Identifying gaps in primary care services: reaching the ‘unreached’

In an equitable system, the health needs of communities are matched by the services provided. Whilst a recent review of the performance of the health systems of seven countries by the Commonwealth Fund reported that ‘Australia and the U.K. continue to demonstrate superior performance’, it is important that health services provided to Australians are able to be utilised by all who need them. This RESEARCH ROUNDup investigates the concept of equity in health, endeavours to describe those who are most likely to be ‘unreached’ by primary health care services, and how they may be identified

Avoiding hospitalisation: effective primary care interventions

Ambulatory care sensitive conditions (ACSCs) “represent a range of conditions for which hospitalisation should be able to be avoided because the disease or condition has been prevented from occurring, or because individuals have had access to timely and effective primary care”. This RESEARCH ROUNDup investigates the factors that may predict avoidable hospital admissions. It also provides an overview of interventions that may be effective in reducing avoidable hospitalisations, and follows from a previous issue that examined the scope of ACSCs in Australia, and their reliability as a measure of primary health care (PHC) performance

Local community reporting models for regional primary health care organisations

Community reporting models used by primary health care organisations (PHCOs) in New Zealand, Canada (Ontario), England and Scotland were reviewed. The roles, functions and mandated community engagement requirements for these PHCOs varied, shaping the scope of their reporting. All countries included in this report recognised the importance of engaging the community in healthcare and the value of communication between service providers, service commissioners and the public. All countries were involved in receiving information from the community to inform decisions relating to the planning, design and implementation of health care services. It was, however, difficult to ascertain the extent of this involvement, and how well disadvantaged groups were included in this process

Avoiding hospitalisation: ambulatory care sensitive conditions

This RESEARCH ROUNDup examines the scope of ambulatory care sensitive conditions (ACSC) in Australia, and their reliability as a measure of primary health care (PHC) performance. Avoidable hospitalisation statistics for Australia, Victoria and New South Wales are presented. Complications of diabetes are the most common ACSCs encountered in Australia. Rurality and socio-economic disadvantage are linked to avoidable hospitalisation

Continuity and safety in care transitions: communication at the hospital/community care interface

In the health care setting, risks to patient safety may arise when there is poor written or verbal communication between personnel during times of care transition. Care transition refers to the “set of actions designed to ensure the coordination and continuity of healthcare as patients transfer between different locations or different levels of care within the same location”. Transitions occur at staff shift changes within health care institutions, transfer between institutions, or, at the interface between acute and community care. This RESEARCH ROUNDup outlines communication mishaps that may occur in the latter instance, during discharge from hospital to community based care

Initiatives to integrate primary and acute health care, including ambulatory care services

Most people, at some time in their lives, will require health care services from multiple health care providers, whether it is for short-term unexpected ill health, long-term chronic conditions or co-morbidities that cross disciplines (eg. substance-related conditions and mental health). Integration of health services is particularly important for patients with chronic and complex conditions as they must frequently negotiate a path through different health care sectors, including primary, acute and ambulatory care services, as well as the public and private health jurisdictions. Standardised pathways for the more common chronic conditions may be needed to enable seamless transitions and avoid negative outcomes that may result from delays, duplications and errors in a system that operates as multiple independent organisations

Kimberley Transitions, Collaborating to Care for Our Common Home: Beginnings...

This scoping paper is a preliminary introduction to the aspirations, interrelated literature and research involved in development of the Kimberley Transitions Project. Our focus is on Western Australia’s Kimberley region, a landscape of immense natural and cultural significance. Along with the rest of Australia, and indeed the world in which we all live, the Kimberley is on the verge of major climate, political, social and economic change. The direction of changes being proposed by governments and industry are regularly criticised, both globally and locally, by individuals and organisations concerned about damage to its rich biodiversity and cultural integrity. With the aim of collaboratively generating Kimberley-based responses grounded in local knowledges, a mix of disciplines and emerging international theories, scholars and relevant groups have come together to form a Kimberley-wide practical and shared research agenda. One of the key influences behind the project is an international transitions movement which aims to generate collaborative change incorporating a process of transition. Locally identified issues using local knowledges and capacity are central to its evolution. A conceptual and theoretical framing known as ‘transitions discourse’ is also emerging internationally and nationally, one that foregrounds diverse epistemologies and challenges mainstream economics and associated ideologies, such as neoliberalism. Via the Kimberley Transitions project, Kimberley-based researchers and collaborators aim to support and further document social, cultural and economic change inspired by the transitions movement and informed by transition discourses. It has the Kimberley landscape and people at its heart; a transformative approach featuring cultural healing, intellectual rigour and an ethos aimed at enduring, practical and interconnected sustainable outcomes.https://researchonline.nd.edu.au/nulungu_research/1001/thumbnail.jp

Right care, right time, right place: improving outcomes for people with spinal cord injury through early access to intervention and improved access to specialised care: study protocol

Background: Traumatic spinal cord injury is a devastating condition impacting adversely on the health and wellbeing, functioning and independence, social participation and quality of life of the injured person. In Australia, there are approximately 15 new cases per million population per year; economic burden estimates suggest 2 billion dollars annually. For optimal patient outcomes expert consensus recommends expeditious transfer (“24 hours) in a Spinal Cord Injury Unit. Examining current health service and clinical intervention pathways in this Australian population-based sample, in relation to their outcomes, will provide an understanding of factors associated with patient flow, resource utilisation and cost, and patient and family quality of life. Barriers to streamlined effective early-care pathways and facilitators of optimal treatment for these patients will be identified