Follow-up of indigenous-specific health assessments - a socioecological analysis

Jodie Bailie, Gill H. Schierhout, Margaret A. Kelaher, Alison F. Laycock, Nicole Ann Percival, Lynette R. O'Donoghue, Tracy L. Mcneair, Amal Chakraborty, Barbara D. Beacham, Ross S. Bailie

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Objective: To describe patterns of uptake of Indigenous-specific health assessments and associated follow-up items, and examine the barriers and enablers to delivery and billing of follow-up over the first 3 years of implementation of the Indigenous Chronic Disease Package (ICDP). 

    Design, setting and participants: We used a socioecological approach to analyse data derived from the Sentinel Sites Evaluation of the ICDP - with data from 24 sites across Australia. Administrative data (1 May 2009 to 30 May 2012) and program data (1 March 2010 to 30 May 2012) were provided by the Department of Health. Data on barriers and enablers to follow-up of health assessments were obtained from community focus groups, in-depth interviews and discussions with key informants (1 November 2010 to 30 December 2012). 

    Main outcome measures: Monthly number of Medicare Benefits Schedule items claimed for Indigenous-specific health services and follow-up; qualitative data on enablers and barriers categorised according to patient, patient-health service relationship, health service or organisation, community and policy environment levels or influence. 

    Results: There was an increase in the uptake of health assessments, but relatively limited delivery of follow-up care and billing for Indigenous-specific follow-up items. Follow-up was constrained by factors that operated at various levels: patient, interpersonal, health service, community and policy. Constraints included practitioners' lack of awareness of item numbers, staffing, poor state of clinical information systems, billing against non-Indigenous-specific items or more general follow-up items, emphasis on health assessments with less attention to requirements for follow-up, limited capacity to arrange and facilitate follow-up, and communication and transport challenges for patients. 

    Conclusions: Work is required across various levels of the system to address barriers to follow-up care. Enhancing follow-up care is vital to achieving health benefits from the large financial and human resource investment in health assessments.

    Original languageEnglish
    Pages (from-to)653-657
    Number of pages5
    JournalMedical Journal of Australia
    Volume200
    Issue number11
    DOIs
    Publication statusPublished - 16 Jun 2014

    Fingerprint

    Aftercare
    Health
    Health Services
    Indigenous Health Services
    Chronic Disease
    Insurance Benefits
    Medicare
    Health Policy
    Focus Groups
    Information Systems
    Appointments and Schedules
    Communication
    Outcome Assessment (Health Care)
    Organizations
    Interviews

    Cite this

    Bailie, J., Schierhout, G. H., Kelaher, M. A., Laycock, A. F., Percival, N. A., O'Donoghue, L. R., ... Bailie, R. S. (2014). Follow-up of indigenous-specific health assessments - a socioecological analysis. Medical Journal of Australia, 200(11), 653-657. https://doi.org/10.5694/mja13.00256
    Bailie, Jodie ; Schierhout, Gill H. ; Kelaher, Margaret A. ; Laycock, Alison F. ; Percival, Nicole Ann ; O'Donoghue, Lynette R. ; Mcneair, Tracy L. ; Chakraborty, Amal ; Beacham, Barbara D. ; Bailie, Ross S. / Follow-up of indigenous-specific health assessments - a socioecological analysis. In: Medical Journal of Australia. 2014 ; Vol. 200, No. 11. pp. 653-657.
    @article{434d100abfd749c2b150a0b16b2ccc77,
    title = "Follow-up of indigenous-specific health assessments - a socioecological analysis",
    abstract = "Objective: To describe patterns of uptake of Indigenous-specific health assessments and associated follow-up items, and examine the barriers and enablers to delivery and billing of follow-up over the first 3 years of implementation of the Indigenous Chronic Disease Package (ICDP). Design, setting and participants: We used a socioecological approach to analyse data derived from the Sentinel Sites Evaluation of the ICDP - with data from 24 sites across Australia. Administrative data (1 May 2009 to 30 May 2012) and program data (1 March 2010 to 30 May 2012) were provided by the Department of Health. Data on barriers and enablers to follow-up of health assessments were obtained from community focus groups, in-depth interviews and discussions with key informants (1 November 2010 to 30 December 2012). Main outcome measures: Monthly number of Medicare Benefits Schedule items claimed for Indigenous-specific health services and follow-up; qualitative data on enablers and barriers categorised according to patient, patient-health service relationship, health service or organisation, community and policy environment levels or influence. Results: There was an increase in the uptake of health assessments, but relatively limited delivery of follow-up care and billing for Indigenous-specific follow-up items. Follow-up was constrained by factors that operated at various levels: patient, interpersonal, health service, community and policy. Constraints included practitioners' lack of awareness of item numbers, staffing, poor state of clinical information systems, billing against non-Indigenous-specific items or more general follow-up items, emphasis on health assessments with less attention to requirements for follow-up, limited capacity to arrange and facilitate follow-up, and communication and transport challenges for patients. Conclusions: Work is required across various levels of the system to address barriers to follow-up care. Enhancing follow-up care is vital to achieving health benefits from the large financial and human resource investment in health assessments.",
    keywords = "Australia, Focus Groups, Follow-Up Studies, Health Services Accessibility, Health Services, Indigenous, Humans, Oceanic Ancestry Group, Primary Health Care, Program Evaluation, Retrospective Studies",
    author = "Jodie Bailie and Schierhout, {Gill H.} and Kelaher, {Margaret A.} and Laycock, {Alison F.} and Percival, {Nicole Ann} and O'Donoghue, {Lynette R.} and Mcneair, {Tracy L.} and Amal Chakraborty and Beacham, {Barbara D.} and Bailie, {Ross S.}",
    year = "2014",
    month = "6",
    day = "16",
    doi = "10.5694/mja13.00256",
    language = "English",
    volume = "200",
    pages = "653--657",
    journal = "Medical Journal of Australia",
    issn = "0025-729X",
    publisher = "Australasian Medical Publishing Company",
    number = "11",

    }

    Bailie, J, Schierhout, GH, Kelaher, MA, Laycock, AF, Percival, NA, O'Donoghue, LR, Mcneair, TL, Chakraborty, A, Beacham, BD & Bailie, RS 2014, 'Follow-up of indigenous-specific health assessments - a socioecological analysis', Medical Journal of Australia, vol. 200, no. 11, pp. 653-657. https://doi.org/10.5694/mja13.00256

    Follow-up of indigenous-specific health assessments - a socioecological analysis. / Bailie, Jodie; Schierhout, Gill H.; Kelaher, Margaret A.; Laycock, Alison F.; Percival, Nicole Ann; O'Donoghue, Lynette R.; Mcneair, Tracy L.; Chakraborty, Amal; Beacham, Barbara D.; Bailie, Ross S.

    In: Medical Journal of Australia, Vol. 200, No. 11, 16.06.2014, p. 653-657.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Follow-up of indigenous-specific health assessments - a socioecological analysis

    AU - Bailie, Jodie

    AU - Schierhout, Gill H.

    AU - Kelaher, Margaret A.

    AU - Laycock, Alison F.

    AU - Percival, Nicole Ann

    AU - O'Donoghue, Lynette R.

    AU - Mcneair, Tracy L.

    AU - Chakraborty, Amal

    AU - Beacham, Barbara D.

    AU - Bailie, Ross S.

    PY - 2014/6/16

    Y1 - 2014/6/16

    N2 - Objective: To describe patterns of uptake of Indigenous-specific health assessments and associated follow-up items, and examine the barriers and enablers to delivery and billing of follow-up over the first 3 years of implementation of the Indigenous Chronic Disease Package (ICDP). Design, setting and participants: We used a socioecological approach to analyse data derived from the Sentinel Sites Evaluation of the ICDP - with data from 24 sites across Australia. Administrative data (1 May 2009 to 30 May 2012) and program data (1 March 2010 to 30 May 2012) were provided by the Department of Health. Data on barriers and enablers to follow-up of health assessments were obtained from community focus groups, in-depth interviews and discussions with key informants (1 November 2010 to 30 December 2012). Main outcome measures: Monthly number of Medicare Benefits Schedule items claimed for Indigenous-specific health services and follow-up; qualitative data on enablers and barriers categorised according to patient, patient-health service relationship, health service or organisation, community and policy environment levels or influence. Results: There was an increase in the uptake of health assessments, but relatively limited delivery of follow-up care and billing for Indigenous-specific follow-up items. Follow-up was constrained by factors that operated at various levels: patient, interpersonal, health service, community and policy. Constraints included practitioners' lack of awareness of item numbers, staffing, poor state of clinical information systems, billing against non-Indigenous-specific items or more general follow-up items, emphasis on health assessments with less attention to requirements for follow-up, limited capacity to arrange and facilitate follow-up, and communication and transport challenges for patients. Conclusions: Work is required across various levels of the system to address barriers to follow-up care. Enhancing follow-up care is vital to achieving health benefits from the large financial and human resource investment in health assessments.

    AB - Objective: To describe patterns of uptake of Indigenous-specific health assessments and associated follow-up items, and examine the barriers and enablers to delivery and billing of follow-up over the first 3 years of implementation of the Indigenous Chronic Disease Package (ICDP). Design, setting and participants: We used a socioecological approach to analyse data derived from the Sentinel Sites Evaluation of the ICDP - with data from 24 sites across Australia. Administrative data (1 May 2009 to 30 May 2012) and program data (1 March 2010 to 30 May 2012) were provided by the Department of Health. Data on barriers and enablers to follow-up of health assessments were obtained from community focus groups, in-depth interviews and discussions with key informants (1 November 2010 to 30 December 2012). Main outcome measures: Monthly number of Medicare Benefits Schedule items claimed for Indigenous-specific health services and follow-up; qualitative data on enablers and barriers categorised according to patient, patient-health service relationship, health service or organisation, community and policy environment levels or influence. Results: There was an increase in the uptake of health assessments, but relatively limited delivery of follow-up care and billing for Indigenous-specific follow-up items. Follow-up was constrained by factors that operated at various levels: patient, interpersonal, health service, community and policy. Constraints included practitioners' lack of awareness of item numbers, staffing, poor state of clinical information systems, billing against non-Indigenous-specific items or more general follow-up items, emphasis on health assessments with less attention to requirements for follow-up, limited capacity to arrange and facilitate follow-up, and communication and transport challenges for patients. Conclusions: Work is required across various levels of the system to address barriers to follow-up care. Enhancing follow-up care is vital to achieving health benefits from the large financial and human resource investment in health assessments.

    KW - Australia

    KW - Focus Groups

    KW - Follow-Up Studies

    KW - Health Services Accessibility

    KW - Health Services, Indigenous

    KW - Humans

    KW - Oceanic Ancestry Group

    KW - Primary Health Care

    KW - Program Evaluation

    KW - Retrospective Studies

    UR - http://www.scopus.com/inward/record.url?scp=84904489239&partnerID=8YFLogxK

    U2 - 10.5694/mja13.00256

    DO - 10.5694/mja13.00256

    M3 - Article

    VL - 200

    SP - 653

    EP - 657

    JO - Medical Journal of Australia

    JF - Medical Journal of Australia

    SN - 0025-729X

    IS - 11

    ER -

    Bailie J, Schierhout GH, Kelaher MA, Laycock AF, Percival NA, O'Donoghue LR et al. Follow-up of indigenous-specific health assessments - a socioecological analysis. Medical Journal of Australia. 2014 Jun 16;200(11):653-657. https://doi.org/10.5694/mja13.00256