“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

Eloise Osborn, Marida Ritha, Rona Macniven, Tim Agius, Vita Christie, Heather Finlayson, Josephine Gwynn, Kate Hunter, Robyn Martin, Rachael Moir, Donna Taylor, Susannah Tobin, Katrina Ward and Kylie Gwynne
Additional contact information
Eloise Osborn: Centre for Global Indigenous Futures, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia
Marida Ritha: Centre for Global Indigenous Futures, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia
Rona Macniven: Centre for Global Indigenous Futures, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia
Tim Agius: Durri Aboriginal Corporation Medical Service, Kempsey, NSW 2440, Australia
Vita Christie: Poche Centre for Indigenous Health, University of Sydney, Sydney, NSW 2006, Australia
Heather Finlayson: Brewarrina Multipurpose Service, Brewarrina, NSW 2839, Australia
Josephine Gwynn: Poche Centre for Indigenous Health, University of Sydney, Sydney, NSW 2006, Australia
Kate Hunter: The George Institute for Global Health, The University of New South Wales, Sydney, NSW 2052, Australia
Robyn Martin: Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia
Rachael Moir: Poche Centre for Indigenous Health, University of Sydney, Sydney, NSW 2006, Australia
Donna Taylor: Pius X Aboriginal Medical Service, Moree, NSW 2400, Australia
Susannah Tobin: Honorary Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
Katrina Ward: Brewarrina Aboriginal Medical Service, Brewarrina, NSW 2839, Australia
Kylie Gwynne: Centre for Global Indigenous Futures, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia

IJERPH, 2022, vol. 19, issue 5, 1-14

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.

Keywords: Aboriginal Australians; remote health; availability; accessibility; community-based healthcare services; healthcare services (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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