Understanding Indigenous patient attendance: A qualitative study

Copeland, Stephen Paul; Muir, Josephine; Turner, Angus

doi:10.1111/ajr.12348

Cited by 17 publications

(25 citation statements)

References 18 publications

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“…Therefore, while Aboriginal and Torres Strait Islanders make up a relatively small section of the community, they are overrepresented in the medical imaging environment and could be considered a vulnerable subpopulation. Greater focus on the cultural capability of clinical staff to improve patient‐centred communication, improved appointment access as well as better access to transport services, may assist in closing the gap in medical imaging appointment attendance rates …”

Section: Discussionmentioning

confidence: 99%

Factors associated with appointment non‐attendance at a medical imaging department in regional Australia: a retrospective cohort analysis

Mander

Reynolds

Cook

et al. 2018

J of Medical Radiation Sci

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IntroductionAppointment non‐attendance contributes added cost to the healthcare sector through wasted resource allocations. Medical imaging departments commonly schedule appointments for most modalities; however, no study has quantified patient attendance rates in the Australian regional setting. This is despite evidence that regional, rural and remote Australians tend to demonstrate poorer health than metropolitan counterparts. This study aims to identify the factors that influence appointment non‐attendance at a teaching hospital in regional Australia.MethodsCategories restricted to age, gender, indigenous status, distance from investigation site, referral source and imaging modality were collected for all appointments (N = 13,458) referred to the medical imaging department in 2015. The likelihood of each of these factors correlating with a patient not attending a scheduled appointment was calculated using the chi‐squared analysis and binary logistic regression.ResultsGender, indigenous status as well as specific imaging modalities, referral sources and age categories were significantly associated with non‐attendance. Overall, male patients were 1.57 (P < 0.001) times more likely to miss a scheduled appointment than female patients. Patients who identified as Aboriginal and Torres Strait Islander were 2.66 (P < 0.001) times more likely to miss a scheduled appointment than patients who did not identify as Aboriginal and Torres Strait Islander.ConclusionsSeveral key factors appear to affect medical imaging appointment non‐attendance. Key factors include indigenous status, gender, image modality, referral source and age. Further improvement is required to better meet the needs of underrepresented patient demographics.

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Section: Discussionmentioning

confidence: 99%

Factors associated with appointment non‐attendance at a medical imaging department in regional Australia: a retrospective cohort analysis

Mander

Reynolds

Cook

et al. 2018

J of Medical Radiation Sci

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“…Primary eye care coordination included organising outreach optometry clinics as part of primary health care services, providing transport, and enabling patient attendance . Secondary and tertiary eye care coordination included organising and facilitating surgery attendance, booking travel and accommodation for ophthalmic care, and ensuring appropriate follow‐up care . Key providers of eye care coordination and associated support included eye health coordinators, Aboriginal Health Workers (AHWs), primary health care staff, and community liaison staff .…”

Section: Resultsmentioning

confidence: 99%

“…Administrative functions, such as clerical support for visiting eye care practitioners, and case management, including organising eye care appointments for patients, were identified as cost‐effective enablers of improved outcomes for patients undergoing cataract surgery. Cultivating patient engagement with eye care was noted as a central component of coordination, with several studies identifying that contacting and counselling patients, reminding them about appointments, and community outreach were enablers of patient attendance at ophthalmic outreach clinics and cataract surgery . A mixed methods study in urban Queensland found that introducing regional cataract surgery coordinators at the primary care level increased the rate of surgery completion among Indigenous patients from one of 55 (2%) to 46 of 103 patients (45%); the increase was partially attributed to additional non‐clinical support, such as facilitating patient and community engagement.…”

Section: Resultsmentioning

confidence: 99%

“…Organising travel and providing transport were identified in four studies as facilitators of patient attendance . For instance, an intervention in which home visits were introduced as additional non‐clinical support for chronic disease patients and transport was provided by chronic care coordinators was associated with an 18% increase in visual acuity checks and a 20% increase in attendance at ophthalmology appointments over two years .…”

Section: Resultsmentioning

confidence: 99%

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Non‐clinical eye care support for Aboriginal and Torres Strait Islander Australians: a systematic review

Yashadhana

Lee

Massie

et al. 2020

Medical Journal of Australia

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Objectives To describe research into non‐clinical support eye health care for Aboriginal and Torres Strait Islander (Indigenous) Australians, the people who provide such care, and its impact on eye health outcomes. Study design Systematic review and qualitative analysis of peer‐reviewed research publications. Data sources Peer‐reviewed research articles published between January 2000 and July 2018 and included in MEDLINE/EMBASE, Web of Science, Informit, EBSCO (CINAHL and Anthropology Plus), or ProQuest Central. Study selection We included English language, peer‐reviewed articles reporting empirical data on non‐clinical support for eye health for Indigenous Australians. Two authors independently assessed the titles and abstracts of 1678 unique articles for inclusion in a full text review; the full texts of 104 publications were reviewed, of which 77 were excluded and 27 included in our qualitative analysis. Data synthesis Qualitative analysis identified five key areas of non‐clinical support for Indigenous eye health: coordination of eye care, integrating and linking services, cultural support, health promotion, and social and emotional support. People who provide non‐clinical support include eye health coordinators, Aboriginal Health Workers, primary care clinicians, family members, carers, and community‐based liaison workers. The availability of non‐clinical support is associated with increased patient attendance at eye care services, higher visual acuity examination and cataract surgery rates, broader eye health knowledge, and greater cultural responsivity. Conclusion Non‐clinical support is critical for facilitating attendance at appointments by patients and ensuring that preventive, primary, and tertiary eye care services are accessible to Indigenous Australians. Greater financial investment is needed to support key providers of non‐clinical support, especially eye health coordinators, community‐based liaison officers, and family members and carers.

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“…This demonstrated a significant increase in the odds of a patient attending the LOVV compared with previous outreach clinics (odds ratio [OR] 2.05, 95% confidence interval [CI] 1.38‐3.06, P = .0004). Patient attendance compares favourably to previous outreach clinics, with attendance across 17 aboriginal medical services averaging 49% . The number of patient referrals to sites outside of Derby for eye care decreased after implementation of the LOVV to six transfers compared to 16 in previous year (OR 4.39, 95% CI 1.66‐11.66, P = .003).…”

mentioning

confidence: 92%