. This study aims to explore how the lack of specialised PD services impacts on the person’s experiences of the health care they receive in rural Victoria. This study compared the health-care experiences of two different cohorts of people with PD living in rural Victoria; one cohort living in East Gippsland have had an established comprehensive care model implemented with local trained teams and supported by a metropolitan PD centre, and the other cohort was recruited from the remainder of Victoria who had received standard rural care. Methods. This descriptive study used a survey to explore health-care experiences. Questionnaires were mailed to participants living in rural Victoria. Eligibility criteria included having a diagnosis of PD or Parkinsonism and sufficient English to respond to the survey. The validated Patient-Centred Questionnaire for PD was used to measure health-care experiences. The questions are grouped accordingly under one of the 6 subscales or domains. Outcomes from the questionnaire included summary experience scores (SES) for 6 subscales; overall patient-centeredness score (OPS); and quality improvement scores (QIS). Secondary outcomes included health-related quality of life using the disease-specific questionnaire PDQ39; disease severity using the Hoehn and Yahr staging tool; and disability using the Movement Disorders Society-Unified Parkinson’s Disease Rating Scale, part II. Results. Thirty-nine surveys were returned from the East Gippsland group and 68 from the rural group. The East Gippsland group rated significantly more positive the subscales “empathy and PD expertise,” P=0.02, and “continuity and collaboration of professionals,” P=0.01. The groups did not differ significantly for the remaining 4 subscales (P>0.05) nor for the OPS (P=0.17). The QIS showed both groups prioritised the health-care aspect “provision of tailored information” for improvement. Quality of life was greater (P<0.05) and impairment (P=0.012) and disability were less (P=0.002) in the East Gippsland group. Conclusion. Participants who received health care from the East Gippsland program had better key health-care experiences along with better QOL and less impairment and disability. Participants prioritised provision of information as needing further improvement.
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Barrington, Dani, Kathryn Fuller, and Andrew McMillan. "Water safety planning: adapting the existing approach to community-managed systems in rural Nepal." Journal of Water, Sanitation and Hygiene for Development 3, no. 3 (May 6, 2013): 392–401. http://dx.doi.org/10.2166/washdev.2013.120.
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Water Safety Plans (WSPs) improve the quality and secure the quantity of drinking water supplies, and hence improve public health outcomes. In developing countries such as Nepal, thousands of residents die each year as a result of poor water, sanitation and hygiene (WASH) services and WSPs show great promise for improving both health and livelihoods. The Nepali Non-Governmental Organisation Nepal Water for Health (NEWAH) has been working in partnership with Engineers Without Borders Australia and WaterAid Nepal to develop a WSP methodology suited to rural, community-managed water supply systems. Three pilot projects were undertaken incorporating community-based hazard management into the standard World Health Organization and Nepali Department of Water Supply and Sewerage WSP approaches. The successes and challenges of these pilots were assessed, and it was determined that community education, behaviour change, and the distribution of simplified WSP documentation to households and managers were essential to implementing successful WSPs within this context. This new WSP methodology is currently being mainstreamed throughout all of NEWAH's WASH projects in rural Nepal, as well as being shared with the wider Nepali WASH sector.
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Hopper, Bruce, Melissa Buckman, and Matthew Edwards. "Evaluation of Satisfaction of Parents With the Use of Videoconferencing for a Pediatric Genetic Consultation." Twin Research and Human Genetics 14, no. 4 (August 1, 2011): 343–46. http://dx.doi.org/10.1375/twin.14.4.343.
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Telegenetics is a new development in the service delivery of Genetic Services in Australia. This project was designed to establish if it was an acceptable alternative to a face-to-face consultation in the genetic assessment of intellectual disability, including morphological assessment, of the patient. Ten children from two outreach clinics in rural NSW who were referred by their pediatrician were assessed by a single geneticist via telehealth and then seen again face-to-face as a ‘gold standard'. Satisfaction surveys were then sent to both the parents and the referring pediatricians. After the face-to-face appointment, the clinical geneticist reviewed the recordings of both the transmitted footage and the high definition footage that was sent separately. There were very few morphological findings missed by the telegenetic assessments. The discrepancies that were noted could decrease in frequency as staff become more familiar with the methods. The parents of the patients reported no problem with the cameras and telehealth. They would have preferred face-to-face appointment but would be happy to have the telehealth appointment if it meant being seen earlier. This pilot study suggests that clinical genetic diagnostic assessment could be performed by telemedicine.
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Percy, Alisa, and Jo-Anne Kelder. "Editorial: JUTLP Issue 16.5." Journal of University Teaching and Learning Practice 16, no. 5 (December 1, 2019): 2–3. http://dx.doi.org/10.53761/1.16.5.1.
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Welcome to the final issue of the Journal of University Teaching and Learning Practice for 2019. In this issue we have papers from Finland, the US, Ecuador, Thailand and Australia covering a range of topics and approaches exploring university teaching and learning practice. Evaluating an intervention into students’ wellbeing and organising strategies in Finland, Asikanen, Kaipainen and Katajavouri provides evidence that pharmacy students undertaking a 7 week online course designed to promote psychological flexibility had a positive impact on their study behaviors during the intervention. Addressing issues of engagement in first year, Kearney makes the case for his Authentic Self and Peer Assessment for Learning (ASPAL) Model as a particular kind of transition pedagogy that engages students in the development of a deep understanding of assessment expectations and standards of performance. Also focused on student transition, Pattanaphanchai reports on students’ learning achievement and their positive perceptions of the flipped classroom in an introductory computing class in Thailand. Dealing with contentious content in first year, Ford, Bennett and Kilmister report on a study they conducted into pedagogical models in a large first year history subject that services teacher education students and had its own history of heated debate and conflict when exploring the ANZAC mythologies. Considering how content transforms perceptions and values, Njoku reports on a longitudinal evaluation of the use of learner-centred teaching and its impact on learning outcomes in an undergraduate rural public health course in the US. And finally, Freyn introduces the pedagogical strategies used in a LGBTQ literature course in Ecuador, and reports on the results of a phenomenological study of its impact on the participants’ agency in terms of advocacy and support for the LGBTQ community.
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Fry, D. "SYSTEMS OF STANDARDS FOR COMMUNITY HEALTH SERVICES IN AUSTRALIA." International Journal for Quality in Health Care 2, no. 1 (March 1, 1990): 59–67. http://dx.doi.org/10.1093/intqhc/2.1.59.
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Underhill, Craig, Rebecca Bartel, David Goldstein, Helen Snodgrass, Stephen Begbie, Patsy Yates, Kate White, Kathy Jong, and Paul Grogan. "Mapping oncology services in regional and rural Australia." Australian Journal of Rural Health 17, no. 6 (December 2009): 321–29. http://dx.doi.org/10.1111/j.1440-1584.2009.01106.x.
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Littleford, Angela, Debbie Martin, Lee Martinez, and Angela May. "Rural and Metropolitan Community Health: Celebrating the Strengths." Australian Journal of Primary Health 5, no. 3 (1999): 60. http://dx.doi.org/10.1071/py99034.
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The paper outlines the strengths, similarities and differences of metropolitan and rural community health sectors. Case studies are used to look at the history of community health in South Australia, its current status is described and some future directions are proposed. Perspectives are drawn from the authors' collective experiences. Rural and metropolitan community health services in South Australia have developed from different models since they were established in the 1970s. Rural community health services have invariably been established as entities within hospitals and health services, although metropolitan community health services have generally been established as stand alone facilities independent of the acute sector. To illustrate this, two case studies are used to demonstrate the evolution of metropolitan and rural community health services.
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Lessing, Kate, and Ilse Blignault. "Mental health telemedicine programmes in Australia." Journal of Telemedicine and Telecare 7, no. 6 (December 1, 2001): 317–23. http://dx.doi.org/10.1258/1357633011936949.
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A national survey of mental health telemedicine programmes was conducted and data collected on their catchment areas, organizational structure, equipment, clinical and non-clinical activity, and use by populations who traditionally have been poorly served by mental health services in Australia. Of 25 programmes surveyed, information was obtained for 23. Sixteen programmes had dealt with a total of 526 clients during the preceding three months. Of these, 397 (75%) were resident in rural or remote locations at the time of consultation. Thirty-seven (7%) were Aboriginals or Torres Strait Islanders. Only 19 (4%) were migrants from non-English-speaking backgrounds. The programmes provided both direct clinical and secondary support services. Overall, the number of videoconferencing sessions devoted to clinical activity was low, the average being 123 sessions of direct clinical care per programme per year. Videoconferencing was also used for professional education, peer support, professional supervision, administration and linking families. The results of the study suggest that telehealth can increase access to mental health services for people in rural and remote areas, particularly those who have hitherto been poorly served by mental health services in Australia.
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Humphreys, J. S., and H. C. Weinand. "Evaluating consumer preferences for health care services in rural Australia." Australian Geographer 22, no. 1 (May 1991): 44–56. http://dx.doi.org/10.1080/00049189108703020.
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McKinstry, Carol, and Anne Cusick. "Australia needs more occupational therapists in rural mental health services." Australian Occupational Therapy Journal 62, no. 5 (October 2015): 275–76. http://dx.doi.org/10.1111/1440-1630.12229.
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Homer, Caroline S. E., Janice Biggs, Geraldine Vaughan, and Elizabeth A. Sullivan. "Mapping maternity services in Australia: location, classification and services." Australian Health Review 35, no. 2 (2011): 222. http://dx.doi.org/10.1071/ah10908.
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Objective. To describe maternity services available to Australian women and, in particular, the location, classification of services and support services available. Design. A descriptive study was conducted using an online survey that was emailed to eligible hospitals. Inclusion criteria for the study included public and private maternity units with greater than 50 births per year. In total, 278 maternity units were identified. Units were asked to classify their level of acuity (Levels 2–6). Results. A total of 150 (53%) maternity units responded. Those who responded were reasonably similar to those who did not respond, and were representative of Australian maternity units. Almost three-quarters of respondents were from public maternity units and almost 70% defined themselves as being in a rural or remote location. Maternity units with higher birth rates were more likely to classify themselves as providing higher acuity services, that is, Levels 5 and 6. Private maternity units were more likely to have higher acuity classifications. Interventions such as induction of labour, either using an artificial rupture of membranes (ARM) and oxytocin infusion or with prostaglandins, were common across most units. Although electronic fetal monitoring (EFM) was also widely available, access to fetal scalp pH monitoring was low. Conclusion. Maternity service provision varies across the country and is defined predominately by location and annual birth rate. What is known about the topic? In 2007, over 99% of the 289 496 women who gave birth in Australia did so in a hospital. It is estimated that there are more than 300 maternity units in the country, ranging from large tertiary referral centres in major cities to smaller maternity units in rural towns, some of which only provide postnatal care with the woman giving birth at a larger facility. Geographical location, population and ability to attract a maternity workforce determine the number of maternity units within a region, although the means of determining the number of maternity units within a region is often unclear. In recent years, a large number of small maternity units have closed, particularly in rural areas, often due to difficulties securing an adequate workforce, particularly midwives and general practitioner obstetricians. There is a lack of understanding about the nature of maternity service provision in Australia and considerable differences across states and territories. What does this paper add? This paper provides a description of the geographic distribution and level of maternity services, the demand on services, the available obstetric interventions, the level of staffing (paediatric and anaesthetic) and support services available and the private and public mix of maternity units. The paper also provides an exploration of the different interventions and discusses whether these are appropriate, given the level of acuity and access to emergency Caesarean section services. What are the implications for practitioners? This study provides useful information particularly for policy-makers, managers and practitioners. This is at a time when considerable maternity reform is underway and changes at a broader level to the health system are planned. Understanding the nature of maternity services is critical to this debate and ongoing planning decisions.
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Graham, Susan K., and Ian D. Cameron. "A survey of rehabilitation services in Australia." Australian Health Review 32, no. 3 (2008): 392. http://dx.doi.org/10.1071/ah080392.
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A survey, which achieved a 54% response rate, was completed to assess the availability and type of rehabilitation health services in Australia. 1044 surveys were sent out and 561 were returned. The details of a total of 346 rehabilitation services were obtained. There were more services in metropolitan compared with rural areas, more services in New South Wales and Victoria than in the other states, and a higher proportion of services led by health care workers other than rehabilitation physicians in rural compared with metropolitan areas. There is likely to be a need for additional rehabilitation services of all types across Australia. The majority of rural, regional and remote areas are likely to need additional physician-led, allied health and nursing services. Further work is needed to assess the size and catchment areas of services in the capital cities and other large population centres to assess whether additional services are also needed in these areas.
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Draper, Diane. "Preparing for New Health Privacy Legislation in Rural Australia." Health Information Management 31, no. 2 (June 2003): 15–17. http://dx.doi.org/10.1177/183335830303100210.
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This Rural Professional Practice item describes the benefits of a collaborative, regional approach to implementing new health privacy legislation. Videoconferencing has been adopted to surmount the problems of long-distance communication between the Privacy Officers of 11 regional health services spread throughout a large region of south-eastern Australia.
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Collins, Joanne E., Helen Winefield, Lynn Ward, and Deborah Turnbull. "Understanding help seeking for mental health in rural South Australia: thematic analytical study." Australian Journal of Primary Health 15, no. 2 (2009): 159. http://dx.doi.org/10.1071/py09019.
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This study investigated barriers to help seeking for mental health concerns and explored the role of psychological mindedness using semistructured interviews with sixteen adults in a South Australian rural centre. Prior research-driven thematic analysis identified themes of stigma, self-reliance and lack of services. Additional emergent themes were awareness of mental illness and mental health services, the role of general practitioners and the need for change. Lack of psychological mindedness was related to reluctance to seek help. Campaigns, interventions and services promoting mental health in rural communities need to be compatible with rural cultural context, and presented in a way that is congruent with rural values.
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Tan, Amy CW, Lynne M. Emmerton, H. Laetitia Hattingh, and Adam La Caze. "Funding issues and options for pharmacists providing sessional services to rural hospitals in Australia." Australian Health Review 39, no. 3 (2015): 351. http://dx.doi.org/10.1071/ah14081.
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Objective Many of Australia’s rural hospitals operate without an on-site pharmacist. In some, community pharmacists have sessional contracts to provide medication management services to inpatients. This paper discusses the funding arrangements of identified sessional employment models to raise awareness of options for other rural hospitals. Methods Semistructured one-on-one interviews were conducted with rural pharmacists with experience in a sessional employment role (n = 8) or who were seeking sessional arrangements (n = 4). Participants were identified via publicity and referrals. Interviews were conducted via telephone or Skype for ~40–55 min each, recorded and analysed descriptively. Results A shortage of state funding and reliance on federal funding was reported. Pharmacists accredited to provide medication reviews claimed remuneration via these federal schemes; however, restrictive criteria limited their scope of services. Funds pooling to subsidise remuneration for the pharmacists was evident and arrangements with local community pharmacies provided business frameworks to support sessional services. Conclusion Participants were unaware of each other’s models of practice, highlighting the need to share information and these findings. Several similarities existed, namely, pooling funds and use of federal medication review remuneration. Findings highlighted the need for a stable remuneration pathway and business model to enable wider implementation of sessional pharmacist models. What is known about the topic? Many rural hospitals lack an optimal workforce to provide comprehensive health services, including pharmaceutical services. One solution to address medication management shortfalls is employment of a local community pharmacist or consultant pharmacist on a sessional basis in the hospital. There is no known research into remuneration options for pharmacists providing sessional hospital services. What does this paper add? Viability of services and financial sustainability are paramount in rural healthcare. This paper describes and compares the mechanisms initiated independently by hospitals or pharmacists to meet the medication needs of rural hospital patients. Awareness of the funding arrangements provides options for health service providers to extend services to other rural communities. What are the implications for practitioners? Rural practitioners who identify unmet service needs may be inspired to explore funding arrangements successfully implemented by our participants. Innovative use of existing funding schemes has potential to create employment options for rural practitioners and increase provision of services in rural areas.
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Hoodless, Mary, and Frank Evans. "The Multipurpose Service Program: The Best Health Service Option for Rural Australia." Australian Journal of Primary Health 7, no. 1 (2001): 90. http://dx.doi.org/10.1071/py01015.
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Small relatively isolated rural communities in Australia have been provided with the opportunity to address the difficulties surrounding the provision of health services. The Multi Purpose Services (MPS) program was initiated in 1991 when it was identified that small rural communities have been disadvantaged by separated Commonwealth and state funding arrangements and the criteria for these arrangements where services were often unable to be sustained separately. The MPS program provided the opportunity for sustainability through flexibility and pooling of resources. The application of a primary health care framework would enable more community consultation and participation in reorientating rural health services. Upper Murray Health and Community Services (UMH&CS), a small rural health service in North East Victoria, embraced the concept and undertook a rigorous Evidence Based Needs Assessment to reorientate its health service. The needs assessment combined a sociodemographic, epidemiological and community consultative approach. Evidence of best practice was identified and the recommendations were used for ongoing service development. UMH&CS represents a highly integrated health service and as such a number of strategies are used to enable the continuum of care. These include point of contact advocacy, continuum and coordination of care and the use of a standardised multidisciplinary assessment and outcome based care plan. This paper expands on these processes and the opportunities the MPS has provided to address the health needs of small rural communities.
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Islam, Md Irteja, Claire O’Neill, Hibah Kolur, Sharif Bagnulo, Richard Colbran, and Alexandra Martiniuk. "Patient-Reported Experiences and Satisfaction with Rural Outreach Clinics in New South Wales, Australia: A Cross-Sectional Study." Healthcare 10, no. 8 (July 26, 2022): 1391. http://dx.doi.org/10.3390/healthcare10081391.
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Introduction: Many studies have been conducted on how physicians view outreach health services, yet few have explored how rural patients view these services. This study aimed to examine the patient experience and satisfaction with outreach health services in rural NSW, Australia and the factors associated with satisfaction. Methods: A cross-sectional study was conducted among patients who visited outreach health services between December 2020 and February 2021 across rural and remote New South Wales, Australia. Data on patient satisfaction were collected using a validated questionnaire. Both bivariate (chi-squared test) and multivariate analyses (logistic regression) were performed to identify the factors associated with the outcome variable (patient satisfaction). Results: A total of 207 participants were included in the study. The mean age of respondents was 58.6 years, and 50.2% were men. Ninety-three percent of all participants were satisfied with the outreach health services. Respectful behaviours of the outreach healthcare practitioners were significantly associated with the higher patient satisfaction attending outreach clinics. Conclusions: The current study demonstrated a high level of patient satisfaction regarding outreach health services in rural and remote NSW, Australia. Further, our study findings showed the importance of collecting data about patient satisfaction to strengthen outreach service quality.
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Rosen, Alan, Vivienne Miller, and Gordon Parker. "Standards of Care for Area Mental Health Services." Australian & New Zealand Journal of Psychiatry 23, no. 3 (September 1989): 379–95. http://dx.doi.org/10.3109/00048678909068296.
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A provisional set of standards of care was derived from a quality assurance strand of a wider research project, which reported the development of evaluation strategies for area integrated mental health services (AIMHS). In contrast to most published standards, they apply to all facets of care in a comprehensive catchment area mental health service, whether clinical or functional, community or hospital based, urban or rural, or managed by the public, private or voluntary sectors. We review briefly existing sets of standards of mental health services and report the process of development of standards of care, each with sub-sets of performance indicators and examples. While the AIMHS standards and a companion quality assurance manual are still undergoing refinement, they offer a guide for mental health professionals to the provision of services, and a checklist to service-users of services that should be available to them at every stage of care in a mental health system.
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Rosen, Alan, Vivienne Miller, and Gordon Parker. "Standards of Care for Area Mental Health Services." Australian & New Zealand Journal of Psychiatry 23, no. 3 (September 1989): 379–95. http://dx.doi.org/10.1177/000486748902300325.
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A provisional set of standards of care was derived from a quality assurance strand of a wider research project, which reported the development of evaluation strategies for area integrated mental health services (AIMHS). In contrast to most published standards, they apply to all facets of care in a comprehensive catchment area mental health service, whether clinical or functional, community or hospital based, urban or rural, or managed by the public, private or voluntary sectors. We review briefly existing sets of standards of mental health services and report the process of development of standards of care, each with sub-sets of performance indicators and examples. While the AIMHS standards and a companion quality assurance manual are still undergoing refinement, they offer a guide for mental health professionals to the provision of services, and a checklist to service-users of services that should be available to them at every stage of care in a mental health system.
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Jo Wainer. "Rural Women's Health." Australian Journal of Primary Health 4, no. 3 (1998): 80. http://dx.doi.org/10.1071/py98033.
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Rural women in Australia have reduced access to health and illness-management services, live in more hazardous environments, and yet describe themselves as healthier than urban women. These contradictions illustrate some of the consequences of different ways of measuring health. Data based on presentations to hospital for episodes of illness management, within a conceptual framework of biomedicine which has been developed with little input from women, presents one picture of the health of a community. Data based on asking women what is going on provides another picture. These different pictures highlight the distinction between health and illness management. This article introduces the reader to rural culture, considers some of the epidemiological evidence about the presentation of illness and mortality for rural women, summarises the outcomes of research and consultations with women, and concludes by making recommendations about effective ways to enhance rural women's health through service delivery.
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Barr, Megan, Kerry Dally, and Jill Duncan. "Services for children with hearing loss in urban and rural Australia." Australian Journal of Rural Health 28, no. 3 (June 2020): 281–91. http://dx.doi.org/10.1111/ajr.12613.
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Bryant, Lia, Bridget Garnham, Deirdre Tedmanson, and Sophie Diamandi. "Tele-social work and mental health in rural and remote communities in Australia." International Social Work 61, no. 1 (November 27, 2015): 143–55. http://dx.doi.org/10.1177/0020872815606794.
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Rural and remote communities often have complex and diverse mental health needs and inadequate mental health services and infrastructure. Information and communication technologies (ICTs) provide an array of potentially innovative and cost-effective means for connecting rural and remote communities to specialist mental health practitioners, services, and supports, irrespective of physical location. However, despite this potential, a review of Australian and international literature reveals that ICT has not attained widespread uptake into social work practice or implementation in rural communities. This article reviews the social work literature on ICT, draws on research on tele-psychology and tele-education, and provides suggestions on how to enhance engagement with ICT by social workers to implement and provide mental health services and supports tailored to community values, needs, and preferences that are commensurate with the values of the social work profession.
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Kocanda, Lucy, Karin Fisher, Leanne J. Brown, Jennifer May, Megan E. Rollo, Clare E. Collins, Andrew Boyle, and Tracy L. Schumacher. "Informing telehealth service delivery for cardiovascular disease management: exploring the perceptions of rural health professionals." Australian Health Review 45, no. 2 (2021): 241. http://dx.doi.org/10.1071/ah19231.
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ObjectiveTo explore the perceptions of rural health professionals who use telehealth services for cardiovascular health care, including the potential role of telehealth in enhancing services for this patient group. MethodsSemi-structured interviews were conducted with ten rural health professionals across a range of disciplines, including medicine, nursing and allied health. All study participants were based in the same rural region in New South Wales, Australia. ResultsParticipant responses emphasised the importance of including rural communities in ongoing dialogue to enhance telehealth services for cardiovascular care. Divergent expectations about the purpose of telehealth and unresolved technology issues were identified as factors to be addressed. Rural health professionals highlighted the importance of all stakeholders coming together to overcome barriers and enhance telehealth services in a collaborative manner. ConclusionThis study contributes to an evolving understanding of how health professionals based in regional Australia experience telehealth services. Future telehealth research should proceed in collaboration with rural communities, supported by policy that actively facilitates the meaningful inclusion of rural stakeholders in telehealth dialogue. What is known about the topic?Telehealth is frequently discussed as a potential solution to overcome aspects of rural health, such as poor outcomes and limited access to services compared with metropolitan areas. In the context of telehealth and cardiovascular disease (CVD), research that focuses on rural communities is limited, particularly regarding the experiences of these communities with telehealth. What does this paper add?This paper offers insight into how telehealth is experienced by rural health professionals. The paper highlights divergent expectations of telehealth’s purpose and unresolved technological issues as barriers to telehealth service delivery. It suggests telehealth services may be enhanced by collaborative approaches that engage multiple stakeholder groups. What are the implications for practitioners?The use and development of telehealth in rural communities requires a collaborative approach that considers the views of rural stakeholders in their specific contexts. To improve telehealth services for people living with CVD in rural communities, it is important that rural stakeholders have opportunities to engage with non-rural clinicians, telehealth developers and policy makers.
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Moffatt, Jennifer J., and Diann S. Eley. "The reported benefits of telehealth for rural Australians." Australian Health Review 34, no. 3 (2010): 276. http://dx.doi.org/10.1071/ah09794.
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Objective.A literature review was conducted to identify the reported benefits attributed to telehealth for people living and professionals working in rural and remote areas of Australia. Data sources.Scopus and relevant journals and websites were searched using the terms: telemedicine, telehealth, telepsychiatry, teledermatology, teleradiology, Australia, and each state and territory. Publications since 1998 were included. Study selection.The initial search resulted in 176 articles, which was reduced to 143 when research reporting on Australian rural, regional or remote populations was selected. Data synthesis.A narrative review was conducted using an existing ‘benefits’ framework. Patients are reported to have benefited from: lower costs and reduced inconvenience while accessing specialist health services; improved access to services and improved quality of clinical services. Health professionals are reported to have benefited from: access to continuing education and professional development; provision of enhanced local services; experiential learning, networking and collaboration. Discussion.Rural Australians have reportedly benefited from telehealth. The reported improved access and quality of clinical care available to rural Australians through telemedicine and telehealth may contribute to decreasing the urban–rural health disparities. The reported professional development opportunities and support from specialists through the use of telehealth may contribute to improved rural medical workforce recruitment and retention. What is known about the topic?An extensive international literature has reported on the efficacy of telehealth, and to a lesser extent the clinical outcomes and cost-effectiveness of telemedicine. Systematic reviews conclude that the quality of the studies preclude definitive conclusions being drawn about clinical and cost-effectiveness, although there is some evidence of effective clinical outcomes and the potential for cost-benefits. Little attention has been paid to the benefits reported for people who live in rural and remote Australia, despite this being a rationale for the use of telehealth in rural and remote locations. What does this paper add?Patients in rural and remote locations in Australia are reported to benefit from telehealth by increased access to health services and up-skilled health professionals. Health professionals are reported to benefit from telehealth by up-skilling from increased contact with specialists and increased access to professional development. The review findings suggest that one strategy, the increased use of telehealth, has the potential to reduce the inequitable access to health services and the poorer health status that many rural Australians experience, and contribute to addressing the on-going problem of the recruitment and retention of the rural health workforce. What are the implications for practitioners?The use of telehealth appears to be a path to up-skilling for rural and remote practitioners.
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Ward, Bernadette, Julie Ellis, and Karen Anderson. "Barriers to the provision of home and community care services to culturally and linguistically diverse populations in rural Australia." Australian Journal of Primary Health 11, no. 2 (2005): 147. http://dx.doi.org/10.1071/py05033.
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In 2002, qualitative methods in the form of in-depth interviews and focus groups were used to gather data from culturally and linguistically diverse (CALD) population residents, service providers and key stakeholders across rural Victoria, to identify and describe barriers to the effective delivery of home services to people from CALD populations in rural Australia. Barriers to the provision of Home and Community Care (HACC) services to CALD populations in rural areas were not specific to HACC programs. For CALD residents, barriers included lack of information about the range of available services, cultural factors, and negative past and recent experiences in dealing with both the broader community and service providers. Service providers indicated lack of information about the profile of the local CALD population and lack of experience in working with these groups to be barriers. Communication was also an issue both for CALD residents and service providers, in terms of cultural factors and specific communication strategies such as inadequate printed material and under-utilisation of existing resources such as interpreter services. As one of the world?s most ethno-culturally diverse nations, Australia has a responsibility to provide health services that are culturally responsive and acceptable. Greater attention needs to be given to the needs of rural CALD population groups in accessing home services.
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Lawn, Sharon, Elaine Waddell, Taryn Cowain, Carol Turnbull, and Janne McMahon. "Implementing national mental health carer partnership standards in South Australia." Australian Health Review 44, no. 6 (2020): 880. http://dx.doi.org/10.1071/ah19156.
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ObjectiveThe aim of this study was to describe the current state of carer engagement and partnership in two mental health (MH) services in South Australia and the implementation of the six partnership standards in A Practical Guide to Working with Carers of People with a Mental Illness. MethodsAnonymous surveys of carer experiences and clinician self-ratings of their own practice against the six partnership standards were completed by 94 staff and 58 carers within public and private MH in-patient units before and after exposure of clinicians to education about the partnership standards. Descriptive statistical analysis was performed and, where applicable, a comparative analysis used the two-sample Z-test of proportions. Qualitative data was analysed thematically. ResultsConsiderable gaps were evident between carer experiences and clinician self-ratings of their own practice. Overall, the surveys point to the lack of a consistent approach by both public and private services, and suggest potential barriers to fostering carer participation and engagement. Confidentiality was a particularly noted barrier to partnership with carers. ConclusionSignificant improvement is needed to meet the partnership standards. Brief exposure to the Guide is not, in itself, sufficient to effect change in the overall attitudes, skills and knowledge of clinical staff about engaging carers. Significantly more focus on staff education, clinical discussions and supervision is needed to meet the MH carer partnership standards. What is known about the topic?Partnership with MH consumers and carers is an established key principle within national MH policies and accreditation standards. Family carers play an important role in supporting consumers’ recovery, yet many carers continue to report being excluded, particularly by in-patient clinical staff. What does this paper add?This is the first study to investigate the partnership standards in practice by comparing the perspectives of carers and in-patient MH clinical staff. What are the implications for practitioners?Improving partnership with carers of people with mental illness will require significant MH service leadership support shifts in current practice and culture. In addition, a more nuanced understanding of confidentiality is required to overcome the barriers to involving family carers more meaningfully in care.
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Lakra, V. "Telehealth in Australia." European Psychiatry 65, S1 (June 2022): S569. http://dx.doi.org/10.1192/j.eurpsy.2022.1457.
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Introduction There is a significant psychiatry workforce shortage in Australia, particularly in rural and remote communities. Given the large distances involved, telehealth – providing consultation via videoconference – has been widely accepted. Psychiatrists were among the highest users of telehealth services in Australia before the COVID-19 pandemic. However, the outbreak of COVID-19 resulted in a major transformation to service delivery across Australia. Private psychiatrists and state public mental health services had to rapidly transition to largely telehealth delivery to ensure continuity of care for consumers. In March 2020, additional telehealth item numbers were added to the Australian Medicare Benefits Schedule (MBS) to encourage physical distancing for those accessing medical services during the pandemic. Objectives To provide an overview of the increase in telehealth activity since the COVID-19 pandemic. Methods The MBS is the list of services for which the Australian Government will pay a rebate. Key data on MBS telehealth activity since March 2020 was examined. Results The use of telehealth has increased during the pandemic. A survey of Royal Australian and New College of Psychiatrists (RANZCP) psychiatrists found that 93% supported retention of telehealth MBS item number numbers following the COVID-19 pandemic, noting increased accessibility for consumers. Positive feedback has been received from consumers. Conclusions During 2020 and 2021, the RANZCP worked with the Australian Government to ensure there were appropriate MBS telehealth services available for consumers. The RANZCP continues to work with the Government as they plan for a longer-term transformation of telehealth services beyond 2021. Disclosure No significant relationships.
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Longman, Jo, Jennifer M. Pilcher, Deborah A. Donoghue, Margaret Rolfe, Sue V. Kildea, Sue Kruske, Jeremy J. N. Oats, Geoffrey G. Morgan, and Lesley M. Barclay. "Identifying maternity services in public hospitals in rural and remote Australia." Australian Health Review 38, no. 3 (2014): 337. http://dx.doi.org/10.1071/ah13188.
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Objective This paper articulates the importance of accurately identifying maternity services. It describes the process and challenges of identifying the number, level and networks of rural and remote maternity services in public hospitals serving communities of between 1000 and 25 000 people across Australia, and presents the findings of this process. Methods Health departments and the national government’s websites, along with lists of public hospitals, were used to identify all rural and remote Australian public hospitals offering maternity services in small towns. State perinatal reports were reviewed to establish numbers of births by hospital. The level of maternity services and networks of hospitals within which services functioned were determined via discussion with senior jurisdictional representatives. Results In all, 198 rural and remote public hospitals offering maternity services were identified. There were challenges in sourcing information on maternity services to generate an accurate national picture. The nature of information about maternity services held centrally by jurisdictions varied, and different frameworks were used to describe minimum requirements for service levels. Service networks appeared to be based on a combination of individual links, geography and transport infrastructure. Conclusions The lack of readily available centralised and comparable information on rural and remote maternity services has implications for policy review and development, equity, safety and quality, network development and planning. Accountability for services and capacity to identify problems is also compromised. What is known about the topic? Australian birthing services have previously been identified for hospitals with 50 or more births a year. Less is known about public hospitals with fewer than 50 births a year or those with only antenatal and postnatal services, particularly in rural and remote locations, or how maternity services information may be identified from publicly available sources. What does this paper add? This paper describes the process and challenges of identifying maternity services in rural and remote public hospitals serving towns of between 1000 and 25 000, and presents the findings of this process. What are the implications for practitioners? Nationally accessible, reliable and comparable information is important for health planners, policy makers and health practitioners. This paper provides useful information on the variations in the capability and location of maternity services across Australia. Opportunities exist for consistent collection, collation and reporting of maternity services across rural and remote Australia. This will ensure quality and safety of services, contribute to policy review, support the development and maintenance of service networks, and assist in planning services and expenditure, as well as in the identification of problems. It is therefore key to providing equitable services across the country.
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O'Sullivan, Belinda G., Matthew R. McGrail, Catherine M. Joyce, and Johannes Stoelwinder. "Service distribution and models of rural outreach by specialist doctors in Australia: a national cross-sectional study." Australian Health Review 40, no. 3 (2016): 330. http://dx.doi.org/10.1071/ah15100.
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Objective This paper describes the service distribution and models of rural outreach by specialist doctors living in metropolitan or rural locations. Methods The present study was a national cross-sectional study of 902 specialist doctors providing 1401 rural outreach services in the Medicine in Australia: Balancing Employment and Life study, 2008. Five mutually exclusive models of rural outreach were studied. Results Nearly half of the outreach services (585/1401; 42%) were provided to outer regional or remote locations, most (58%) by metropolitan specialists. The most common model of outreach was drive-in, drive-out (379/902; 42%). In comparison, metropolitan-based specialists were less likely to provide hub-and-spoke models of service (odd ratio (OR) 0.31; 95% confidence interval (CI) 0.21–0.46) and more likely to provide fly-in, fly-out models of service (OR 4.15; 95% CI 2.32–7.42). The distance travelled by metropolitan specialists was not affected by working in the public or private sector. However, rural-based specialists were more likely to provide services to nearby towns if they worked privately. Conclusions Service distribution and models of outreach vary according to where specialists live as well as the practice sector of rural specialists. Multilevel policy and planning is needed to manage the risks and benefits of different service patterns by metropolitan and rural specialists so as to promote integrated and accessible services. What is known about this topic? There are numerous case studies describing outreach by specialist doctors. However, there is no systematic evidence describing the distribution of rural outreach services and models of outreach by specialists living in different locations and the broad-level factors that affect this. What does this paper add? The present study provides the first description of outreach service distribution and models of rural outreach by specialist doctors living in rural versus metropolitan areas. It shows that metropolitan and rural-based specialists have different levels of service reach and provide outreach through different models. Further, the paper highlights that practice sector has no effect on metropolitan specialists, but private rural specialists limit their travel distance. What are the implications for practitioners? The complexity of these patterns highlights the need for multilevel policy and planning approaches to promote integrated and accessible outreach in rural and remote Australia.
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OʼTarpey, Margie. "Quality Improvement, Standards, and Accreditation for Community Health Services in Australia, 1983–1995." Journal of Public Health Management and Practice 4, no. 4 (July 1998): 37–43. http://dx.doi.org/10.1097/00124784-199807000-00013.
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Buckley, Dermot, and Tony Lower. "Factors influencing the utilisation of health services by rural men." Australian Health Review 25, no. 2 (2002): 11. http://dx.doi.org/10.1071/ah020011.
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This research identified the barriers and enablers that influence the utilisation of health services by rural men in the Midwest region of Western Australia. The methodology was based on participatory action research, including qualitative assessments to determine the issues for a larger quantitative study. Four variables were identified as predictors for the use of health services: those who attended for preventive reasons; those not affected by seasonal work;men who thought a medical telephone line was not important; and those who did not consider privacy an important issue. Modification of health service delivery to men could potentially enhance appropriate utilisation of health services in rural areas.
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Chater, Alan B. "Looking after health care in the bush." Australian Health Review 32, no. 2 (2008): 313. http://dx.doi.org/10.1071/ah080313.
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LOOKING AFTER health care in rural Australia involves providing adequate services to meet the urgent and non-urgent needs of rural patients in a timely, cost-effective and safe manner. The very provision of these services requires an appropriate workforce and facilities in rural areas. This provides challenges for clinicians, administrators and medical educators. While preventive medicine has made some significant gains globally in reducing the need for acute care and hospitalisation in some areas of medicine such as infectious disease and asthma, these demands have been replaced by an increase in trauma, chronic disease and mental illness1 which, with an ageing population, eventually means presentations at an older age which can require hospitalisation. Rural patients have always had to deal with a relative undersupply of health practitioners. Rural people have coped valiantly with this. The legendary stoicism of rural people has been shown by Schrapnel2 and Davies to be a prominent feature of the rural personality. This both allowed them to cope with lack of services and to suffer in silence while their health status fell below the Australian average.3 Rural Australians use fewer Medicare services and see the doctor less per annum than the Australian average.
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Chauhan, Sanjay L., Beena N. Joshi, Neena Raina, and Ragini N. Kulkarni. "Utilization of quality assessments in improving adolescent reproductive and sexual health services in rural block of Maharashtra, India." International Journal Of Community Medicine And Public Health 5, no. 4 (March 23, 2018): 1639. http://dx.doi.org/10.18203/2394-6040.ijcmph20181249.
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Background: The present study was conducted with an objective to evaluate the quality of ARSH services; assess if these services met the National Standards of care and to utilize periodic program improvement recommendations through the WHO - quality assessment (QA) tools. Quality of ARSH services at twenty public health facilities in a rural block of a state in India were assessed using WHO-QA tools with a pre-test post-test interrupted time series design.Methods: Seven standards of care addressing provision of quality ARSH services (Standard I-IV); demand generation for these services (V-VI); and management information system (Standard VII) were assessed using WHO-QA tools for five years (2009-2014). Data analysis was done using Excel scoring template developed jointly with WHO. Scores were given for each standard and to each facility.Results: Periodic interventions resulted in improving the average facility score from 27% to 83% and overall standards score from 28% to 81% at baseline and endline survey respectively. The average scores for Standards I-IV improved from 43% 86%; for standards V–VI from 3% to 66% while for standard VII from 16% to 92% at baseline and endline survey respectively.Conclusions: Appropriate QA and periodic evidence-informed program inputs improved the quality and utilization of ARSH services. However, community outreach activities continued to be challenging. The assessment demonstrated feasibility and usefulness of using the WHO-QA tools to monitor and improve the quality of ARSH services.
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Kruger, Estie, Irosha Perera, and Marc Tennant. "Primary oral health service provision in Aboriginal Medical Services-based dental clinics in Western Australia." Australian Journal of Primary Health 16, no. 4 (2010): 291. http://dx.doi.org/10.1071/py10028.
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Australians living in rural and remote areas have poorer access to dental care. This situation is attributed to workforce shortages, limited facilities and large distances to care centres. Against this backdrop, rural and remote Indigenous (Aboriginal) communities in Western Australia seem to be more disadvantaged because evidence suggests they have poorer oral health than non-Indigenous people. Hence, provision of dental care for Aboriginal populations in culturally appropriate settings in rural and remote Western Australia is an important public health issue. The aim of this research was to compare services between the Aboriginal Medical Services (AMS)-based clinics and a typical rural community clinic. A retrospective analysis of patient demographics and clinical treatment data was undertaken among patients who attended the dental clinics over a period of 6 years from 1999 to 2004. The majority of patients who received dental care at AMS dental clinics were Aboriginal (95.3%), compared with 8% at the non-AMS clinic. The rate of emergency at the non-AMS clinic was 33.5%, compared with 79.2% at the AMS clinics. The present study confirmed that more Indigenous patients were treated in AMS dental clinics and the mix of dental care provided was dominated by emergency care and oral surgery. This indicated a higher burden of oral disease and late utilisation of dental care services (more focus on tooth extraction) among rural and remote Indigenous people in Western Australia.
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Prior, Sarah Jane, Nicole S. Reeves, and Steven J. Campbell. "Challenges of delivering evidence‐based stroke services for rural areas in Australia." Australian Journal of Rural Health 28, no. 1 (February 2020): 15–21. http://dx.doi.org/10.1111/ajr.12579.
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Moorhouse, Christopher, Maria George, and Beth Smith. "Palliative Care in Rural Australia: Involving the Community in Multidisciplinary Coordinated Care." Australian Journal of Primary Health 6, no. 4 (2000): 141. http://dx.doi.org/10.1071/py00047.
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This paper describes the process and outcomes of a project aimed at promoting community based multidisciplinary coordinated palliative care services in rural Australia. In preliminary health service needs assessment in rural Tasmania, key health workers appealed for additional information, support and education in palliative care. They expressed a preference for this education to be delivered locally to strengthen existing knowledge in communities and to take into account contextual factors. The project aimed to enhance skills available in rural communities by involving key stakeholders including formal and informal carers, volunteers, clergy, pharmacists, community nurses and general practitioners. The project objective was to strengthen existing expertise and commitment in rural communities, enabling service providers to respond to community needs in a sustainable way. This was achieved by facilitating options for sustainable linkages and ongoing support and through outreach programs from urban Palliative Care Units. An important element in this was the Tasmanian Telehealth network, which harnesses videoconferencing, digital diagnostic equipment and image transmission technologies to offer access to healthcare services to Tasmania's rural and isolated communities. The process centred on workshops facilitated by a multidisciplinary team, which provided information about the core components of palliative care. The paper reports on the responses of health professionals and community participants to the workshops.
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Burke, David, Ayse Burke, and Jacqueline Huber. "Psychogeriatric SOS (services-on-screen) – a unique e-health model of psychogeriatric rural and remote outreach." International Psychogeriatrics 27, no. 11 (July 29, 2015): 1751–54. http://dx.doi.org/10.1017/s1041610215001131.
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Mental health service delivery to rural and remote communities can be significantly impeded by the tyranny of distance. In Australia, rural and remote mental health services are characterized by limited resources stretched across geographically large and socio-economically disadvantaged regions (Inderet al., 2012; Thomaset al., 2012). Internationally, rural and remote area mental health workforce shortages are common, especially in relation to specialist mental health services for older people (McCarthyet al., 2012; Bascuet al., 2012).
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Fitzpatrick, Scott J., Tonelle Handley, Nic Powell, Donna Read, Kerry J. Inder, David Perkins, and Bronwyn K. Brew. "Suicide in rural Australia: A retrospective study of mental health problems, health-seeking and service utilisation." PLOS ONE 16, no. 7 (July 21, 2021): e0245271. http://dx.doi.org/10.1371/journal.pone.0245271.
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Background Suicide rates are higher in rural Australia than in major cities, although the factors contributing to this are not well understood. This study highlights trends in suicide and examines the prevalence of mental health problems and service utilisation of non-Indigenous Australians by geographic remoteness in rural Australia. Methods A retrospective study of National Coronial Information System data of intentional self-harm deaths in rural New South Wales, Queensland, South Australia and Tasmania for 2010–2015 from the National Coronial Information System. Results There were 3163 closed cases of intentional self-harm deaths by non-Indigenous Australians for the period 2010–2015. The suicide rate of 12.7 deaths per 100,000 persons was 11% higher than the national Australian rate and increased with remoteness. Among people who died by suicide, up to 56% had a diagnosed mental illness, and a further 24% had undiagnosed symptoms. Reported diagnoses of mental illness decreased with remoteness, as did treatment for mental illness, particularly in men. The most reported diagnoses were mood disorders (70%), psychotic disorders (9%) and anxiety disorders (8%). In the six weeks before suicide, 22% of cases had visited any type of health service at least once, and 6% had visited two or more services. Medication alone accounted for 76% of all cases treated. Conclusions Higher suicide rates in rural areas, which increase with remoteness, may be attributable to decreasing diagnosis and treatment of mental disorders, particularly in men. Less availability of mental health specialists coupled with socio-demographic factors within more remote areas may contribute to lower mental health diagnoses and treatment. Despite an emphasis on improving health-seeking and service accessibility in rural Australia, research is needed to determine factors related to the under-utilisation of services and treatment by specific groups vulnerable to death by suicide.
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Nancarrow, Susan A., Alison Roots, Sandra Grace, and Vahid Saberi. "Models of care involving district hospitals: a rapid review to inform the Australian rural and remote context." Australian Health Review 39, no. 5 (2015): 494. http://dx.doi.org/10.1071/ah14137.
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Objectives District hospitals are important symbolic structures in rural and remote communities; however, little has been published on the role, function or models of care of district hospitals in rural and remote Australia. The aim of the present study was to identify models of care that incorporate district hospitals and have relevance to the Australian rural and remote context. Methods A systematic, rapid review was conducted of published peer-reviewed and grey literature using CINAHL, Medline, PsychInfo, APAIS-Health, ATSI health, Health Collection, Health & Society, Meditext, RURAL, PubMed and Google Scholar. Search terms included ‘rural’, ‘small general and district hospitals’, ‘rural health services organisation & administration’, ‘medically underserved area’, ‘specific conditions, interventions, monitoring and evaluation’, ‘regional, rural and remote communities’, ‘NSW’, ‘Australia’ and ‘other OECD countries’ between 2002 and 2013. Models of teaching and education, multipurpose services centres, recruitment and/or retention were excluded. Results The search yielded 1626 articles and reports. Following removal of duplicates, initial screening and full text screening, 24 data sources remained: 21 peer-reviewed publications and three from the grey literature. Identified models of care related specifically to maternal and child health, end-of-life care, cancer care services, Aboriginal health, mental health, surgery and emergency care. Conclusion District hospitals play an important role in the delivery of care, particularly at key times in a person’s life (birth, death, episodes of illness). They enable people to remain in or near their own community with support from a range of services. They also play an important role in the essential fabric of the community and the vertical integration of the health services. What is known about the topic? Little has been published on the function of small-to-medium district hospitals in rural and remote Australia, and almost nothing is known about models of care that are relevant to these settings. What does this paper add? District hospitals form an important part of vertically integrated models of care in Australia. Effective models of care aim to keep health services close to home. There is scope for networked models of care that keep health care within the community supported by hub-and-spoke models of service delivery. What are the implications for practitioners? This review found limited evidence on the skill mix required in district hospitals; however, the skill mix underpins the extent of service and speciality that can be provided locally, particularly with regard to the provision of surgery and emergency services. International evidence suggests that providing surgical services locally can help increase the sustainability of smaller hospitals because they typically provide high return, short episodes of care; however, this depends on the funding model being used. Similarly, the skill mix of staff required to sustain a functioning emergency department brings a skill base that supports a higher level of expertise across the hospital.
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Radha Prabhu, V., Armita Hanley, and Sue Kearney. "Evaluation of a hospital volunteer program in rural Australia." Australian Health Review 32, no. 2 (2008): 265. http://dx.doi.org/10.1071/ah080265.
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A voluntary survey questionnaire that assessed experience with and perception of the volunteering program was mailed to 62 current and 9 former volunteers and 47 staff members of Latrobe Regional Hospital (LRH). Sixty-one completed questionnaires were returned. The nature of hospital work attracted volunteers (57%) and most volunteers felt oriented to the hospital, supervised and supported. The volunteers enjoyed working with patients and felt they contributed to better services and staff and patient support. There was a need felt that more training and development, recognition, orientation and supervision would be beneficial. Overall, most volunteers rated their experience as good (60%) to excellent (25%). Staff rated the contribution from volunteers as good (41%) to excellent (47%). Volunteers identified several areas of improvement, including opportunities for further training and supervision. Volunteers play a crucial role within the health care system. There is tremendous scope for further development of the volunteer role and increasing opportunities for training and development, recognition and encouragement.
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Dew, Angela, Gisselle Gallego, Kim Bulkeley, Craig Veitch, Jennie Brentnall, Michelle Lincoln, Anita Bundy, and Scott Griffiths. "Policy Development and Implementation for Disability Services in Rural New South Wales, Australia." Journal of Policy and Practice in Intellectual Disabilities 11, no. 3 (September 2014): 200–209. http://dx.doi.org/10.1111/jppi.12088.
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Ireland, Sarah, Suzanne Belton, and Frances Doran. "‘I didn’t feel judged’: exploring women’s access to telemedicine abortion in rural Australia." Journal of Primary Health Care 12, no. 1 (2020): 49. http://dx.doi.org/10.1071/hc19050.
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ABSTRACT INTRODUCTIONRegardless of geographical location, safe and legal abortion is an essential reproductive health service. Accessing an abortion is problematic for women in rural areas. Although telemedicine is globally established as safe and effective for medical abortion in urban settings, there is a paucity of research exploring access to telemedicine abortion for women in rural locations. AIMThe aim of this qualitative research is to explore and better understand women’s access to telemedicine abortion in Australian rural areas. METHODSStructured interviews were conducted with women (n=11) living in rural areas who had experienced a telemedicine abortion within the last 6 months. Phone interviews were recorded and transcribed verbatim. Data underwent a Patient-Centred Access framework analysis and were coded according to the domain categories of approachability/ability to perceive, acceptability/ability to seek, availability/ability to reach, affordability/ability to pay, and appropriateness/ability to engage. RESULTSRural women had severely limited access to abortion care. The five domains of the Patient-Centred Access model demonstrated that when women with the prerequisite personal skills and circumstances are offered a low-cost service with compassionate staff and technical competence, telemedicine can innovate to ensure rural communities have access to essential reproductive health services. DISCUSSIONTelemedicine offers an innovative model for ensuring women’s access to medical abortion services in rural areas of Australia and likely has similar applicability to international non-urban contexts. Strategies are needed to ensure women with lower literacy and less favourable situational contexts, can equitably access abortion services through telemedicine.