Development of a nurse-led primary healthcare service for injecting drug users in inner-city Sydney

2011 ◽  
Vol 17 (1) ◽  
pp. 10 ◽  
Author(s):  
Carolyn A. Day ◽  
M. Mofizul Islam ◽  
Ann White ◽  
Sharon E. Reid ◽  
Stephen Hayes ◽  
...  
Keyword(s):  
Health Care ◽  
Health Service ◽  
Inner City ◽  
Primary Healthcare ◽  
Drug Users ◽  
Service Use ◽  
Injecting Drug Users ◽  
Service Utilisation ◽  
Medical Support ◽  
Transmitted Infection

Injecting drug users (IDUs) experience numerous health problems, but report barriers to utilising general practitioners (GPs). A nurse-led Harm Minimisation-based Primary Healthcare (HMPH) service for IDUs was established within a needle and syringe program in inner-city Sydney with Area Health Service medical support and clinical governance. This paper aimed to describe the HMPH service, review service utilisation and assess nurses’ perceptions of their work with IDUs. A review of the most recent 200 clinic files was undertaken. Service utilisation, GP and other health service use and access were extracted and analysed using SPSS. A semi-structured qualitative interview with clinic nurses regarding their experience working with IDUs and local GPs was conducted and analysed. Since its inception in mid-2006, the service has been utilised by 417 clients. Of the most recent 200 files, blood-borne virus and sexually transmitted infection screening were the primary reason for presentation (64.5%). At least one follow-up visit was attended by 90% of clients. A total of 62% of clients reported consulting a GP in the last 12 months. The service provided 102 referrals. Nurses believed that IDUs tend to utilise GPs ineffectively and that self-care is a low priority, but that they can support IDUs to overcome some barriers to GPs and facilitate access. Targeted primary health care services led by nurses with focussed medical support and co-located with needle and syringe programs can fill an important gap in delivering and facilitating health care to IDUs.

scholarly journals The Stepping On Fall Prevention Program Scale-Up in NSW: Program Reach and Fall-Related Health Service Use

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Serene S Paul ◽  
Qiang Li ◽  
Lara Harvey ◽  
Therese Carroll ◽  
Annabel Priddis ◽  
...  
Keyword(s):  
Health Service ◽  
Fall Prevention ◽  
Prevention Program ◽  
Service Use ◽  
Hospital Admissions ◽  
Scale Up ◽  
Service Utilisation ◽  
Program Outcomes ◽  
Fall Prevention Program ◽  
Routinely Collected Data

IntroductionFalls in older adults are associated with increased healthcare costs. Falls may be prevented or minimised with multifactorial interventions including exercise and behavioural modification. Objectives and ApproachTo describe the reach of the scale-up of Stepping On, a fall prevention program targeting community-dwellers aged 65 years and older in NSW, Australia; and fall-related ambulance service use and fall-related hospitalisations after scale-up. Routinely-collected data on program reach, fall-related ambulance usage and fall-related hospital admissions in NSW residents aged ≥65 years between 2009 and 2015 were compared within Statistical Local Areas prior to and following implementation of Stepping On using multilevel models. ResultsFrom 2009 to 2014 the program was delivered in 1,077 sites to 10,096 people with an average (SD) age of 81.0 (7.2) years. Rates of fall-related ambulance use and hospital admissions per 100-person-years were 1-2 in people aged 66-74, 4-5 in people aged 75-84 and 12-13 in people aged ≥85. These rates increased over time (p<.001). Overall, the interaction between time and program delivery was not significant for fall-related ambulance use or hospital admissions. The time-related increase in fall-related ambulance usage in people aged 75-84 years may have been moderated by Stepping On (RR 0.97, 95% CI 0.93–1.00, p=.045). Conclusion / ImplicationsThere was no indication of either a reduced rate of fall-related ambulance use or hospital admissions across the entire sample. There was a suggestion of a reduction in ambulance call-outs for falls in people aged 75-84. The lack of a detectable impact on fall-related health service usage may be due to the use of routinely collected data not intended for research purposes or inability to remove those who would be ineligible for Stepping On from the data analyses. Increasing the program reach and targeting groups contributing most to health service utilisation may improve program outcomes.

Barriers to and facilitators of health services utilisation by refugees in resettlement countries: an overview of systematic reviews

2020 ◽  
Vol 44 (1) ◽  
pp. 132 ◽  
Author(s):  
Jamuna Parajuli ◽  
Dell Horey
Keyword(s):  
Health Care ◽  
Health Service ◽  
Health Services ◽  
Systematic Reviews ◽  
Health Professionals ◽  
Health Service Utilisation ◽  
Barriers And Facilitators ◽  
Service Utilisation ◽  
Knowledge And Skills ◽  
Overview Of Systematic Reviews

Objective The aim of this study was to provide an overview of the previously reviewed research literature to identify barriers and facilitators to health service utilisation by refugees in resettlement countries. Methods An overview of systematic reviews was conducted. Seven electronic databases (Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, ProQuest Central, Scopus, EBSCO and Google Scholar) were searched for systematic reviews of barriers and facilitators to health-seeking behaviour and utilisation of health services by refugees following resettlement. The two authors independently undertook data selection, data extraction and quality assessment using a validated tool. Results Nine systematic reviews covered a range of study areas and refugee populations. Barriers to health service utilisation fell into three broad areas: (1) issues related to refugees, including refugee characteristics, sociocultural factors and the effects of previous experiences; (2) issues related to health services, including practice issues and the knowledge and skills of health professionals; and (3) issues related to the resettlement context, including policies and practical issues. Few facilitators were identified or evaluated, but these included approaches to care, health service responses and behaviours of health professionals. Conclusions Barriers to accessing health care include refugee characteristics, practice issues in health services, including the knowledge and skills of health professionals, and the resettlement context. Health services need to identify barriers to culturally sensitive care. Improvements in service delivery are needed that meet the needs of refugees. More research is needed to evaluate facilitators to improving health care accessibility for these vulnerable groups. What is known about the topic? Refugee health after resettlement is poor, yet health service use is low. What does this paper add? Barriers to accessing health services in resettlement countries are related not only to refugees, but also to issues regarding health service practices and health professionals’ knowledge and skill, as well as the context of resettlement. Few facilitators to improving refugee access to health services have been identified. What are the implications for practitioners? The barriers associated with health professionals and health services have been linked to trust building, and these need to be addressed to improve accessibility of care for refugees.

A Qualitative Investigation into the Use of Health Services among Melbourne Chinese

2001 ◽  
Vol 7 (3) ◽  
pp. 38 ◽  
Author(s):  
Bridget H-H. Hsu-Hage ◽  
K. C. Tang ◽  
Rebecca Jie Li ◽  
Vivian Lin ◽  
Tony Chow ◽  
...  
Keyword(s):  
Health Care ◽  
Health Service ◽  
Health Information ◽  
General Health ◽  
Health Care Services ◽  
Service Utilisation ◽  
Community Groups ◽  
Health Concerns ◽  
Care Services ◽  
Use Of Health Care

Understanding health service utilisation by community groups can be used to enhance cost-effective service delivery planning. In an inquiry into general health needs, and experiences with health service utilisation by Chinese living in Melbourne, we conducted a series of focus group discussions to explore community health-seeking behaviour. Seven focus groups were drawn from community groups and bilingual health workers in the period September-October 1999. Discussions were carried out in dialect familiar to the participants, facilitated by trained multilingual researchers, tape recorded and transcribed in Chinese and then translated into English. Cross validation was carried out by an independent researcher. Themes that emerged from these discussions included common pathways to care seeking, barriers to the use of health care services, general health concerns, and perceived validity of health information sources. Participants opt for self care when feeling unwell if the condition is perceived as ?not severe?. Use of over-the-counter medication is usually the first course of action. There is a tendency to ?wait and see? when feeling unwell. The use of Traditional Chinese Medicine Practitioners (TCMP) is common, while continuing to see Orthodox Western Medicine practitioners. There are, however, common concerns about the quality of care provided by TCM practitioners and their qualifications. Language, transport, and cost are among other barriers that undermine the use of health care services. Participants reported diabetes, heart disease risk factors, peptic ulcer, hay fever and asthma, poor vision, dental problems, social isolation, and gambling among the most common health concerns. Participants accepted health information from a wide range of sources and placed greater trust in material disseminated by SBS Chinese Radio Programs and the Chinese Health Foundation; an established community organisation run by voluntary health professionals. In conclusion, the study confirmed a number of patterns by which the Chinese community sought and utilised health services and associated factors.

The Role of Physician and Nurse Attitudes in the Health Care of Injecting Drug Users

2010 ◽  
Vol 45 (7-8) ◽  
pp. 1007-1018 ◽  
Author(s):  
Loren Brener ◽  
William Von Hippel ◽  
Susan Kippax ◽  
Kristopher J. Preacher
Keyword(s):  
Health Care ◽  
Drug Users ◽  
Injecting Drug Users ◽  
Nurse Attitudes
Sign in / Sign up

Export Citation Format

Share Document