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Wakerman, John, and Cindy Shannon. "Strengthening primary health care to improve Indigenous health outcomes." Medical Journal of Australia 204, no. 10 (June 2016): 363–64. http://dx.doi.org/10.5694/mja16.00031.
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Crowshoe, Lynden (Lindsay), Anika Sehgal, Stephanie Montesanti, Cheryl Barnabe, Andrea Kennedy, Adam Murry, Pamela Roach, et al. "The Indigenous primary health care and policy research network: Guiding innovation within primary health care with Indigenous peoples in Alberta." Health Policy 125, no. 6 (June 2021): 725–31. http://dx.doi.org/10.1016/j.healthpol.2021.02.007.
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McMurray, Anne, and Rani Param. "Culture-specific care for Indigenous people: A primary health care perspective." Contemporary Nurse 28, no. 1-2 (April 2008): 165–72. http://dx.doi.org/10.5172/conu.673.28.1-2.165.
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Boudville, Andrea I., Mitchell D. Anjou, and Hugh R. Taylor. "Improving eye care for Indigenous Australians in primary health care settings." Australian Journal of Rural Health 21, no. 2 (April 2013): 121–27. http://dx.doi.org/10.1111/ajr.12014.
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Henderson, Rita, Stephanie Montesanti, Lindsay Crowshoe, and Charles Leduc. "Advancing Indigenous primary health care policy in Alberta, Canada." Health Policy 122, no. 6 (June 2018): 638–44. http://dx.doi.org/10.1016/j.healthpol.2018.04.014.
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Rankoana, Sejabaledi A. "Indigenous Plant-Derived Medical Applications for Primary Health Care." International Journal of Social Science Research and Review 5, no. 11 (November 5, 2022): 163–68. http://dx.doi.org/10.47814/ijssrr.v5i11.719.
Повний текст джерелаАнотація:
Traditional medicine is an important primary health care resource for many people and has been acknowledged as a necessary component of reaching universal health. The purpose of this research is to offer an overview of indigenous plant-derived medicinal applications administered to treat current human ailments. The data were collected via a mixed-methods research in four Bapedi communities in South Africa's Limpopo Province. The research documented six different techniques for administering indigenous plant-derived medications, including decoction, infusion, steam bath, incense, poultice, and powder. These uses are determined by the kind of plant material employed and the type of illness being treated. For instance, a leaf poultice is applied directly to wounds to promote healing, while decoctions and infusions of the root, bark, and bulb are used as purgatives and enemas to treat gastrointestinal diseases and as emetics to alleviate cough. Steam baths and incense inhalation increase sweat, which is beneficial in the treatment of fever and cough. The standard dose for decoctions and infusions is a teacup, but there are no accounts of particular dosages for poultices, steam, ash, burned root, or leaf sap. This research advises hastening the process of authenticating traditional medicine in order to assure optimal practices, such as accurate dosage uses for medications.
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MacLean, Sarah, Angela Harney, and Kerry Arabena. "Primary health-care responses to methamphetamine use in Australian Indigenous communities." Australian Journal of Primary Health 21, no. 4 (2015): 384. http://dx.doi.org/10.1071/py14126.
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Crystal methamphetamine (commonly known as ‘ice’) use is currently a deeply concerning problem for some Australian Indigenous peoples and can cause serious harms to individual, families and communities. This paper is intended to support best practice responses by primary health-care staff working with Australian Indigenous people who use methamphetamine. It draws on a systematic search of relevant databases to identify literature from January 1999 to February 2014, providing an overview of prevalence, treatment, education and harm reduction, and community responses. The prevalence of methamphetamine use is higher in Indigenous than non-Indigenous communities, particularly in urban and regional settings. No evidence was identified that specifically related to effective treatment and treatment outcomes for Indigenous Australians experiencing methamphetamine dependence or problematic use. While studies involving methamphetamine users in the mainstream population suggest that psychological and residential treatments show short-term promise, longer-term outcomes are less clear. Community-driven interventions involving Indigenous populations in Australia and internationally appear to have a high level of community acceptability; however, outcomes in terms of methamphetamine use are rarely evaluated. Improved national data on prevalence of methamphetamine use among Indigenous people and levels of treatment access would support service planning. We argue for the importance of a strength-based approach to addressing methamphetamine use, to counteract the stigma and despair that frequently accompanies it.
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Shahaed, Heba, Guneet Sandhu, and Eric Seidlitz. "Reviewing Inequities in Primary Care Received by Indigenous Peoples in Ontario." Sciential - McMaster Undergraduate Science Journal, no. 5 (December 4, 2020): 21–28. http://dx.doi.org/10.15173/sciential.v1i5.2542.
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Research has shown that Indigenous peoples in Canada experience health inequities when compared to the non-Indigenous population. High quality primary care has been described in literature; however, this has not been explored through the lens of Indigenous health. A scoping review was performed in order to investigate the quality of primary care received by indigenous peoples in Ontario. To conduct this review, a search of current literature on primary care in Indigenous communities in Ontario was performed. The studies examined in this review were derived from four different databases and many evaluated specific communities using a qualitative and quantitative approach. Several themes were identified including inadequate preparation and training of health care providers, physician and nursing shortages, strategies associated with improved quality of care, management of mental health, disparities in health service delivery station types and ineffective primary care impacts on hospitalizations. This literature search demonstrated a clear gap in the literature on the quality of primary care received by the Indigenous population in Ontario. Thus, further research is necessary in order to outline the current state of primary care being delivered to Indigenous populations in Ontario, and develop strategies to enhance the quality of care for this population.
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Diehl, Eliana Elisabeth, and Esther Jean Langdon. "Indigenous participation in primary care services in Brazil." Regions and Cohesion 8, no. 1 (March 1, 2018): 54–76. http://dx.doi.org/10.3167/reco.2018.080104.
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English abstract:In 1990, the Brazilian Unified Health System institutionalized new relationships between the government and society. In recognition of the inequalities and inequities inflicted upon Indigenous Peoples, the Indigenous Health Subsystem was established in 1999. Roles were created for the democratic exercise of Indigenous participation and prominence in three border spaces: Indigenous health agents as members of health teams; Indigenous representatives on health councils; and Indigenous organizations as primary care providers. This article explores these spaces based on ethnographic research from southern Brazil. It concludes that the roles created for Indigenous participation and governance are ambiguous and contradictory. When participating in new opportunities created by the government, Indigenous actors are subjected to a centralized and bureaucratized system that offers little possibility of autonomous decision- making or action.Spanish abstract:En 1990, el Sistema Único de Salud institucionalizó nuevas relaciones entre el gobierno y la sociedad, estableciendo en 1999 el Subsistema de Salud Indígena. Se crearon nuevos roles para el ejercicio democrático de la participación indígena con prominencia en tres espacios de frontera: agentes indígenas de salud como miembros de los equipos de salud; representantes indígenas en los consejos de salud; y organizaciones indígenas como proveedores de atención primaria. Este artículo explora estos espacios basado en investigación etnográfi ca del sur de Brasil. Se concluye que los roles creados para la participación y gobernanza indígena son ambiguos y contradictorios. Cuando se participa en nuevas oportunidades creadas por el gobierno, los actores indígenas son sometidos a un sistema que ofrece poca posibilidad de tomar decisiones autónomas o actuar.French abstract:1990 le système unique de santé brésilien, le SUS (Sistema Único de Saúde) institutionnalisait de nouvelles relations entre le gouvernement et la société en donnant aux usagers un rôle central et en leur att ribuant une large participation dans tous les secteurs des soins. En reconnaissance des inégalités et iniquités historiques infl igées aux peuples indigènes, le sous-système de soin indigène fut établi en 1999. De nouveaux rôles furent créés pour l’exercice démocratique de la participation indigène et sa reconnaissance dans trois zones d’action et de communication délimitées. Cet article explore ces espaces sur la base de recherches ethnographiques réalisées au Sud du Brésil et conclut que les rôles créés pour la participation indigène et la notion associée de gouvernance sont souvent ambigus et contradictoires.
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Turner, Lyle, Tim Albers, Adrian Carson, Carmel Nelson, Renee Brown, and Marianna Serghi. "Building a regional health ecosystem: a case study of the Institute for Urban Indigenous Health and its System of Care." Australian Journal of Primary Health 25, no. 5 (2019): 424. http://dx.doi.org/10.1071/py19038.
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Efforts to address Indigenous health disadvantage require a refocus on urban settings, where a rapidly increasing majority (79%) of Indigenous Australians live. Proximity to mainstream primary care has not translated into health equity, with the majority of the Indigenous burden of disease (73%) remaining in urban areas and urban Indigenous people continuing to face significant barriers in accessing comprehensive and culturally appropriate care. This paper presents a case study of how the Institute for Urban Indigenous Health (IUIH) has strategically responded to these challenges in South East Queensland – home to Australia’s largest and equal fastest growing Indigenous population. The IUIH has developed a new regional and systematised model – a regional health ‘ecosystem’ – for how primary care is delivered and intersects with the broader health system. Through intentional action, which strengthens the self-efficacy of community, the IUIH System of Care has delivered real gains for the Indigenous population of the region and has the capacity to deliver similar improvements in health access and outcomes in other regions.
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Rumbold, Alice R., Ross S. Bailie, Damin Si, Michelle C. Dowden, Catherine M. Kennedy, Rhonda J. Cox, Lynette O'Donoghue, et al. "Assessing the quality of maternal health care in Indigenous primary care services." Medical Journal of Australia 192, no. 10 (May 2010): 597–98. http://dx.doi.org/10.5694/j.1326-5377.2010.tb03646.x.
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Harfield, S., C. Davy, A. McArthur, Z. Munn, A. Brown, and N. Brown. "Characteristics of Indigenous primary health care models of service delivery." International Journal of Evidence-Based Healthcare 14, no. 4 (December 2016): 200. http://dx.doi.org/10.1097/01.xeb.0000511345.04823.36.
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Roach, Pamela, Meagan Ody, Paige Campbell, Cara Bablitz, Ellen Toth, Adam Murry, Rita Henderson, et al. "Access, relationships, quality and safety (ARQS): a qualitative study to develop an Indigenous-centred understanding of virtual care quality." BMJ Open Quality 11, no. 4 (December 2022): e002028. http://dx.doi.org/10.1136/bmjoq-2022-002028.
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BackgroundAmong Indigenous peoples in Canada, access to high-quality healthcare remains an important determinant of health. The shift to virtual and remote-based approaches, expedited during the COVID-19 pandemic, influenced the ways in which individuals accessed care and the quality of care received. This study sought to determine which elements are required for effective and sustainable virtual care approaches for delivery of primary care to Indigenous patients and develop quality indicators grounded in Indigenous community and experience. We share a conceptual framework to understand how Indigenous patients access and define high-quality virtual care, grounded in Indigenous patient experiences and worldviews.MethodsUsing principles of patient-oriented research, we grounded this work in social justice and participatory action research. We sought to gain an in-depth understanding of the Indigenous experiences of virtual care and specifically of primary care. This was developed through semistructured interviews with Indigenous patients and Indigenous virtual primary care providers.ResultsThirteen participants were interviewed between 5 August 2021 and 25 October 2021. Using Framework Analysis, we constructed four domains including access, relationships, quality and safety as being primary facets of defining high-quality Indigenous virtual primary care.DiscussionThe results presented here indicate that the shift to virtual care, largely seen in response to the COVID-19 pandemic, does not compromise quality of care, nor does it lead to negative patient experiences. Optimal care is possible in virtual settings for some care needs and types of appointments and has the potential to decrease barriers to access and improve patient experiences of safety and quality while facilitating patient/provider relationships.ConclusionIn summary, high-quality Indigenous virtual care benefits from attention to patients’ experiences of access, relationships, safety and quality with their service providers and healthcare teams.
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Sam, Johanna, Chris G. Richardson, and Leanne M. Currie. "Application of Two-Eyed Seeing in Adolescent Mental Health to Bridge Design Thinking and Indigenous Collective Storytelling." International Journal of Environmental Research and Public Health 19, no. 22 (November 14, 2022): 14972. http://dx.doi.org/10.3390/ijerph192214972.
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Background: eMental health apps are increasingly being considered for use in health care with growing recognition of the importance of considering end-user preferences in their design and implementation. The key to the success of using apps with Indigenous youth is tailoring the design and content to include Indigenous perspectives. In this study we used a Two-Eyed Seeing perspective to integrate Indigenous and human computer interaction methodologies to identify end-user preferences for a tablet-based mental health screening app used in a primary care clinic serving Indigenous youth. Objective: The research objectives used a Two-Eyed Seeing approach to (i) collectively create stories about Indigenous youth lived experiences accessing integrated primary care for their mental health concerns; and (ii) engage Indigenous youth in Design Circles to determine their usability preferences for digital mental health screening tools. Method: Eight adolescents (n = 4 young women; n = 3 young men; and n = 1 Two Spirit) between 20 to 24 years old who self-identified as Indigenous participated. Indigenous youth joined Design Circles to co-create a story about accessing mental health care and their needs and preferences for an eMental Health app. Results: Findings highlighted the importance of collective Indigenous storytelling about accessing integrated primary care for mental health needs. Participants created three persona stories about their challenges accessing mental health care and the role of social support. Participants sorted their usability design preferences for an eMental Health app to be inclusive of Indigenous knowledges. Conclusions: A Two-Eyed Seeing perspective was useful to incorporate a design thinking approach as collective storytelling among Indigenous youth. This research may inform and shape the design of eMental health apps used in health clinics to better engage Indigenous youth.
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Cuesta-Briand, Beatriz, Sherry Saggers, and Alexandra McManus. "‘It still leaves me sixty dollars out of pocket’: experiences of diabetes medical care among low-income earners in Perth." Australian Journal of Primary Health 20, no. 2 (2014): 143. http://dx.doi.org/10.1071/py12096.
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Diabetes prevalence is increasing in Australia, and there are stark inequities in prevalence and clinical outcomes experienced by Indigenous people and low socioeconomic groups compared with non-Indigenous and socioeconomically advantaged groups. This paper explores the impact of Indigenous status and socioeconomic disadvantage on the experience of diabetes care in the primary health setting. Data were collected through focus groups and interviews. The sample, comprising 38 participants (Indigenous and non-Indigenous), was recruited from disadvantaged areas in Perth, Australia. Data analysis was mainly deductive and based on a conceptual framework for the relationship between socioeconomic position and diabetes health outcomes. Most participants reported accessing general practitioners regularly; however, evidence of access to dietitians and podiatrists was very limited. Perceived need, cost, lack of information on available services and previous negative experiences influenced health care-seeking behaviour. Complexity and lack of coordination characterised the model of care reported by most participants. In contrast, Indigenous participants accessing an Aboriginal community-controlled health organisation reported a more accessible and coordinated experience of care. Our analysis suggests that Indigenous and socioeconomically disadvantaged people tailor their health care-seeking behaviour to the limitations imposed by their income and disadvantaged circumstances. To reduce inequities in care experiences, diabetes services in primary care need to be accessible and responsive to the needs of such groups in the community.
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Schmidt, Barbara, Sandra Campbell, and Robyn McDermott. "Community health workers as chronic care coordinators: evaluation of an Australian Indigenous primary health care program." Australian and New Zealand Journal of Public Health 40, S1 (November 11, 2015): S107—S114. http://dx.doi.org/10.1111/1753-6405.12480.
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Haswell-Elkins, Melissa, Ernest Hunter, Tricia Nagel, Carolyn Thompson, Brenda Hall, Robert Mills, Rachael Wargent, Komla Tsey, Leanne Knowles, and Yvonne Wilkinson. "Reflections on integrating mental health into primary health care services in remote Indigenous communities in Far North Queensland and the Northern Territory." Australian Journal of Primary Health 11, no. 2 (2005): 62. http://dx.doi.org/10.1071/py05023.
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At present, there is a perceived and functional separation of mental health services from the general delivery of primary health care services in remote Indigenous communities in most places in the country. There are a range of issues underlying this separation; many are historical but continue to influence patterns of thinking about mental and physical health. With the increasing shift of focus of care at primary level from being largely reactive to presentations of acute illnesses towards proactive and strategically guided approaches to the management of chronic diseases, coupled with similar national strategic documents guiding mental health care into a primary health care format, the opportunity to integrate the provision of mental and physical health care has never been better. Accompanying this integration should be a reflection and improvement on models of care that address needs of Indigenous people in a more culturally and contextually appropriate manner, as is clearly defined in an increasing range of Indigenous health policy documents. This paper will begin with a summary of the link between mental and physical health supported by key references. It will then briefly reflect on the current organisation of mental and physical health services in remote Indigenous settings of Far North Queensland and the Northern Territory, identifying some of the major disadvantages being experienced. The paper will close with a description of the approach and some early outcomes to address these issues by the Indigenous Stream of the AIMhi project (Australian Integrated Mental Health Initiative), which is a major National Health & Medical Research Council (NH&MRC) Strategic Partnership initiative that began implementing a framework of research activities in mid-2003.
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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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Harriss, Linton R., Fintan Thompson, Kenny Lawson, Mary O'Loughlin, and Robyn McDermott. "Preventable hospitalisations in regional Queensland: potential for primary health?" Australian Health Review 43, no. 4 (2019): 371. http://dx.doi.org/10.1071/ah18033.
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Objective The aims of this study were to: (1) use local health data to examine potentially preventable hospitalisations (PPHs) as a proportion of total hospital separations and estimated costs to a large regional hospital in northern Queensland, including differences associated with Indigenous status; and (2) identify priority conditions and discuss issues related to strategic local primary health intervention. Methods A cross-sectional analysis was conducted using Queensland Hospital Admitted Patient Data Collection data (July 2012–June 2014) restricted to 51087 separations generated by 29485 local residents. PPHs were identified from the International Statistical Classification of Diseases and Related Health Problems 10th Revision Australian Modification (ICD-10-AM) and procedure codes using National Healthcare Agreement definitions. Age-standardised separation rates were calculated using Australian 2001 reference population and associated economic costs were estimated using Australian-refined diagnosis related groups. Results Eleven per cent (n=5488) of all hospital separations were classified as PPH, and most were for common chronic (n=2486; 45.3%) and acute (n=2845; 51.8%) conditions. Because many acute presentations reflect chronic underlying disease, chronic conditions account for up to 76.5% of all PPHs. Age-standardised PPH rates were 3.4-fold higher for Indigenous than non-Indigenous people. Associated 2-year costs were AU$32.7million, which was 10.7% of estimated total health care expenditure for hospital separations, and were higher for Indigenous (14.9%) than non-Indigenous (9.7%) people. Conclusions High hospitalisation rates and costs for common preventable chronic conditions represent opportunities for primary healthcare interventions. In particular, community-level health services need to be more responsive to the needs of local Indigenous families. What is known about the topic? PPH rates are used as a measure of timely access to quality primary health care, and are incrementally higher in regional and remote areas than in major cities. Investment in primary healthcare services has been shown to significantly reduce costs associated with avoidable hospitalisations. What does this paper add? This study used local health data to identify the most common PPH conditions presenting to a large regional hospital in northern Queensland, including estimation of costs and differences associated with Indigenous status. Recommendations are made to strengthen primary healthcare and reduce hospital-related costs. What are the implications for practitioners? Interventions to address high PPH rates should be tailored to meet the needs of the local population. Primary health strategies targeting common chronic conditions provide the greatest opportunity to reduce avoidable hospitalisations and costs in this regional area. Investment in collaborative, evidence-based interventions is recommended and justified, especially for Indigenous Australians.
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Shakeshaft, Anthony, Anton Clifford, and Maree Shakeshaft. "Reducing alcohol related harm experienced by Indigenous Australians: identifying opportunities for Indigenous primary health care services." Australian and New Zealand Journal of Public Health 34 (July 2010): S41—S45. http://dx.doi.org/10.1111/j.1753-6405.2010.00552.x.
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Chopra, Sahil, Tahne Joseph Lahiff, Richard Franklin, Alex Brown, and Roy Rasalam. "Effective primary care management of type 2 diabetes for indigenous populations: A systematic review." PLOS ONE 17, no. 11 (November 10, 2022): e0276396. http://dx.doi.org/10.1371/journal.pone.0276396.
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Background Indigenous peoples in high income countries are disproportionately affected by Type 2 Diabetes. Socioeconomic disadvantages and inadequate access to appropriate healthcare are important contributors. Objectives This systematic review investigates effective designs of primary care management of Type 2 Diabetes for Indigenous adults in Australia, Canada, New Zealand, and the United States. Primary outcome was change in mean glycated haemoglobin. Secondary outcomes were diabetes-related hospital admission rates, treatment compliance, and change in weight or Body Mass Index. Methods Included studies were critically appraised using Joanna Briggs Institute appraisal checklists. A mixed-method systematic review was undertaken. Quantitative findings were compared by narrative synthesis, meta-aggregation of qualitative factors was performed. Results Seven studies were included. Three reported statistically significant reductions in means HbA1c following their intervention. Seven components of effective interventions were identified. These were: a need to reduce health system barriers to facilitate access to primary care (which the other six components work towards), an essential role for Indigenous community consultation in intervention planning and implementation, a need for primary care programs to account for and adapt to changes with time in barriers to primary care posed by the health system and community members, the key role of community-based health workers, Indigenous empowerment to facilitate community and self-management, benefit of short-intensive programs, and benefit of group-based programs. Conclusions This study synthesises a decade of data from communities with a high burden of Type 2 Diabetes and limited research regarding health system approaches to improve diabetes-related outcomes. Policymakers should consider applying the seven identified components of effective primary care interventions when designing primary care approaches to mitigate the impact of Type 2 Diabetes in Indigenous populations. More robust and culturally appropriate studies of Type 2 Diabetes management in Indigenous groups are needed. Trail registration Registered with PROSPERO (02/04/2021: CRD42021240098).
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Corso, Melissa, Astrid DeSouza, Ginny Brunton, Hainan Yu, Carolina Cancelliere, Silvano Mior, Anne Taylor-Vaisey, Kathy MacLeod-Beaver, and Pierre Côté. "Integrating Indigenous healing practices within collaborative care models in primary healthcare in Canada: a rapid scoping review." BMJ Open 12, no. 6 (June 2022): e059323. http://dx.doi.org/10.1136/bmjopen-2021-059323.
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ObjectivesIn November 2020, a series of reports, In Plain Sight, described widespread Indigenous-specific stereotyping, racism and discrimination limiting access to medical treatment and negatively impacting the health and wellness of Indigenous Peoples in British Columbia, Canada. To address the health inequalities experienced by Indigenous peoples, Indigenous healing practices must be integrated within the delivery of care. This rapid scoping review aimed to identify and synthesise strategies used to integrate Indigenous healing practices within collaborative care models available in community-based primary healthcare, delivered by regulated health professionals in Canada.Eligibility criteriaWe included quantitative, qualitative and mixed-methods studies conducted in community-based primary healthcare practices that used strategies to integrate Indigenous healing practices within collaborative care models.Sources of evidenceWe searched MEDLINE, Embase, Indigenous Studies Portal, Informit Indigenous Collection and Native Health Database for studies published from 2015 to 2021.Charting methodsOur data extraction used three frameworks to categorise the findings. These frameworks defined elements of integrated healthcare (ie, functional, organisational, normative and professional), culturally appropriate primary healthcare and the extent of community engagement. We narratively summarised the included study characteristics.ResultsWe identified 2573 citations and included 31 in our review. Thirty-nine per cent of reported strategies used functional integration (n=12), 26% organisational (n=8), 19% normative (n=6) and 16% professional (n=5). Eighteen studies (58%) integrated all characteristics of culturally appropriate Indigenous healing practices into primary healthcare. Twenty-four studies (77%) involved Indigenous leadership or collaboration at each phase of the study and, seven (23%) included consultation only or the level of engagement was unclear.ConclusionsWe found that collaborative and Indigenous-led strategies were more likely to facilitate and implement the integration of Indigenous healing practices. Commonalities across strategies included community engagement, elder support or Indigenous ceremony or traditions. However, we did not evaluate the effectiveness of these strategies.
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Strobel, Natalie A., Kimberley McAuley, Veronica Matthews, Alice Richardson, Jason Agostino, Ross Bailie, Karen M. Edmond, and Daniel McAullay. "Understanding the structure and processes of primary health care for young indigenous children." Journal of Primary Health Care 10, no. 3 (2018): 267. http://dx.doi.org/10.1071/hc18006.
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ABSTRACT INTRODUCTION Primary health care organisations need to continuously reform to more effectively address current health challenges, particularly for vulnerable populations. There is growing evidence that optimal health service structures are essential for producing positive outcomes. AIM To determine if there is an association between process of care indicators (PoCIs) for important young indigenous child health and social issues and: (i) primary health-care service and child characteristics; and (ii) organisational health service structures. METHODS This was a cross-sectional study of 1554 clinical child health audits and associated system assessments from 74 primary care services from 2012 to 2014. Composite PoCIs were developed for social and emotional wellbeing, child neurodevelopment and anaemia. Crude and adjusted logistic regression models were fitted, clustering for health services. Odds ratios and 95% confidence intervals were derived. RESULTS Overall, 32.0% (449) of records had a social and emotional wellbeing PoCI, 56.6% (791) had an anaemia PoCI and 49.3% (430) had a child neurodevelopment PoCI. Children aged 12–23 months were significantly more likely to receive all PoCIs compared to children aged 24–59 months. For every one point increase in assessment scores for team structure and function (aOR 1.14, 95% CI 1.01–1.27) and care planning (aOR 1.14, 95% CI 1.01–1.29) items, there was a 14% greater odds of a child having an anaemia PoCI. Social and emotional wellbeing and child neurodevelopment PoCIs were not associated with system assessment scores. DISCUSSION Ensuring young indigenous children aged 24–59 months are receiving quality care for important social and health indicators is a priority. Processes of care and organisational systems in primary care services are important for the optimal management of anaemia in indigenous children.
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Michiel Oosterveer, Tim, and T. Kue Young. "Primary health care accessibility challenges in remote indigenous communities in Canada's North." International Journal of Circumpolar Health 74, no. 1 (January 31, 2015): 29576. http://dx.doi.org/10.3402/ijch.v74.29576.
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Muller, Megan K. "Colonial Geographies: Indigenous Access to Primary Care in British Columbia." Medical Anthropology 41, no. 3 (January 18, 2022): 359–72. http://dx.doi.org/10.1080/01459740.2021.2021901.
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Harriss, Linton R., Fintan Thompson, Kenny Lawson, Mary O’Loughlin, and Robyn McDermott. "Corrigendum to: Preventable hospitalisations in regional Queensland: potential for primary health?" Australian Health Review 43, no. 4 (2019): 483. http://dx.doi.org/10.1071/ah18033_co.
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Objective The aims of this study were to: (1) use local health data to examine potentially preventable hospitalisations (PPHs) as a proportion of total hospital separations and estimated costs to a large regional hospital in northern Queensland, including differences associated with Indigenous status; and (2) identify priority conditions and discuss issues related to strategic local primary health intervention.Methods A cross-sectional analysis was conducted using Queensland Hospital Admitted Patient Data Collection data (July 2012–June 2014) restricted to 51087 separations generated by 29485 local residents. PPHs were identified from the International Statistical Classification of Diseases and Related Health Problems 10th Revision Australian Modification (ICD-10-AM) and procedure codes using National Healthcare Agreement definitions. Age-standardised separation rates were calculated using Australian 2001 reference population and associated economic costs were estimated using Australian-refined diagnosis related groups.Results Eleven per cent (n=5488) of all hospital separations were classified as PPH, and most were for common chronic (n=2486; 45.3%) and acute (n=2845; 51.8%) conditions. Because many acute presentations reflect chronic underlying disease, chronic conditions account for up to 76.5% of all PPHs. Age-standardised PPH rates were 3.4-fold higher for Indigenous than non-Indigenous people. Associated 2-year costs were AU$32.7million, which was 10.7% of estimated total health care expenditure for hospital separations, and were higher for Indigenous (14.9%) than non-Indigenous (9.7%) people.Conclusions High hospitalisation rates and costs for common preventable chronic conditions represent opportunities for primary healthcare interventions. In particular, community-level health services need to be more responsive to the needs of local Indigenous families.What is known about the topic? PPH rates are used as a measure of timely access to quality primary health care, and are incrementally higher in regional and remote areas than in major cities. Investment in primary healthcare services has been shown to significantly reduce costs associated with avoidable hospitalisations.What does this paper add? This study used local health data to identify the most common PPH conditions presenting to a large regional hospital in northern Queensland, including estimation of costs and differences associated with Indigenous status. Recommendations are made to strengthen primary healthcare and reduce hospital-related costs.What are the implications for practitioners? Interventions to address high PPH rates should be tailored to meet the needs of the local population. Primary health strategies targeting common chronic conditions provide the greatest opportunity to reduce avoidable hospitalisations and costs in this regional area. Investment in collaborative, evidence-based interventions is recommended and justified, especially for Indigenous Australians.
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Lavoie, Josée G., and Judith Dwyer. "Implementing Indigenous community control in health care: lessons from Canada." Australian Health Review 40, no. 4 (2016): 453. http://dx.doi.org/10.1071/ah14101.
Повний текст джерелаАнотація:
Objective Over past decades, Australian and Canadian Indigenous primary healthcare policies have focused on supporting community controlled Indigenous health organisations. After more than 20 years of sustained effort, over 89% of eligible communities in Canada are currently engaged in the planning, management and provision of community controlled health services. In Australia, policy commitment to community control has also been in place for more than 25 years, but implementation has been complicated by unrealistic timelines, underdeveloped change management processes, inflexible funding agreements and distrust. This paper discusses the lessons from the Canadian experience to inform the continuing efforts to achieve the implementation of community control in Australia. Methods We reviewed Canadian policy and evaluation grey literature documents, and assessed lessons and recommendations for relevance to the Australian context. Results Our analysis yielded three broad lessons. First, implementing community control takes time. It took Canada 20 years to achieve 89% implementation. To succeed, Australia will need to make a firm long term commitment to this objective. Second, implementing community control is complex. Communities require adequate resources to support change management. And third, accountability frameworks must be tailored to the Indigenous primary health care context to be meaningful. Conclusions We conclude that although the Canadian experience is based on a different context, the processes and tools created to implement community control in Canada can help inform the Australian context. What is known about the topic? Although Australia has promoted Indigenous control over primary healthcare (PHC) services, implementation remains incomplete. Enduring barriers to the transfer of PHC services to community control have not been addressed in the largely sporadic attention to this challenge to date, despite significant recent efforts in some jurisdictions. What does this paper add? The Canadian experience indicates that transferring PHC from government to community ownership requires sustained commitment, adequate resourcing of the change process and the development of a meaningful accountability framework tailored to the sector. What are the implications for practitioners? Policy makers in Australia will need to attend to reform in contractual arrangements (towards pooled or bundled funding), adopt a long-term vision for transfer and find ways to harmonise the roles of federal and state governments. The arrangements achieved in some communities in the Australian Coordinated Care Trials (and still in place) provide a model.
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Barnabe, Cheryl, Jean Miller, Sylvia Teare, Casey Eaglespeaker, Brenda Roland, Nicole Eshkakogan, Lindsay Crowshoe, Elena Lopatina, and Deborah Marshall. "Solution Model for Enhancing the Experiences of Urban First Nations and Métis Patients Accessing and Navigating the Health System for Inflammatory Arthritis Care." International Indigenous Policy Journal 10, no. 2 (May 10, 2019): 1–13. http://dx.doi.org/10.18584/iipj.2019.10.2.3.
Повний текст джерелаАнотація:
Health system innovations that better support Indigenous patients, particularly in urban settings, exist in primary health services, but this has not been translated and integrated into specialty care. We sought to identify the experiences of urban First Nations and Métis patients with inflammatory arthritis in accessing and navigating the health system. We used a qualitative research method called Patient and Community Engagement Research Program (PaCER) led by patients using an iterative three phase process: Set, Collect, and Reflect. Initial access and continuity of specialty care can be facilitated with collaboration between primary and specialty care in an urban Indigenous health service model, where health system change was built on culturally responsive models of care.
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Fleuriet, K. Jill. "Health and Health Care Problems Among the Kumiai of San Antonio Necua and Their Indigenous Relatives in Baja California." Californian Journal of Health Promotion 1, no. 1 (March 1, 2003): 140–57. http://dx.doi.org/10.32398/cjhp.v1i1.1670.
Повний текст джерелаАнотація:
The rural Kumiai community of San Antonio Necua is one of the few remaining indigenous communities in Baja California, Mexico. Necuan health and health care problems are best understood through a consideration of the effects of colonialism and marginalization on indigenous groups in northern Baja California as well as a tradition of medical pluralism in Mexico. The lack of traditional healers and biomedical providers in the community, high rates of preventable or manageable illnesses, and a blend of biomedical, folk mestizo, and traditional indigenous beliefs about health and illness reflect current conditions of rural poverty and economic isolation. Descriptions of health and health care problems are based on ethnographic fieldwork among the Kumiai, their Paipai relatives, and their primary nongovernmental aid organization.
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Fleuriet, K. Jill. "Health and Health Care Problems Among the Kumiai of San Antonio Necua and Their Indigenous Relatives in Baja California." Californian Journal of Health Promotion 1, no. 1 (March 1, 2003): 140–57. http://dx.doi.org/10.32398/cjhp.v1i1.389.
Повний текст джерелаАнотація:
The rural Kumiai community of San Antonio Necua is one of the few remaining indigenous communities in Baja California, Mexico. Necuan health and health care problems are best understood through a consideration of the effects of colonialism and marginalization on indigenous groups in northern Baja California as well as a tradition of medical pluralism in Mexico. The lack of traditional healers and biomedical providers in the community, high rates of preventable or manageable illnesses, and a blend of biomedical, folk mestizo, and traditional indigenous beliefs about health and illness reflect current conditions of rural poverty and economic isolation. Descriptions of health and health care problems are based on ethnographic fieldwork among the Kumiai, their Paipai relatives, and their primary nongovernmental aid organization.
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Lennon, Robert P., Kristian Camilo Orduña Lopez, Javier Andres Moreno Socha, Fabián Eduardo García Montealegre, Jerry W. Chandler, Nicholas N. Sweet, Lesley A. Hawley, Dustin K. Smith, and Kristian E. Sanchack. "Health Characteristics of the Wayuu Indigenous People." Military Medicine 184, no. 7-8 (February 22, 2019): e230-e235. http://dx.doi.org/10.1093/milmed/usz021.
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Abstract Introduction The identified number of isolated populations with unique medical characteristics is growing. These populations are difficult to study. Civil-military humanitarian operations are part of our medical force readiness training, and are also a venue through which unique populations can be simultaneously served and evaluated. Continuing Promise 2017 was a collaborative effort between the US Navy, non-governmental organizations, and the Colombian Ministry of Health, Navy and Army to provide primary medical care to the Wayuu indigenous people in the La Guajira Department of Colombia. Materials and Methods In the course of providing primary care services, demographic and health data of the Wayuu people were collected. Descriptive statistics were used to generate averages, and t-tests were used to compare Wayuu means with age and gender matched US means for weight and age in children and blood pressure in adults. Observational data on skin afflictions and arthritis were also collected. This project was approved by Naval Medical Center Portsmouth Institutional Review Board. Results Although the Wayuu live in an arid desert with chronic sun exposure, they have no apparent affliction from squamous cell carcinoma or melanoma. They live almost exclusively through manual labor, yet rarely develop osteoarthritic joint disease. Their incidence of hypertension is 35% lower than their US age and gender matched cohort. Although their region is known for extreme poverty and malnutrition, their weight-for-age curve from 2 months through 17 years is similar to their US cohort. Conclusions This study is the first to document the general health characteristics of the Wayuu people. It demonstrates that in addition to providing important readiness training to our own personnel, humanitarian missions can provide medical care and explore unique, isolated populations. Although retrospective and limited in size, it can be used to shape future medical missions to their region, and will hopefully stimulate formal research into their remarkable characteristics.
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Bailie, Ross, Beverly Sibthorpe, Karen Gardner, and Damin Si. "Quality improvement in Indigenous primary health care: History, current initiatives and future directors." Australian Journal of Primary Health 14, no. 2 (2008): 53. http://dx.doi.org/10.1071/py08022.
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This paper addresses the question: "What is the current situation for Aboriginal primary health care services in relation to continuous quality improvement (CQI) in clinical care and what is needed for sustainable practice to be achievable five years from now?" The paper describes a number of recent CQI initiatives that evolved within an accountability framework, the origins of which are based on a top-down government approach to performance measurement. Over the last decade there has been a shift to a more negotiated approach and most recently to an emerging agenda that focuses more on systems to support CQI at the primary care coalface. Further development should aim to capitalise on the synergies between different CQI-related initiatives and effectively align quality improvement with performance measurement. Principles of CQI and key challenges for the future are identified.
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Tsey, Komla, Helen Travers, Teresa Gibson, Mary Whiteside, Yvonne Cadet-James, Melissa Haswell-Elkins, Janya McCalman, and Andrew Wilson. "The role of empowerment through life skills development in building comprehensive primary health care systems in Indigenous Australia." Australian Journal of Primary Health 11, no. 2 (2005): 16. http://dx.doi.org/10.1071/py05017.
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This paper examines the potential contribution of empowerment through life skills development in building effective primary health Care (PHC) systems in Indigenous Australia. More specifically, it assesses the effectiveness of a Family Wellbeing (FWB) empowerment program as a tool for "engaging" Aboriginal people of Cape York to take greater control and responsibility for their health and wellbeing as part of a broader Cape York Partnerships Initiative. Preliminary findings from the pilot study demonstrated the acceptability of the program to both adults and school children. Challenges and opportunities involved in introducing and sustaining such programs in remote Indigenous settings were also highlighted. This follow-up study presents information which demonstrates the critical role that empowerment programs such as FWB may play in achieving the "hardest parts" of the PHC ideal; namely, enhancing the capacity of people to be their own change agents. The key features of the FWB approach that make it effective are that it starts small and focuses on people, it puts people before structures, and it works from personal empowerment or the micro before broadening out to tackling structural issues. This paper highlights the importance of empowerment through life skills development as critical components of PHC systems. The paper also highlights the need for health professionals to work towards creating comprehensive PHC environments through policies and programs that address crucial parts of the PHC ideal - parts which, until now, have been left in the "too hard basket". They include equity, self-determination, world peace and reductions in spending on armaments in order to increase resources to the PHC sector. The aim is to ensure healthy policy environments that support local Indigenous health development initiatives such as those currently being pursued by Cape York leaders.
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Chakraborty, Amal, Emma Walke, Roxanne Bainbridge, Ross Bailie, Veronica Matthews, Sarah Larkins, Paul Burgess, et al. "VOICE–Validating Outcomes by Including Consumer Experience: A Study Protocol to Develop a Patient Reported Experience Measure for Aboriginal and Torres Strait Islander Peoples Accessing Primary Health Care." International Journal of Environmental Research and Public Health 20, no. 1 (December 26, 2022): 357. http://dx.doi.org/10.3390/ijerph20010357.
Повний текст джерелаАнотація:
Aboriginal and Torres Strait Islander peoples’ (hereafter respectfully referred to as Indigenous Australians) experiences of health care are shaped by historical, social and cultural factors, with cultural security critical to effective care provision and engagement between services and community. Positive patient experiences are associated with better health outcomes. Consequently, it is an accreditation requirement that primary health care (PHC) services must formally gather and respond to patient feedback. However, currently available patient feedback tools were not developed with Indigenous Australians, and do not reflect their values and world views. Existing tools do not capture important experiences of care of Indigenous Australians in PHC settings, nor return information that assists services to improve care. Consistent with the principles of Indigenous Data Sovereignty, we will co-design and validate an Indigenous-specific Patient Reported Experience Measure (PREM) that produces data by and for community, suitable for use in quality improvement in comprehensive PHC services. This paper presents the protocol of the study, outlining the rationale, methodologies and associated activities that are being applied in developing the PREM. Briefly, guided by an Aboriginal and Torres Strait Islander Advisory Group, our team of Indigenous and non-Indigenous researchers, service providers and policy makers will use a combination of Indigenous methodologies, participatory, and traditional western techniques for scale development. We will engage PHC service staff and communities in eight selected sites across remote, regional, and metropolitan communities in Australia for iterative cycles of data collection and feedback throughout the research process. Yarning Circles with community members will identify core concepts to develop an “Experience of Care Framework”, which will be used to develop items for the PREM. Staff members will be interviewed regarding desirable characteristics and feasibility considerations for the PREM. The PREM will undergo cognitive and psychometric testing.
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Masters-Awatere, Bridgette, Moana Rarere, Rewa Gilbert, Carey Manuel, and Nina Scott. "He aha te mea nui o te ao? He tāngata! (What is the most important thing in the world? It is people!)." Australian Journal of Primary Health 25, no. 5 (2019): 435. http://dx.doi.org/10.1071/py19027.
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This paper highlights the importance of people as a central factor in improving health for Māori (Indigenous people of New Zealand). How whānau (family) relationships, connections, values and inspiration are integral to achieving Indigenous health goals is explained. Descriptions of how community researchers, healthcare staff, consumers and academics worked together to design interventions for two health services (in the Waikato and Bay of Plenty regions) is included. Through highlighting the experiences of health consumers, the potential for future interventions to reduce the advancement of pre-diabetes among whānau is described. Evidence from the study interviews reinforces the importance of whānau and whakapapa (heritage) as enabling factors for Indigenous people to improve health. Specifically, the positive effect of whānau enhancing activities that support peoples’ aspirations of tino rangatiratanga (self-determination) in their lives when engaging with health care has been observed. This study highlights the many positives that have emerged, and offers an opportunity for taking primary health to the next level by placing whānau alongside Indigenous primary care providers at the centre of change strategies.
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Caffery, Liam, Natalie Bradford, Maria Meurer, and Anthony Smith. "Association between patient age, geographical location, Indigenous status and hospitalisation for oral and dental conditions in Queensland, Australia." Australian Journal of Primary Health 23, no. 1 (2017): 46. http://dx.doi.org/10.1071/py15105.
Повний текст джерелаАнотація:
A retrospective analysis of hospitalisation due to oral and dental conditions (ODC) was performed for patients in Queensland. The aim was to identify the rate and cost of hospitalisation and to examine the association between hospitalisation and age, geographical location and Indigenous status. There were 81528 admissions to Queensland’s hospitals due to ODC during the 3-year study period (2011–2013). The annual cost of ODC-related hospitalisation was estimated to be AU$87million. Indigenous infants (Z=4.08, P<0.001) and primary school children (Z=2.01, P=0.046) were significantly more likely to be hospitalised than their non-Indigenous counterparts. A non-Indigenous high school child was almost fourfold more likely to be hospitalised. There was no significant difference in the rate of hospitalisation for adults. Infants (Z=6.70, P<0.001) and primary school children (Z=8.73, P<0.001) from remote areas were significantly more likely to be hospitalised than their age-matched metropolitan counterparts. Whereas high school children (Z=2.74, P=0.006) and adults (Z=6.02, P<0.001) from remote areas were significantly less likely to be hospitalised. Our findings suggest that there is a need for alternative models of primary dental care to service remote areas of Queensland and Indigenous populations. Strategies that enable Indigenous Health Workers to provide dental care, and the use of teledentistry, are models of care that may reduce potentially preventable hospitalisations and lead to cost savings and better health outcomes.
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Thomas, David P., Ian P. Anderson, and Margaret A. Kelaher. "Accessibility and quality of care received in emergency departments by Aboriginal and Torres Strait Islander people." Australian Health Review 32, no. 4 (2008): 648. http://dx.doi.org/10.1071/ah080648.
Повний текст джерелаАнотація:
Objectives: To examine the accessibility and quality of care received in emergency departments by Aboriginal and Torres Strait Islander people compared with other Australians. Methods: We examined 2004?05 data from the National Non-admitted Patient Emergency Department Care database from the Northern Territory and Western Australia, the only jurisdictions where Indigenous identification in the database was considered acceptable. Results: In the NT, Indigenous people were 1.7 times as likely to present to an emergency department as non-Indigenous people. Indigenous patients in the NT and WA do not appear to use EDs for ?primary care? problems more than non- Indigenous patients. More NT Indigenous patients walked out before being seen or before their treatment was completed. However, Indigenous patients generally waited a similar time, and often slightly shorter, to be seen as similar non-Indigenous patients in WA and the NT. Conclusions: We recommend the regular monitoring of equity in the accessibility and quality of ED care for Indigenous people compared with other Australians. Indigenous identification in the database needs to improve so monitoring of ED performance can extend beyond WA and the NT.
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Sanjida, Saira, Gail Garvey, James Ward, Roxanne Bainbridge, Anthony Shakeshaft, Stephanie Hadikusumo, Carmel Nelson, Prabasha Thilakaratne, and Xiang-Yu Hou. "Indigenous Australians’ Experiences of Cancer Care: A Narrative Literature Review." International Journal of Environmental Research and Public Health 19, no. 24 (December 16, 2022): 16947. http://dx.doi.org/10.3390/ijerph192416947.
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To provide the latest evidence for future research and practice, this study critically reviewed Indigenous peoples’ cancer care experiences in the Australian healthcare system from the patient’s point of view. After searching PubMed, CINAHL and Scopus databases, twenty-three qualitative studies were included in this review. The inductive approach was used for analysing qualitative data on cancer care experience in primary, tertiary and transitional care between systems. Three main themes were found in healthcare services from Indigenous cancer care experiences: communication, cultural safety, and access to services. Communication was an important theme for all healthcare systems, including language and literacy, understanding of cancer care pathways and hospital environment, and lack of information. Cultural safety was related to trust in the system, privacy, and racism. Access to health services was the main concern in transitional care between healthcare systems. While some challenges will need long-term and collective efforts, such as institutional racism as a downstream effect of colonisation, cultural training for healthcare providers and increasing the volume of the Indigenous workforce, such as Indigenous Liaison Officers or Indigenous Care Coordinators, could effectively address this inequity issue for Indigenous people with cancer in Australia in a timely manner.
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Zhao, Yuejen, and Rosalyn Malyon. "Cost drivers of remote clinics: remoteness and population size." Australian Health Review 34, no. 1 (2010): 101. http://dx.doi.org/10.1071/ah09685.
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This report examines the impact of remoteness and population size on the costs of providing primary health care services in remote Northern Territory Indigenous communities. For remote health clinics servicing a population of similar size, total expenditure increased as remoteness increased. Total expenditure in remote clinics increased with population size, but average per capita expenditure was highest in clinics servicing populations of less than 200 people and lowest for populations of between 600 and 999. Staffing costs comprised over 70% of expenses. The largest non-staffing cost was property management. The higher costs of clinics that are in more remote locations or servicing smaller populations need to be recognised in funding distribution methodologies. What is known about the topic?People in rural and remote locations tend to have poorer health status and poorer access to primary care services than those in urban areas. There has, however, been a lack of information on the relative cost of providing primary care services in remote areas and the nature of those costs, particularly in remote Indigenous communities. What does this paper add?This study analyses the costs of primary care services in Northern Territory remote Indigenous communities and their associations with two key cost drivers: remoteness and population size. What are the implications for practitioners?This paper provides information on the importance of including remoteness and population size in resource allocation formulas for primary care services in remote areas.
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Valery, Patricia C., Christina M. Bernardes, Audra de Witt, Jennifer Martin, Euan Walpole, Gail Garvey, Daniel Williamson, et al. "Patterns of primary health care service use of Indigenous Australians diagnosed with cancer." Supportive Care in Cancer 28, no. 1 (May 2, 2019): 317–27. http://dx.doi.org/10.1007/s00520-019-04821-1.
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Carfagnini, Jessica, Alexis Harvey, Monique Lizon, and Johanne McCarthy. "Inclusion of Naturopaths in Northern Ontario Primary Care: A Proposed Solution for The Health Human Resources Shortage." CAND Journal 29, no. 4 (December 15, 2022): 4–11. http://dx.doi.org/10.54434/candj.127.
Повний текст джерелаАнотація:
The shortage of primary healthcare practitioners, such as physicians and nurses, in northern Ontario has persisted fordecades despite multiple strategies to address it. Poor health outcomes for people living in northern Ontario must be viewed through an equity lens that takes into account the multiple proximal, intermediate, and distal social determinants of health, including, but not limited to, the impact of colonization and continued colonialism on the health of Indigenous Peoples, challenges in housing, education and employment, as well as lack of food security. The increase in chronic health conditions in northern Ontario and the need for interprofessional healthcare teams that offer patient-centred care are key issues. Whole person care that takes into consideration the integration of body, mind, and spirit is central to Indigenous concepts of health and wellness, as well as being central to the foundations of naturopathic medical philosophy. Inclusion of naturopathic doctors in publicly funded multi-disciplinary primary healthcare settings is proposed as an achievable strategy to fill gaps in health human resources and advance the movement towards holistic care for Indigenous Peoples and others living in northern Ontario.
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Pitama, Suzanne, Annabel Ahuriri-Driscoll, Tania Huria, Cameron Lacey, and Paul Robertson. "The value of te reo in primary care." Journal of Primary Health Care 3, no. 2 (2011): 123. http://dx.doi.org/10.1071/hc11123.
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INTRODUCTION: The influence of indigeneity is widely recognised as a health determinant; however the impact of the utilisation of the indigenous language on health care has not been closely examined. AIM: To explore the Maori language (te reo) as a determinant of health from a Maori patients perspective. METHODS: Maori patients were recruited through Maori health networks and the snowballing technique. Thirty participants participated in one of three focus group interviews. A semi-structured interview explored the utilisation of health services, comfortability with service delivery and perceptions of general practice surgeries cultural competency. Thematic analysis was utilised to interpret the data. RESULTS: Te reo was recognised as an important cultural competency, noted by participants as contributing to the development of appropriate doctorpatient relationships and their feelings of being valued within a practice. Patient-led use of te reo was identified as most appropriate, an indicator of quality of care. DISCUSSION: The training of primary care staff in te reo should be encouraged. Developed as a competency, this will see primary care settings better able to respond to Maori patients and in turn support Maori health gains. KEYWORDS: Maori health; Maori language; family practice; quality health indicators
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Reid, Papaarangi, Sarah-Jane Paine, Braden Te Ao, Esther J. Willing, Emma Wyeth, Rhema Vaithianathan, and Belinda Loring. "Estimating the economic costs of Indigenous health inequities in New Zealand: a retrospective cohort analysis." BMJ Open 12, no. 10 (October 2022): e065430. http://dx.doi.org/10.1136/bmjopen-2022-065430.
Повний текст джерелаАнотація:
ObjectivesDespite significant international interest in the economic impacts of health inequities, few studies have quantified the costs associated with unfair and preventable ethnic/racial health inequities. This Indigenous-led study is the first to investigate health inequities between Māori and non-Māori adults in New Zealand (NZ) and estimate the economic costs associated with these differences.DesignRetrospective cohort analysis. Quantitative epidemiological methods and ‘cost-of-illness’ (COI) methodology were employed, within a Kaupapa Māori theoretical framework.SettingData for 2003–2014 were obtained from national data collections held by NZ government agencies, including hospitalisations, mortality, outpatient and primary care consultations, laboratory and pharmaceutical usage and accident claims.ParticipantsAll adults in NZ aged 15 years and above who had engagement with the health system between 2003 and 2014 (deidentified).Primary and secondary outcome measuresRates of ‘potentially avoidable’ hospitalisations and mortality as well as ‘excess or underutilisation’ of healthcare were calculated, as the difference between actual rates for Māori and the rate expected if Māori had the same rates as non-Māori. These differences were then quantified using COI methodology to estimate the financial cost of ethnic inequities.ResultsIn this conservative estimate, health inequities between Māori and non-Māori adults cost NZ$863.3 million per year. Direct costs of NZ$39.9 million per year included costs from ambulatory sensitive hospitalisations and outpatient care, with cost savings from underutilisation of primary care. Indirect costs of NZ$823.4 million per year came from years of life lost and lost wages.ConclusionsIndigenous adult health inequities in NZ create significant direct and indirect costs. The ‘cost of doing nothing’ is predominantly borne by Indigenous communities and society. The net cost of adult health inequities to the government conceals substantial savings to the government from underutilisation of primary care and accident/injury care.
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Padmasiri, G. R. "AN INVESTIGATION INTO UTILIZATION, BELIEFS AND PRACTICE OF INDIGENOUS MEDICINE IN SRI LANKA." African Journal of Traditional, Complementary and Alternative Medicines 15, no. 4 (October 16, 2018): 1. http://dx.doi.org/10.21010/ajtcam.v15i4.1.
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Background: Most countries pose their own indigenous knowledge systems. Native knowledge on indigenous
medicine is one of the knowledge systems widely used in many countries in Asia and Africa. In some countries, 80% of
the population depend on indigenous medicine for primary health care. Sri Lanka is an island enriched with a wellestablished
indigenous medical system.
Materials and Methods: The objectives of the study were to identify characteristics, usage patterns, and perceptions of
communities concerning indigenous medicine. Beneficiaries of indigenous medicine were selected through purposive
sampling for this study. The data were collected through a documentary survey and interviews.
Results: The study identified that the indigenous medical system of the country is called ‘DeshiyaChikitsa,’ ‘Sinhala
Vedakama,’ or ‘Hela Vedakama,’ which encompass ritual healing practices, astrology, religious observances, and
spiritual powers. Different approaches of people including the use of domestic medicine, obtaining the assistance of
astrology, and rituals were identified. Regardless of age, level of education, or employment, communities trust
indigenous medicine as a primary or a secondary option on the health care system of the country. The survey identified
the growing demand for the indigenous medicine.
Conclusion: Around 60 to 70% of the rural population which is comprise 77.3% of total population relies on
indigenous medicine. Domestic medicine, astrology and rituals associated with indigenous medicine plays a vital role
in people’s health care process. Experts in indigenous medicine are scattered in the country.
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Walker, Judi, and Grant Lennox. "Duelling Band-aids: Debating and Debunking Issues Affecting Primary Health Care to Achieve Deliverance for Australia's Health." Australian Journal of Primary Health 6, no. 4 (2000): 147. http://dx.doi.org/10.1071/py00048.
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The constant pressure for growth on all areas of health spending is not matched by the country's capacity to pay. Despite a progressive shift to a primary health care approach that promotes health and wellbeing, illness prevention, healthy lifestyles, early detection, rehabilitation and public health strategies, not all segments of Australian society enjoy good health. In this paper, general indications of the health and wellbeing of Australians are described, and the health and wellbeing of two important population groups: rural and remote and Indigenous populations are discussed, providing a review of Australia's health system. Anomalies in the status of the health of Australians are apparent. Models of primary healthcare, individual health and urban health are compared with models of acute and institutional care, population health and rural health.
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Green, Monica, Joan Cunningham, Dianne O'Connell, and Gail Garvey. "Improving outcomes for Aboriginal and Torres Strait Islander people with cancer requires a systematic approach to understanding patients’ experiences of care." Australian Health Review 41, no. 2 (2017): 231. http://dx.doi.org/10.1071/ah15214.
Повний текст джерелаАнотація:
Indigenous Australians experience a greater burden of cancer than other Australians, but there is little systematic information about their experiences of cancer care. Patient-centred care is increasingly recognised as one of the core domains of quality care, alongside clinical effectiveness and patient safety. Qualitative studies have identified significant issues relating to Indigenous patients’ experiences of cancer care, but these data are often insufficient to inform and evaluate health service improvement. We need to establish appropriate methods that will lead to systematic, routinely collected, accurate, population-based data on the experiences of care of Indigenous people with cancer, and determine how best to translate these data into improvements in the delivery of care to this population. Genuine Indigenous leadership and involvement will be necessary, with the whole approach underpinned by the primary aim of improving health outcomes for this population.
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McDermott, Robyn, and Leonie Segal. "Cost Impact of Improved Primary Level Diabetes Care in Remote Australian Indigenous Communities." Australian Journal of Primary Health 12, no. 2 (2006): 124. http://dx.doi.org/10.1071/py06031.
Повний текст джерелаАнотація:
The objective of this study is to estimate the direct costs and downstream savings of improved quality of diabetes services, compared to usual care, in the primary care setting in a high-risk remote Indigenous Islander population. The study looked at cost impact analysis over six years (2000-2005) comparing costs of quality improvement with actual and projected savings in avoidable diabetes-related hospitalisations. Costs of service provision were derived from district financial reports, costs of diabetes-related complications requiring hospitalisations were estimated from actual admission data and costed using published Diagnosis-Related Group costings in Australian dollars (year 2000). Net present value cost of the quality improvement intervention was estimated using a 5% discount rate. A district health service in remote northern Australia, with 9,600 mainly Indigenous residents, including 1,000 adults with known diabetes served by 21 primary care centres and two hospitals, was the study population and setting. The main outcome measures are the costs of a quality primary level diabetes service and hospitalisations among people with diabetes for infections and other acute complications, lower limb amputations, end-stage renal disease and cardiovascular disease. Over the six years, a net present value cost of $570,000 is estimated for the new service. This is equivalent to A$1,800 for each major event avoided. After four years of initiation, annual cost savings exceed annual program delivery costs. It is concluded that, in this remote Indigenous population with high prevalence of diabetes and associated complications, investment in quality improvement in primary diabetes care using a chronic disease model will achieve cost savings through prevention of expensive diabetes-related hospitalisations.
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Meiklejohn, Judith A., Brian Arley, Ross Bailie, Jon Adams, Gail Garvey, Jennifer H. Martin, Euan T. Walpole, and Patricia C. Valery. "Community-identified recommendations to enhance cancer survivorship for Aboriginal and Torres Strait Islander people." Australian Journal of Primary Health 24, no. 3 (2018): 233. http://dx.doi.org/10.1071/py17127.
Повний текст джерелаАнотація:
Indigenous Australians diagnosed with cancer experience higher mortality and lower survival rates compared to non-Indigenous Australians. Reasons are multifaceted and complex. Knowledge about Indigenous cancer survivors’ perspectives of positive cancer survivorship is a gap in research evidence. The study explored cancer survivorship perspectives of Indigenous cancer survivors, their support people and healthcare workers with a view to developing recommendations for cancer survivorship. Indigenous Australians who completed cancer treatment in the previous 6 months to 5 years, their support people and primary healthcare workers were recruited from primary healthcare centres and a large tertiary Queensland hospital. Semi-structured interviews and focus groups were conducted with written and informed consent obtained prior. Participants emphasised key action areas and recommendations to enhance cancer survivorship, namely: establishing a community cancer advocate and peer support program, availability and use of a cancer-specific Indigenous primary healthcare worker and hospital-based Indigenous patient navigator, as well as adoption of question prompt lists and cancer survivorship care plans. Existing research suggests significant benefits from implementing the key recommendations identified in this study. Greater support and commitment across health sectors and funding bodies is needed to promote institutional change and health system development.
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Edmond, Karen Margaret, Scarlette Tung, Kimberley McAuley, Natalie Strobel, and Daniel McAullay. "Improving developmental care in primary practice for disadvantaged children." Archives of Disease in Childhood 104, no. 4 (August 7, 2018): 372–80. http://dx.doi.org/10.1136/archdischild-2018-315164.
Повний текст джерелаАнотація:
Our primary objective was to assess if sustained participation in continuous quality improvement (CQI) activities could improve delivery of ‘basic developmental care’ to disadvantaged children in primary care settings. Secondary objectives were to assess if delivery of developmental care differed by age and geographic location.Data were analysed using multivariable logistic regression and generalised estimating equations. 109 indigenous primary care centres across Australia from 2012 to 2014 and2466 client files from indigenous children aged 3–59 months were included. Outcome measures were delivery of basic developmental care.We found that the proportion of children who received basic developmental care ranged from 55% (advice about physical and mental stimulation of child) (1279, 55.1%) to 74% (assessment of developmental milestones) (1510, 73.7%). Ninety-three per cent (92.6%, 88) of children received follow-up care. Centres with sustained CQI participation (completed three or more consecutive audit cycles) (508, 53.9%) were twofold more likely to deliver basic developmental care compared with centres without sustained CQI (completed less than three consecutive audit cycles) (118, 31.0%) (adjusted OR (aOR) 2.37, 95% CI 1.33 to 4.23). Children aged 3–11 months (229, 54.9%) were more likely to receive basic developmental care than children aged 24–59 months (151, 38.5%) (aOR 2.42, 95% CI 1.67 to 3.51). Geographic location had little effect (aOR 0.68, 95% CI 0.30 to 1.53). Overall our study found that sustained CQI can improve basic developmental care in primary care settings. However, many disadvantaged children are not receiving services. Improved resourcing of developmental care and CQI in primary care centres is needed.
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Bailie, Jodie, Alison Laycock, Veronica Matthews, David Peiris, and Ross Bailie. "Emerging evidence of the value of health assessments for Aboriginal and Torres Strait Islander people in the primary healthcare setting." Australian Journal of Primary Health 25, no. 1 (2019): 1. http://dx.doi.org/10.1071/py18088.
Повний текст джерелаАнотація:
The launch of the third edition of the National guide to preventive health assessment for Aboriginal and Torres Strait Islander people in March 2018 heralds a renewed commitment to improving the delivery of preventive care, and should reinvigorate discussions on the effectiveness of Indigenous-specific health assessments and how best to implement them. A substantial body of evidence on adherence to guideline-recommended care has been generated through a research-based continuous quality improvement (CQI) initiative conducted between 2010 and 2014. The research, which involved clinical audits of more than 17000 client records and 119 systems assessments relating to preventive care in 137 Indigenous primary healthcare centres across Australia, shows that a structured CQI program can improve the delivery of preventive health assessments and use of evidence-based guidelines. However, program implementation has also seen the emergence of new challenges. This paper reflects on four major lessons from this collaborative program of applied research that will lead to more effective delivery of preventive care.