Smoothing the path to city care for rural Aboriginal patients

signThe South Australian health system can improve treatment of rural Aboriginal patients in city hospitals by focusing on the whole patient journey, a Flinders University report has found.

The report, Managing Two Worlds Together: City Hospital Care for Country Aboriginal People, was launched today (October 20) at Flinders University Victoria Square.

Professor Judith Dwyer, who led a team of researchers from the Faculty of Health Sciences, said Aboriginal patients from rural and remote areas frequently face a complex set of barriers to effective treatment.

“For this group of patients, it’s almost inevitable that their patient journey is going to be complicated,” Professor Dwyer said.

“In addition to facing long journeys, these patients often speak English as a second language, are lacking in financial resources, are vulnerable because of a high burden of illness and also face the issues of being Aboriginal in a world that is largely non-Aboriginal.”

“While not every Aboriginal patient has all these problems, the health care system needs to anticipate and assume complexity, and prepare for it.”

The team identified and analysed more than 2,700 rural Aboriginal admissions to city hospitals over a two-year period and the researchers also undertook qualitative case-studies from both patient and carer perspectives.

“We found that there are lots of good people doing good things, but it’s in patches,” Professor Dwyer said.

“Often the initiatives have short-term ‘soft’ money – they only last as long as the project funding does.”

Funding, however, is not the primary barrier to improved treatment, Professor Dwyer said.

“South Australia already has high level policies that require these issues to be addressed, but we found that they haven’t been cascading down in a systematic way: what is lacking is operational policy,” she said.

“The units where it’s working well have co-ordinators who focus on managing the patient journey – they are part of the clinical team and they are in the wards, but they are also looking outwards, and know what needs to be done before, during and after admission.

“When that preparedness for complexity is brought in, everything goes so much more smoothly, and it’s actually a better use of resources, not only for the country people and the country health services that refer them, but for the metropolitan hospitals that receive them.”

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