RESEARCH ROUNDup

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    A new climate for Indigenous health
    (Primary Health Care Research & Information Service, 2008-10) Alfred, A ; Kalucy, Elizabeth Carment ; McIntyre, Ellen
    The Apology to the Stolen Generation set the tone for a new and vigorous approach to achieving health equity for Indigenous people. The symbolic impact of the Apology was reinforced and given practical direction by the Australia 2020 Summit and the Australian Government Department of Health and Ageing Budget Statements. The key primary health care messages arising from these are: improving health services for Indigenous people is essential to reducing health inequities between Australians; making health services accessible to Indigenous communities is a primary component of health service provision; and, Indigenous community engagement in health research, health services and health education is critical to meeting equity policy outcomes.
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    Researching patient and family experience
    (Primary Health Care Research & Information Service, 2008-11) Kalucy, Elizabeth Carment ; Alfred, A ; McIntyre, Ellen
    The direction of our health system and the provision of health services must be shaped around the health needs of individuals, their families and communities. The health system should be responsive to individual differences, cultural diversity and preferences through choice in health care.
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    Improving access to rural health care
    (Primary Health Care Research & Information Service, 2008-12) Alfred, A ; Kalucy, Elizabeth Carment ; McIntyre, Ellen
    Doctors and allied health professionals are in short supply in rural and remote areas of Australia. Added to this, scattered populations and small communities make meeting the health needs of the people living and working in these areas a challenge. Major Australian Government measures set by the newly established Office of Rural Health and visa arrangements for overseas trained medical doctors will help. At the local level, traditional approaches must make way for health services that are flexible and responsive to local circumstances to better meet the diverse needs of the population. Current rural research has a role at different stages of policy implementation: assessing the impact of infrastructure changes designed to improve pathways to care, and identifying and evaluating how local rural services are contributing to improved quality of care through increased inter-disciplinary cooperation.
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    Nursing in General Practice: still some way to go
    (Primary Health Care Research & Information Service, 2009-02) Alfred, A ; Kalucy, Elizabeth Carment ; Jackson-Bowers, Eleanor
    A number of barriers and facilitators to an expanded role for practice nurses have been identified. These include legal and funding issues related to the lack of a system-level model, poor role definition for practice nurses, lack of space available in general practices and GP attitudes. Inter-professional issues, medico-legal concerns and a poorly defined scope of practice need to be addressed while a defined educational and career pathway for practice nursing to attract nurses to general practice is needed.
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    The primary care role for people with cancer
    (Primary Health Care Research & Information Service, 2009-03) Jackson-Bowers, Eleanor ; Kalucy, Elizabeth Carment
    The announcement in January 2009 of funding of $5.6 million for cancer research and a Primary Care Cooperative Cancer Clinical Trials Group to focus on prevention, detection and care of people with cancer comes after the call by a number of commentators for an expanded role for primary health care in the care of people with cancer. Some recent studies have shown that transfer of care from hospitals and specialists to general practitioners is safe and effective. However recent Australian research on service design to support cancer care in primary health care is limited, with most research focussing on the differences between care in urban and rural areas. The forthcoming evaluation of the Cancer Service Networks National Demonstration Program (CanNET) will fill a much needed gap in our research knowledge.
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    Dementia and primary health care
    (Primary Health Care Research & Information Service, 2009-04) Katterl, Rachel ; Kalucy, Elizabeth Carment
    Dementia care is becoming increasingly relevant in Australia as our population ages, presenting challenges for an already stretched health system. General practitioners are the first port of call in dementia identification and care, and are the coordinators of dementia identification and management. There is increasing involvement of practice nurses in these processes. Carers and many health professionals believe early diagnosis is critical, though GPs report diagnosing only for functional necessity such as to prescribe medication. Referrals for carers to information and support services are often delayed until carers reach ‘breaking point’, highlighting the need for anticipatory referral processes. Carers are often called the ‘hidden patients’ as they suffer from higher physical and mental illness resulting from caregiver burden.
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    Chronic disease self-management
    (Primary Health Care Research & Information Service, 2009-07) Katterl, Rachel ; Kalucy, Elizabeth Carment
    Chronic conditions cannot be ‘cured’. Therefore effective strategies are required to manage the illnesses and minimise their consequences for patients, their families and the health system. Self-management programs represent a way in which this care may be realised. Self-management programs focus on teaching patients to control their chronic illness more effectively. These programs can be generic (for those with multiple chronic diseases) or disease-specific, and are considered to be a component of the overall management of chronic disease. The Australian Government has focused on a dedicated push towards self-management practice. The Department of Health and Ageing currently administers the Sharing Health Care initiative as part of a package that is targeting older Australians with complex and chronic conditions.
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    Health promotion of physical activity
    (Primary Health Care Research & Information Service, 2009-10) Isherwood, Linda ; Kalucy, Elizabeth Carment ; Katterl, Rachel ; Reinfeld-Kirkman, Nova
    Health promotion, or “the process of enabling people to increase control over their health and its determinants, and thereby improve their health” is expected to be an integral part of future Australian health policy. It has been suggested that a National Health Promotion and Prevention Agency be established to build the evidence base of effective health promotion and prevention strategies. The Preventative Health Taskforce report recently outlined specific strategies to reduce rates of obesity and tobacco and alcohol consumption. This issue of RESEARCH ROUNDup looks at promotion of physical activity (PA), exploring the effectiveness of interventions and the contributions of recent Australian research to the evidence about promoting physical activity in the primary care setting.
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    Evaluation of chronic disease management in primary health care
    (Primary Health Care Research & Information Service, 2009-11) Isherwood, Linda ; Kalucy, Elizabeth Carment
    Rigorous evaluation of health care interventions can provide the evidence needed to improve patient outcomes and to inform decisions regarding future initiatives. A Healthier Future for all Australians emphasises “knowledge-led continuous improvement, innovation and research” and a “greater investment in public health, health policy and health services research including ongoing evaluation of health reforms”. This RESEARCH ROUNDup follows on from a previous issue: Chronic disease self-management. It covers evaluation research which is being undertaken within Australian primary health care in the field of chronic disease management (CDM).
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    Australia’s primary health care research workforce
    (Primary Health Care Research & Information Service, 2009-12) Kalucy, Elizabeth Carment ; Katterl, Rachel ; McIntyre, Ellen
    Australian healthcare is on the brink of a significant reform process. While much is yet to be decided, two clear themes can be identified from the reform reports. The first is the importance of multidisciplinary team work in the primary health care (PHC) setting. The second is the importance of further developing and strengthening Australia’s PHC research sector, which is critical to inform its health policy and practice. These themes of a stronger multidisciplinary focus and a stronger PHC research sector reinforce each other, as clinical, health system and health services research increasingly needs to be undertaken by researchers from multiple disciplines and backgrounds.
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    Continuity and safety in care transitions: communication at the hospital/community care interface
    (Primary Health Care Research & Information Service, 2010-05) Muecke, Sandy ; Kalucy, Elizabeth Carment ; McIntyre, Ellen
    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.
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    Avoiding hospitalisation: ambulatory care sensitive conditions
    (Primary Health Care Research & Information Service, 2010-07) Muecke, Sandy
    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.
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    Identifying gaps in primary care services: reaching the ‘unreached’
    (Primary Health Care Research & Information Service, 2010-08) Muecke, Sandy
    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.
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    How does teamwork support general practitioners and Allied Health Professionals to work together?
    (Primary Health Care Research & Information Service, 2010-09) Jackson-Bowers, Eleanor
    A well coordinated health system provides a comprehensive and continuous experience for the patient, promotes teamwork between practitioners, and the coordination of service delivery organisations. Improving teamwork between General Practitioners (GPs) and Allied Health Providers (AHPs) has been an ongoing challenge for Australia due to the split responsibility for primary health care between Commonwealth and State jurisdictions leading to incompatible systems of funding and accountability. Integration of services at the regional level has been identified as a priority in Australia’s Primary Health Care Strategy. This issue of RESEARCH ROUNDup highlights Australian research and systematic reviews that have addressed the role of teamwork in system integration in primary health care.
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    Avoiding hospitalisation: effective primary care interventions
    (Primary Health Care Research & Information Service, 2010-10) Muecke, Sandy
    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.
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    Meeting the primary health care needs of refugees and asylum seekers
    (Primary Health Care Research & Information Service, 2010-12) Jackson-Bowers, Eleanor ; Cheng, I-Hao
    Australia currently accepts over 13,000 refugee entrants each year. A refugee is a person who, “owing to a well founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside of the country of his nationality and is unable or owing to such fear is unwilling to avail himself of the protection of that country”. An asylum seeker is a person seeking protection as a refugee but whose claim is still being reviewed. The application process may take considerable time. Refugees are provided with the same rights to healthcare as other Australian permanent residents, however asylum seekers have complex visa conditions and not all are eligible to use Medicare funded services. This RESEARCH ROUNDup examines the health needs and associated primary health care challenges for refugees and asylum seekers in Australia.
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    Primary health care for people with intellectual disabilities
    (Primary Health Care Research & Information Service, 2011-06) Katterl, Rachel ; Bywood, Petra Teresia
    Over half a million Australians have an intellectual disability and 61% of those have a severe or profound limitation in ‘core’ activities of daily living. The sparse research available concerning health care service use by people with significant intellectual (or physical disabilities) in Australia suggests there is a higher rate of health care service utilisation in this group than for people without disabilities for all health care provider types. While overall utilisation rates appear to be higher in this group compared to the general population, primary health care access may still be insufficient to meet their needs. This RESEARCH ROUNDup investigates the reasons for primary health care disadvantage in people with intellectual disabilities, and strategies to overcome this disadvantage.
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    Co-morbidity of mental and physical illness: meeting unmet care needs
    (Primary Health Care Research & Information Service, 2011-08) Lunnay, Belinda Kate ; Bywood, Petra Teresia
    People with chronic physical conditions experience poorer mental health compared to the general population. Co-morbid depression and chronic disease are associated with high healthcare use and high costs to the health system. Despite improvements in mental health care service delivery, people experiencing mental illness have high mortality from physical health issues, suggesting that the health care needs of this group are not being met. This RESEARCH ROUNDup explores the reasons for primary health care disadvantage among people with physical and mental illness co-morbidity, and strategies to improve health care provision for this group.
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    Health literacy and primary health care
    (Primary Health Care Research & Information Service, 2011-10) Jackson-Bowers, Eleanor ; Howard, Sara Louise ; Bywood, Petra Teresia
    People with low levels of health literacy report poorer health status and experience poorer health outcomes compared to those with good health literacy. Poor health literacy is most prevalent in socio-economically disadvantaged populations, which are often in greater need of health care to manage complex conditions. In recognition of its potential positive impact on health outcomes, improving the health literacy of populations is being incorporated into policy. This RESEARCH ROUNDup reports on some recent developments in health literacy research and the role of primary health care in enhancing health literacy to improve health outcomes.
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    Primary health care and social networking: opportunities to enhance communication
    (Primary Health Care Research & Information Service, 2011-10) Anikeeva, Olga ; Bywood, Petra Teresia
    The use of social networking technologies in health care and education is known as Health 2.0. Health 2.0 incorporates principles of open access, user-generated content and networking in order to personalise health care, collaborate and promote health education. Social networking technologies that are relevant to primary care include blogs, microblogging websites such as Twitter, wikis and podcasts. This RESEARCH ROUNDup focuses on the ways in which a range of emerging information and communication technologies can improve collaboration between primary health care professionals and across health care sectors.