Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Consumer perspectives of allied health involvement in a public hospital setting: cross-sectional survey and electronic health record review

Laura Jolliffe https://orcid.org/0000-0002-1369-9442 A B C * , Cylie M. Williams https://orcid.org/0000-0002-0223-9141 D , Natalie Bozyk A , Taya A. Collyer https://orcid.org/0000-0001-8612-1724 C , Kirsten Caspers A and David A. Snowdon https://orcid.org/0000-0003-2041-3120 A C
+ Author Affiliations
- Author Affiliations

A Allied Health, Peninsula Health, Melbourne, Vic., Australia.

B School of Primary and Allied Health Care, Department of Occupational Therapy, Monash University, Melbourne, Vic., Australia.

C National Centre for Healthy Ageing, Melbourne, Vic., Australia.

D School of Primary and Allied Health Care, Department of Podiatry, Monash University, Melbourne, Vic., Australia.

* Correspondence to: laura.jolliffe@monash.edu

Australian Health Review 48(2) 191-200 https://doi.org/10.1071/AH23225
Submitted: 1 November 2023  Accepted: 26 January 2024  Published: 20 February 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Objective

Consumer-centred care is fundamental to high-quality health care, with allied health professionals playing a pivotal role in hospital settings. Allied health typically operates within standard weekday working-hours. Consumer preferences for receiving allied health services are largely unexplored but could inform whether weekend and/or out-of-hours services are required. This study aims to understand consumer preferences for hospital-based inpatient and outpatient allied health services.

Methods

Using a cross-sectional survey and convenience sampling approach, consumers of a public health service in Melbourne, Australia were surveyed about preferences for allied health service delivery. Electronic health record reviews compared the accuracy of self-reported service delivery times. Descriptive statistics, concordance and predictive values were calculated. Responses to free-text survey items were analysed using content analysis.

Results

Of 120 participants (79% response rate), most (69%) received allied health services, however, almost half of inpatient responders (44%) were unsure of the specific allied health professional involved. Audit results found moderate–high concordance overall (range, 77–96%) between self-reported and audit-identified allied health services by profession. Most inpatient responders had no strong day of week preference, equally selecting weekdays and weekend days, with most preferring services between 8 am and 4 pm. Outpatient responders (81%) preferred a weekday appointment between 8 am and 12 pm or before 8 am (29%) to complete scheduled activities early in the day.

Conclusion

While provision of allied health services during standard working-hours was preferred by most consumers, some inpatient and outpatient consumers are receptive to receiving weekend and out-of-hours services, respectively. Decisions about offering these services should consider operational capacity and research evidence.

Keywords: allied health, consumer preference, health services, health systems, primary health care, service preferences, time preference.

References

Delaney LJ. Patient-centred care as an approach to improving health care in Australia. Collegian 2018; 25(1): 119-23.
| Google Scholar |

Crawford MJ, Rutter D, Manley C, Weaver T, Bhui K, Fulop N, et al. Systematic review of involving patients in the planning and development of health care. BMJ 2002; 325(7375): 1263.
| Crossref | Google Scholar | PubMed |

Kligler B, Chesney M. Academic health centers and the growth of integrative medicine. J Natl Cancer Inst Monogr [50] 2014; 292-3.
| Crossref | Google Scholar | PubMed |

Australian Institute of Health and Welfare. Allied health care. Canberra: Australian Government; 2023.

Lizarondo L, Turnbull C, Kroon T, Grimmer K, Bell A, Kumar S, et al. Allied health: integral to transforming health. Aust Health Rev 2016; 40(2): 194-204.
| Crossref | Google Scholar | PubMed |

Barr ML, Welberry H, Comino EJ, Harris-Roxas BF, Harris E, Lloyd J, et al. Understanding the use and impact of allied health services for people with chronic health conditions in Central and Eastern Sydney, Australia: a five-year longitudinal analysis. Prim Health Care Res Dev 2019; 20: e141.
| Crossref | Google Scholar | PubMed |

Mutsekwa RN, Byrnes JM, Larkins V, Canavan R, Angus RL, Campbell KL. Role substitution of specialist medical doctors with allied-health professionals: A qualitative exploration of patients’ experiences and perceptions of healthcare quality. J Eval Clin Pract 2022; 28(6): 1096-105.
| Crossref | Google Scholar | PubMed |

Australian Government. About allied health care. In: Department of Health and Aged Care, editor. Canberra: Department of Health and Aged Care; 2023. Available at https://www.health.gov.au/topics/allied-health/about?language=en

Nancarrow SA, Young G, O’Callaghan K, Jenkins M, Philip K, Barlow K. Shape of allied health: an environmental scan of 27 allied health professions in Victoria. Aust Health Rev 2017; 41(3): 327-35.
| Crossref | Google Scholar | PubMed |

10  Davis SF, Enderby P, Harrop D, Hindle L. Mapping the contribution of Allied Health Professions to the wider public health workforce: a rapid review of evidence-based interventions. J Public Health 2016; 39(1): 177-83.
| Crossref | Google Scholar | PubMed |

11  Scrivener K, Jones T, Schurr K, Graham PL, Dean CM. After-hours or weekend rehabilitation improves outcomes and increases physical activity but does not affect length of stay: a systematic review. J Physiother 2015; 61(2): 61-7.
| Crossref | Google Scholar | PubMed |

12  Cifu DX, Kreutzer JS, Kolakowsky-Hayner SA, Marwitz JH, Englander J. The relationship between therapy intensity and rehabilitative outcomes after traumatic brain injury: a multicenter analysis. Arch Phys Med Rehabil 2003; 84(10): 1441-8.
| Crossref | Google Scholar | PubMed |

13  Snowdon D, Haines TP, Skinner EH. Preoperative intervention reduces postoperative pulmonary complications but not length of stay in cardiac surgical patients: a systematic review. J Physiother 2014; 60(2): 66-77.
| Crossref | Google Scholar | PubMed |

14  Beder J. Evaluation research on social work interventions: a study on the impact of social worker staffing. Soc Work Health Care 2008; 47(1): 1-13.
| Crossref | Google Scholar | PubMed |

15  Sarkies MN, White J, Henderson K, Haas R, Bowles J. Additional weekend allied health services reduce length of stay in subacute rehabilitation wards but their effectiveness and cost-effectiveness are unclear in acute general medical and surgical hospital wards: a systematic review. J Physiother 2018; 64(3): 142-58.
| Crossref | Google Scholar | PubMed |

16  Haines TP, Bowles K-A, Mitchell D, O’Brien L, Markham D, Plumb S, et al. Impact of disinvestment from weekend allied health services across acute medical and surgical wards: 2 stepped-wedge cluster randomised controlled trials. PLoS Med 2017; 14(10): e1002412.
| Crossref | Google Scholar | PubMed |

17  Turner S, D´Lima D, Sheringham J, Swart N, Hudson E, Morris S, et al. Evidence use as sociomaterial practice? A qualitative study of decision-making on introducing service innovations in health care. Public Manag Rev 2022; 24(7): 1075-99.
| Crossref | Google Scholar |

18  Roohi G, Mahmoodi G, Khoddam H. Knowledge implementation in health care management: a qualitative study. BMC Health Serv Res 2020; 20(1): 188.
| Crossref | Google Scholar | PubMed |

19  O’Brien L, Mitchell D, Skinner EH, Haas R, Ghaly M, McDermott F, et al. What makes weekend allied health services effective and cost-effective (or not) in acute medical and surgical wards? Perceptions of medical, nursing, and allied health workers. BMC Health Serv Res 2017; 17(1): 345.
| Crossref | Google Scholar | PubMed |

20  Caruana EL, Kuys SS, Clarke J, Brauer SG. Implementing a 6-day physiotherapy service in rehabilitation: exploring staff perceptions. Aust Health Rev 2019; 43(1): 29-35.
| Crossref | Google Scholar |

21  Cosgrave C. Context Matters: Findings from a Qualitative Study Exploring Service and Place Factors Influencing the Recruitment and Retention of Allied Health Professionals in Rural Australian Public Health Services. Int J Environ Res Public Health 2020; 17(16): 5815.
| Crossref | Google Scholar | PubMed |

22  Australian Institute of Health and Welfare Health Workforce. Canberra: Australian Institute of Health and Welfare; 2022.

23  State of Victoria. Allied health capability framework: disability and complex support needs. In: Department of Health and Human Services, editor. 1 Treasury Place, Melbourne: Department of Health and Human Services; 2020.

24  Stevenson A. Oxford Dictionary of English. OUP Oxford; 2010.

25  Qualtrics. Qualtrics. November, 2020 ed. Provo, UT; 2020. Available at https://www.qualtrics.com

26  Patton MQ. Two Decades of Developments in Qualitative Inquiry: A Personal, Experiential Perspective. Qual Soc Work 2002; 1(3): 261-83.
| Crossref | Google Scholar |

27  Bryman A. Integrating quantitative and qualitative research: how is it done? Qual Res 2006; 6(1): 97-113.
| Crossref | Google Scholar |

28  McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb) 2012; 22(3): 276-82.
| Google Scholar | PubMed |

29  Uzochukwu B, Onwujekwe O, Mbachu C, Okwuosa C, Etiaba E, Nyström ME, et al. The challenge of bridging the gap between researchers and policy makers: experiences of a Health Policy Research Group in engaging policy makers to support evidence informed policy making in Nigeria. Glob Health 2016; 12(1): 67.
| Crossref | Google Scholar |

30  White J, Grant K, Sarkies M, Haines T, Morris ME, Carey L, et al. Translating evidence into practice: a longitudinal qualitative exploration of allied health decision-making. Health Res Policy Syst 2021; 19(1): 38.
| Google Scholar |

31  Shroff Z, Aulakh B, Gilson L, Agyepong IA, El-Jardali F, Ghaffar A. Incorporating research evidence into decision-making processes: researcher and decision-maker perceptions from five low-and middle-income countries. Health Res Policy Syst 2015; 13: 70.
| Crossref | Google Scholar | PubMed |

32  Gabbe BJ, Reeder S, Ekegren CL, Mather A, Kimmel L, Cameron PA, Higgins AM. Cost-effectivness of a purpose-built ward environment and new allied health model of care for major trauma. J Trauma Acute Care Surg 2023; 94: 831-838.
| Crossref | Google Scholar | PubMed |

33  Brusco NK, Watts JJ, Shields N, Taylor NF. Are weekend inpatient rehabilitation services value for money? An economic evaluation alongside a randomized controlled trial with a 30 day follow up. BMC Med 2014; 12(1): 89.
| Crossref | Google Scholar | PubMed |

34  Feeney CL, Roberts NJ, Partridge MR. Do medical outpatients want ‘out of hours’ clinics? BMC Health Serv Res 2005; 5(1): 47.
| Crossref | Google Scholar | PubMed |

35  Hardy KJ, O’Brien SV, Furlong NJ. Information given to patients before appointments and its effect on non-attendance rate. BMJ 2001; 323(7324): 1298-300.
| Crossref | Google Scholar | PubMed |

36  Sharp DJ, Hamilton W. Non-attendance at general practices and outpatient clinics. BMJ 2001; 323(7321): 1081-2.
| Crossref | Google Scholar | PubMed |

37  Koshy E, Car J, Majeed A. Effectiveness of mobile-phone short message service (SMS) reminders for ophthalmology outpatient appointments: Observational study. BMC Ophthalmol 2008; 8(1): 9.
| Crossref | Google Scholar | PubMed |

38  Gleeson R, Chant AM, Cusick A, Dickson N, Hodgers E. Non‐compliance with Occupational Therapy Outpatient Attendance: A Quality Assurance Study. Aust Occup Ther J 2010; 38: 55-61.
| Crossref | Google Scholar |

39  Taylor NF, Bottrell J, Lawler K, Benjamin D. Mobile telephone short message service reminders can reduce nonattendance in physical therapy outpatient clinics: a randomized controlled trial. Arch Phys Med Rehabil 2012; 93(1): 21-6.
| Crossref | Google Scholar | PubMed |

40  Collins J, Santamaria N, Clayton L. Why outpatients fail to attend their scheduled appointments: a prospective comparison of differences between attenders and non-attenders. Aust Health Rev 2003; 26(1): 52-63.
| Crossref | Google Scholar | PubMed |

41  Saurman E. Improving access: modifying Penchansky and Thomas’s Theory of Access. J Health Serv Res Policy 2016; 21(1): 36-9.
| Crossref | Google Scholar | PubMed |

42  Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care 1981; 19(2): 127-40.
| Crossref | Google Scholar | PubMed |

43  Trezona A, Rowlands G, Nutbeam D. Progress in Implementing National Policies and Strategies for Health Literacy-What Have We Learned so Far? Int J Environ Res Public Health 2018; 15(7):.
| Crossref | Google Scholar | PubMed |

44  Muscat DM, Ceprnja D, Hobbs K, Gibson J-A, Blumenthal C, Milad R, et al. Development and evaluation of a health literacy training program for allied health professionals: A pre-post study assessing impact and implementation outcomes. Health Promot J Austr 2021; 32(S1): 88-97.
| Crossref | Google Scholar | PubMed |

45  Church E. Colours unveiled for national NHS uniform in England. Wellesley Grove, Croydon: EMAP Publishing Limited Company; 2023; Available at https://www.nursingtimes.net/news/workforce/colours-unveiled-for-national-nhs-uniform-in-england-27-09-2023/ [cited 2023].

46  Peiris CL, Taylor NF, Shields N. Patients value patient–therapist interactions more than the amount or content of therapy during inpatient rehabilitation: a qualitative study. J Physiother 2012; 58(4): 261-8.
| Google Scholar | PubMed |

47  McKinnon AL. Client Values and Satisfaction with Occupational Therapy. Scand J Occup Ther 2000; 7(3): 99-106.
| Crossref | Google Scholar | PubMed |