Australian Journal of Primary Health
Volume 29
Number 1 2023
The COVID-19 pandemic directly impacted the delivery of primary care services. We detail a research project framework used during the first 2 years of the COVID-19 pandemic to understand how general practice activity was impacted by the pandemic. The knowledge outputs and lessons learned can be adapted to future research undertakings across any primary care setting and highlight the utility of action research and interdisciplinary research collaboration to produce knowledge directly relevant to clinical practice.
Future Health Today is a new platform, co-designed by general practice for general practice, which aims to streamline the identification and management of chronic disease to improve health outcomes. This paper describes the development of the technology platform and how it was optimised through an implementation study in general practice.
Cancer screening programs in correctional centres are poorly established and tend to be provided on an ad hoc basis. We show that co-ordinated cancer screening programs in prisons enabled early detection of bowel and breast cancer that may have gone undiagnosed. Intervention at the individual and systems level is required to ensure prisoners can access health care equal to that provided in the community.
Medicare-subsidised Team Care Arrangements (TCAs), designed to coordinate care for people with long-term chronic or terminal conditions requiring treatment from a multidisciplinary team, have not been evaluated for adults newly diagnosed with cancer. Of those, 47.5% have a TCA initiated, but not all take up community-based TCA-subsidised allied health care. Prior poor health and lower socioeconomic status made TCAs more likely. TCAs appear well aligned with need. Apparent incomplete uptake of TCA-subsidised allied health services suggests suboptimal utilisation of this plan. Investigation of the healthcare trajectories of specific patient subgroups may help identify barriers.
Despite documented benefits of interprofessional (IP) healthcare, IP care is not universally implemented in primary healthcare settings. This study explored staff experiences of co-designing and implementing a novel interprofessional First Nations child health assessment, developed in partnership with a remote Aboriginal Community Controlled Health Organisation. Results demonstrated how the incorporation of IP practices into a remote primary care setting led to perceived benefits for both the health service staff and clients.
Indigenous people bear a higher burden of oral disease compared to non-Indigenous people, with rural communities further disadvantaged due to access issues. Engaging Indigenous communities in designing, implementing, and monitoring of oral healthcare programs has been shown to be effective; however, limited research exists on community members’ perceptions of strategies to improve community oral health. This study highlights the importance of establishing formal consultation processes between oral healthcare services, health policy makers and rural Indigenous communities to ensure oral healthcare equity.
The COVID-19 pandemic caused significant challenges and wellbeing issues for healthcare workers such as general practitioners (GPs), especially during the initial months in 2020. A large nationwide survey of Australian healthcare workers was undertaken in 2020 to understand their experiences, from which 299 GPs provided free-text survey responses for qualitative analysis. This analysis showed GPs felt marginalised, undervalued and under-supported while working in risky work conditions, pointing to a need for GP voices to be heard to safeguard their wellbeing.
Pharmacists provide essential services to the public and are one of the most accessible health professionals in Australia. Female pharmacists and newly graduates are likely to report low perceptions of psychological safety. Pharmacists with lower reported occupational self-efficacy and higher emotional labour were more likely to report lower levels of wellbeing. Professional organisations, such as the Pharmacy Guild of Australia, play an important role in developing human resource management policies for providing targeted professional support to pharmacists.
Being physically active and socially connected is predictive of healthy aging; however, COVID-19 has resulted in increased barriers for some older people to engage in these activities. This qualitative research explores the lived experience of participants of the Connect 60+ wellness program, showing how it created a positive environment within the local neighbourhood by having welcoming facilitators, a variety of activities and opportunities for social connection. Community hubs can provide opportunities for older people to engage in healthy aging programs.
People with type 2 diabetes (T2DM) in a single GP practice were asked to use meal replacement shakes for two meals a day for 3 months, followed by a healthy diet for 21 months. Thirty-four patients completed the program losing an average of 7.1 ± 7.0 kg at 12 months, and 4.2 ± 7.7 kg at 24 months. One-third of patients met the criteria for diabetes remission at 24 months, suggesting this low-cost primary care intervention could significantly impact the management of T2DM.
The association between patient cost-sharing and health service utilisation are important for health promotion and healthcare resources allocation. This study revealed significant evidence that reduced patient cost-sharing provided by Health Concession Card (HCC) policy was positively correlated with more health service utilisation by Australian adults. Our findings imply that future promotion efforts are warranted to improve mental health services to reach vulnerable groups and integrate needs assessments when allocating limited health service resources.
Outpatient management of skin infections is a safe and cost-effective alternative to inpatient care in temperate Australia; however, skin infections account for 37% of preventable hospitalisations in the remote Torres Strait region of tropical Australia. This study highlights that outpatient management of skin infections in the Torres Strait is safe, effective and well-accepted by patients. Outpatient management of skin infections in remote, tropical Australia can reduce unnecessary transfers and hospitalisations, optimising the use of finite local health resources.
, Gorkem Sezgin, Rae-Anne Hardie, Stephen Weeding, Christopher Pearce, Adam McLeod, Precious McGuire, Shirmilla Datta, Julie Li, Nasir Wabe, Guilherme S. Franco, Zhaoli Dai 
