“No One Manages It; We Just Sign Them Up and Do It”: A Whole System Analysis of Access to Healthcare in One Remote Australian Community

Abstract

Objective: To assess the accessibility, availability and utilisation of a comprehensive range of community-based healthcare services for Aboriginal people and describe contributing factors to providing effective healthcare services from the provider perspective. Setting: A remote community in New South Wales, Australia. Participants: Aboriginal and non-Aboriginal health and education professionals performing various roles in healthcare provision in the community. Design: Case study. Methodology: The study was co-designed with the community. A mixed-methods methodology was utilised. Data were gathered through structured interviews. Descriptive statistics were used to analyse the availability of 40 health services in the community, whilst quotations from the qualitative research were used to provide context for the quantitative findings. Results: Service availability was mapped for 40 primary, specialised, and allied health services. Three key themes emerged from the analysis: (1) there are instances of both underservicing and overservicing which give insight into systemic barriers to interagency cooperation; (2) nurses, community health workers, Aboriginal health workers, teachers, and administration staff have an invaluable role in healthcare and improving patient access to health services and could be better supported through further funding and opportunities for specialised training; and (3) visiting and telehealth services are critical components of the system that must be linked to existing community-led primary care services. Conclusion: The study identified factors influencing service availability, accessibility and interagency cooperation in remote healthcare services and systems that can be used to guide future service and system planning and resourcing.

Intersectoral collaboration for supporting the health and wellbeing of Aboriginal families and children in out-of-home care: perspectives from Western Australian Aboriginal Community Controlled Health Organisations

“…However, Kuruvilla et al 's (46) study, which analysed case studies from widely differing social, economic, geographic, cultural and historical contexts, noted that despite the heterogeneity of their case studies, there were strong similarities identified in how different sectors collaborated. (53) identified through their analysis was the under-servicing and over-servicing among a variety of Aboriginal healthcare services in the community, which provided insight into the 'systemic barriers to interagency cooperation' (53). These findings were attributed to poor resourcing and incentivisation for health providers to coordinate their services (53).…”

“…While there is research that addresses intersectoral collaboration in Aboriginal primary healthcare settings, studies tend to advocate for the importance of intersectoral collaboration within broader research scopes and do not directly address or interrogate how collaboration plays out ( 47–52 ). A recent study conducted by Osborn et al ( 53 ) in a remote New South Wales community researched a variety of community-based healthcare services for Aboriginal people, including local ACCHOs. A key theme Osborn et al ( 53 ) identified through their analysis was the under-servicing and over-servicing among a variety of Aboriginal healthcare services in the community, which provided insight into the ‘systemic barriers to interagency cooperation’ ( 53 ).…”

“…A recent study conducted by Osborn et al ( 53 ) in a remote New South Wales community researched a variety of community-based healthcare services for Aboriginal people, including local ACCHOs. A key theme Osborn et al ( 53 ) identified through their analysis was the under-servicing and over-servicing among a variety of Aboriginal healthcare services in the community, which provided insight into the ‘systemic barriers to interagency cooperation’ ( 53 ). These findings were attributed to poor resourcing and incentivisation for health providers to coordinate their services ( 53 ).…”

“…A key theme Osborn et al ( 53 ) identified through their analysis was the under-servicing and over-servicing among a variety of Aboriginal healthcare services in the community, which provided insight into the ‘systemic barriers to interagency cooperation’ ( 53 ). These findings were attributed to poor resourcing and incentivisation for health providers to coordinate their services ( 53 ).…”

A Sustainable, Interactive Elderly Healthcare System for Nursing Homes: An Interdisciplinary Design

“…Individuals have made many efforts to explore healthcare services for the aged. Some designs may play an important role in senior citizens' healthcare [16,17]. However, there exist some studies that are not very successful in large-scale application.…”