Follow-up of indigenous-specific health assessments - a socioecological analysis

Bailie, J; Schierhout, GH; Kelaher, MA; Laycock, AF; Percival, NA; O'Donoghue, LR; Mcneair, TL; Chakraborty, A; Beacham, BD; Bailie, RS

Follow-up of indigenous-specific health assessments - a socioecological analysis

Bailie, J Schierhout, GH Kelaher, MA Laycock, AF Percival, NA

O'Donoghue, LR Mcneair, TL Chakraborty, A Beacham, BD Bailie, RS

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Publication Type:: Journal Article
Citation:: Medical Journal of Australia, 2014, 200 (11), pp. 653 - 656
Issue Date:: 2014-06-16

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Field	Value	Language
dc.contributor.author	Bailie, J	en_US
dc.contributor.author	Schierhout, GH	en_US
dc.contributor.author	Kelaher, MA	en_US
dc.contributor.author	Laycock, AF	en_US
dc.contributor.author	Percival, NA https://orcid.org/0000-0002-9191-1736	en_US
dc.contributor.author	O'Donoghue, LR	en_US
dc.contributor.author	Mcneair, TL	en_US
dc.contributor.author	Chakraborty, A	en_US
dc.contributor.author	Beacham, BD	en_US
dc.contributor.author	Bailie, RS	en_US
dc.date.available	2014-04-17	en_US
dc.date.issued	2014-06-16	en_US
dc.identifier.citation	Medical Journal of Australia, 2014, 200 (11), pp. 653 - 656	en_US
dc.identifier.issn	0025-729X	en_US
dc.identifier.uri	http://hdl.handle.net/10453/118791
dc.description.abstract	Objective: To describe patterns of uptake of Indigenous-specific health assessments and associated follow-up items, and examine the barriers and enablers to delivery and billing of follow-up over the first 3 years of implementation of the Indigenous Chronic Disease Package (ICDP). Design, setting and participants: We used a socioecological approach to analyse data derived from the Sentinel Sites Evaluation of the ICDP - with data from 24 sites across Australia. Administrative data (1 May 2009 to 30 May 2012) and program data (1 March 2010 to 30 May 2012) were provided by the Department of Health. Data on barriers and enablers to follow-up of health assessments were obtained from community focus groups, in-depth interviews and discussions with key informants (1 November 2010 to 30 December 2012). Main outcome measures: Monthly number of Medicare Benefits Schedule items claimed for Indigenous-specific health services and follow-up; qualitative data on enablers and barriers categorised according to patient, patient-health service relationship, health service or organisation, community and policy environment levels or influence. Results: There was an increase in the uptake of health assessments, but relatively limited delivery of follow-up care and billing for Indigenous-specific follow-up items. Follow-up was constrained by factors that operated at various levels: patient, interpersonal, health service, community and policy. Constraints included practitioners' lack of awareness of item numbers, staffing, poor state of clinical information systems, billing against non-Indigenous-specific items or more general follow-up items, emphasis on health assessments with less attention to requirements for follow-up, limited capacity to arrange and facilitate follow-up, and communication and transport challenges for patients. Conclusions: Work is required across various levels of the system to address barriers to follow-up care. Enhancing follow-up care is vital to achieving health benefits from the large financial and human resource investment in health assessments.	en_US
dc.relation.ispartof	Medical Journal of Australia	en_US
dc.relation.isbasedon	10.5694/mja13.00256	en_US
dc.subject.classification	General & Internal Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Focus Groups	en_US
dc.subject.mesh	Retrospective Studies	en_US
dc.subject.mesh	Follow-Up Studies	en_US
dc.subject.mesh	Program Evaluation	en_US
dc.subject.mesh	Oceanic Ancestry Group	en_US
dc.subject.mesh	Health Services, Indigenous	en_US
dc.subject.mesh	Primary Health Care	en_US
dc.subject.mesh	Health Services Accessibility	en_US
dc.subject.mesh	Australia	en_US
dc.title	Follow-up of indigenous-specific health assessments - a socioecological analysis	en_US
dc.type	Journal Article
utslib.citation.volume	11	en_US
utslib.citation.volume	200	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	17 Psychology and Cognitive Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access
pubs.issue	11	en_US
pubs.publication-status	Published	en_US
pubs.volume	200	en_US

Abstract:

Objective: To describe patterns of uptake of Indigenous-specific health assessments and associated follow-up items, and examine the barriers and enablers to delivery and billing of follow-up over the first 3 years of implementation of the Indigenous Chronic Disease Package (ICDP). Design, setting and participants: We used a socioecological approach to analyse data derived from the Sentinel Sites Evaluation of the ICDP - with data from 24 sites across Australia. Administrative data (1 May 2009 to 30 May 2012) and program data (1 March 2010 to 30 May 2012) were provided by the Department of Health. Data on barriers and enablers to follow-up of health assessments were obtained from community focus groups, in-depth interviews and discussions with key informants (1 November 2010 to 30 December 2012). Main outcome measures: Monthly number of Medicare Benefits Schedule items claimed for Indigenous-specific health services and follow-up; qualitative data on enablers and barriers categorised according to patient, patient-health service relationship, health service or organisation, community and policy environment levels or influence. Results: There was an increase in the uptake of health assessments, but relatively limited delivery of follow-up care and billing for Indigenous-specific follow-up items. Follow-up was constrained by factors that operated at various levels: patient, interpersonal, health service, community and policy. Constraints included practitioners' lack of awareness of item numbers, staffing, poor state of clinical information systems, billing against non-Indigenous-specific items or more general follow-up items, emphasis on health assessments with less attention to requirements for follow-up, limited capacity to arrange and facilitate follow-up, and communication and transport challenges for patients. Conclusions: Work is required across various levels of the system to address barriers to follow-up care. Enhancing follow-up care is vital to achieving health benefits from the large financial and human resource investment in health assessments.

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http://hdl.handle.net/10453/118791