Are primary health care centres that target injecting drug users attracting and serving the clients they are designed for? A case study from Sydney, Australia

Islam, M. Mofizul; Topp, Libby; Conigrave, Katherine M.; White, Allen; Haber, Paul S.; Day, Carolyn

doi:10.1016/j.drugpo.2012.06.002

Cited by 15 publications

(10 citation statements)

References 31 publications

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“… 18 Over the study period, 64% of the cohort presented to public EDs at least once. Other than the relatively young age of the cohort, baseline characteristics are similar to other Australian cohort studies of PWID 26 27 .…”

Section: Resultssupporting

confidence: 59%

A prospective cohort study of hospital separations among people who inject drugs in Australia: 2008–2013

et al. 2017

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ObjectivesInjecting drug use is a persistent behaviour that increases the risk of morbidities and mortality. We assessed the burden of hospital separations among people who inject drugs (PWID), the excess compared to the general population and characteristics of separations associated with frequent use.DesignProspective cohort study.SettingAll public and private hospitals in Victoria.Participants757 community-based PWID with hospital separations between January 2008 and June 2013 identified through record linkage, who contributed over 3729 person-years.Primary and secondary outcome measuresCounts, proportions and rates of hospital separations, descriptive administrative data including all diagnoses, comparison of separation rates to the general population, trend in separations and factors associated with frequent separations.ResultsThere were 2106 separations in the cohort. The most common principal diagnoses were related to mental and behavioural disorders (31%), but social circumstances influencing health was the most common group of diagnoses (61%) when all contributing diagnoses for each patient were considered. Separation rates were up to three times higher than in the age-matched population, and there was a 12% increase in separations every 6 months. Over a quarter (29%) of the cohort had frequent separations (defined as two or more separations in a calendar year), which were associated with mental health-related diagnoses, being discharged to locations other than a patient’s residence, having a medical as opposed to surgical intervention, seasonal patterns, relationship status and gender.ConclusionsMental health conditions and other characteristics associated with separations and frequent separations in particular, emphasise the importance of providing referrals to harm reduction, social services and mental health services at discharge in order to reduce excess hospital separations among PWID.

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Section: Resultssupporting

confidence: 59%

A prospective cohort study of hospital separations among people who inject drugs in Australia: 2008–2013

et al. 2017

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“…Options include an increased range of services, for example, provision of onsite Pap tests, hepatitis A vaccination, antibiotics for bacterial infections and welfare support by a qualified case‐worker. Although nurses often refer clients to appropriate health‐care providers for services not available onsite and facilitate referral uptake, a significant proportion of referred clients fail to attend appointments . Indeed some commentators have argued that for many injecting drug users, offering referrals only is akin to denying those services .…”

Section: Discussionmentioning

confidence: 99%

“…Indeed some commentators have argued that for many injecting drug users, offering referrals only is akin to denying those services . Given injection‐related infections are common among NSP attendees and that PHC clients are less likely to attend general medical practitioner than other referrals , onsite prescribing of essential medications such as antibiotics may be necessary. In addition, the time currently spent arranging, facilitating and tracking referrals may be impractical once the clinic reaches full utilisation.…”

Section: Discussionmentioning

confidence: 99%

The cost of providing primary health‐care services from a needle and syringe program: A case study

Islam

Shanahan

Topp

et al. 2012

Drug and Alcohol Review

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“…Data were derived from a validated client intake assessment form which is routinely filled in for every client accessing services from the Redfern Harm Minimisation Clinic. This service is an IDU‐targeted low‐threshold primary healthcare centre established in an existing NSP setting in inner‐city, Sydney, Australia 11,12 . This nurse‐led facility provides primary healthcare on both ‘drop in’ and appointment bases.…”

Section: Methodsmentioning

confidence: 99%

Sexually transmitted infections, sexual risk behaviours and perceived barriers to safe sex among drug users

Islam¹,

Topp²,

Conigrave³

et al. 2013

Australian and New Zealand Journal of Public Health

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Are primary health care centres that target injecting drug users attracting and serving the clients they are designed for? A case study from Sydney, Australia

Cited by 15 publications

References 31 publications

A prospective cohort study of hospital separations among people who inject drugs in Australia: 2008–2013

A prospective cohort study of hospital separations among people who inject drugs in Australia: 2008–2013

The cost of providing primary health‐care services from a needle and syringe program: A case study

Sexually transmitted infections, sexual risk behaviours and perceived barriers to safe sex among drug users

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