Health in Sight: November 2024
 
 

Health in Sight: November 2024

MediRecords reads healthcare news from around the globe so we can be well informed on innovation, developments and decisions that may affect future delivery of care. Here are some of the items that stood out in the inbox recently.

Impatient experiences

A data dump from the Australian Bureau of Statistics has shown some Aussies are delaying or doing without healthcare because they can’t afford it. While two thirds of people surveyed (66.4%) could access their preferred GP when needed, 11% of people in disadvantaged areas had to forgo medication or delay it due to the costs involved. And one in five Australians delayed or did not see a mental health professional because they couldn’t afford it. Significant as it is, this data may underestimate the growing gap in access to care. The Patient Experience Survey only interviewed people aged 15 or older who were usual residents of private dwellings, with the effect that people experiencing homelessness, in temporary or public housing are unlikely to have been counted.

While the overall proportion of people surveyed who delayed or did not use health services when needed fell over the past year, this did not apply for people with long term health conditions, or people living in areas of most socio-economic disadvantage, who were more likely to forgo care.

The survey shows GPs remain at the heart of Australian healthcare, with the proportion of people who saw a family doctor up slightly to 82.6% in 2023-24, from 82.3% in 2022-23. In contrast, only 53% saw a dental professional and 39% a medical specialist in 2023-24. Numbers of people seeing a GP for after hours care (5.2%) or urgent medical care (8.8%) were very low, while 15.3% of Australians visited a hospital emergency department in 2023-24. In outer regional, remote or very remote areas, (presumably with fewer GPs and options for after hours care,) 20.4% of people sought care at their local ED.

Significant gender gaps on service usage suggests Australian men do not prioritise their health, with women more likely to present at all the healthcare services listed in the survey. For example, 87.3% of women saw a GP in 2023-24, compared to 77.7% of men. Use of telehealth fell, with the data revealing women are significantly more likely to use telehealth services than men.

To read more of the Patient Experience survey results, go to Patient Experiences, 2023-24 financial year | Australian Bureau of Statistics.

Housing-health linkages

On the subject of doing without, a Victorian Council of Social Service (VCOSS) Health and Energy Hardship project has sounded the alarm that utility bills are no longer affordable for some households, resulting in people living without heating or cooling. VCOSS says energy hardship has demonstrable impacts on health and lists signs for healthcare professionals to watch for here: Health and Energy Hardship | VCOSS

This project is an example of focusing on opportunities to improve health equity, rather than just outcomes data. Cleveland’s Metro Health Institute for Hope recently posted on this issue, suggesting that asking communities how to change health outcomes may be more effective than monitoring distressing data. More detail on the Institute’s logic can be found here: Why health equity’s goal shouldn’t be outcomes

Cultural connections count

With Australian governments generally failing to achieve progress towards Closing the Gap targets for the health and wellbeing of Aboriginal and Torres Strait Islander Australians (see Closing the Gap targets and outcomes | Closing the Gap), fresh approaches are clearly required. Recent University of New South Wales research may be a step in the right direction, with researchers finding that opportunities to practice culture on Country has a positive impact on “stress relief, inter-generational healing, and the journey to overcoming trauma, which in turn had a positive impact on … overall health and wellbeing.” Further details can be found here: The role of culture and connection in improving Aboriginal health :: Hospital + Healthcare

Season for change

The man who puts the flavour in demographic data, Bernard Salt, has added to the growing body of commentary suggesting the future of Australian Healthcare is in our own homes. Mr Salt told a Perth symposium that healthcare is about to be hit by the “baby boomer freight train” and “we will see the care sector redefined, re-imagined and repurposed” by this numerically and financially influential sector of our population. Health Services Daily reported the respected Mr Salt saying: “They will make it clear how their care should be delivered and the vast majority will want in-home care.” (Read more here: https://www.healthservicesdaily.com.au/future-of-care-is-in-the-home-salt/21895)

Spending to save

Whether you call them DNAs (Did not attend) or FTAs (failed to attend), a no show for a medical appointment means lost revenue and longer waitlists for patients who could have utilised the available timeslot. A partnership between Uber Health and Veteran Affairs in the US has made it easier for people to attend medical appointments by removing transportation as a reason for non-attendance. Veterans Health Administration report that 1.8 million appointments are missed annually due to transportation hurdles. Since inserting the Uber option, they say attendance has risen significantly, saving an estimated $196.7 million in missed appointments. (See VA finds medical transportation fix with Uber Health | TechTarget)

MediRecords at the coalface

As an access-anywhere cloud software system purpose-built for multidisciplinary care, MediRecords is used in a multitude of ways in Australian healthcare. These include use by paramedics; a remote mining camp; street, clinic and hospital care for people experiencing homelessness; Aboriginal health services; telehealth businesses; virtual emergency departments; alternative medication businesses and many more. Please reach out to us if you have a unique or innovative use of MediRecords you would like to showcase.

Tim Pegler

Senior Business Development Manager

Homelessness Awareness Week: The housing-health nexus
 

Homelessness Awareness Week: The housing-health nexus

Tonight almost 122,500 Australians will have nowhere safe and secure to sleep, the most recent census data shows. One in seven of them will be children under 12.

In 2022-23, 273,600 people were assisted by homelessness services, with another 108,000 unable to be assisted due to insufficient staff, accommodation or resources. In the group who could not be supported by overstretched services, 80 per cent were women and children, many of whom were fleeing domestic and family violence, according to the Australian Institute of Health and Welfare.

This week, Homelessness Awareness Week, the national peak body for homelessness, Homelessness Australia, is calling for the changes that could turn the tide of homelessness, including:

  • Increasing social housing to 10% of all housing;
  • Increasing funding to homelessness services to meet need; and
  • Increasing income support payments to at least $80 a day.

This week also serves as a stark reminder of the health difficulties faced by people experiencing homelessness (PEH). Studies in Australia and internationally have found about 60% of PEH have a long-term physical condition or long-term mental health conditions – higher than the population who do not experience homelessness.

The health disparities of PEH and a revolving hospital door — PEH are 43% more likely to reattend emergency departments within 28 days — reflect the social circumstances that have contributed to the experience of homelessness.

A wide-ranging review study this year, led by Jean-Phillipe Miller at St Vincent’s Hospital Melbourne, argued that while PEH were often viewed by healthcare services as “hard to reach”, it is the services themselves that are difficult to access for this vulnerable group. 

By bringing healthcare directly to those in need, outreach programs, such as primary healthcare service outreach programs, offer a promising solution. A UK study found they can help bridge the gap between the homeless and essential health services. 

Homeless Healthcare in Perth is one such service, providing outreach health care to PEH on the streets, along with fixed site clinics and a 20-bed inpatient facility.

CEO Alison Sayer said Homeless Healthcare provides services where they are most needed, creating an alternative to busy public emergency departments.

She said Homeless Healthcare supported over 2500 people in 2023, many of whom had multiple health conditions.

Ms Sayer said, “People experiencing homelessness have an average life expectancy of less than 50 years, a stark contrast to the average Australian who can expect to live into their 80s.

“This disparity largely exists due to the many barriers preventing people experiencing homelessness from accessing healthcare. Health problems are among the most significant factors leading to and perpetuating homelessness.” 

MediRecords is proud to support the work of Homeless Healthcare as the electronic health record system for inpatient and outpatient care.

You can help make a difference by donating to Homeless Healthcare today – donate here

Sources and further reading:

Australian Institute of Health and Welfare. (2023). Health of people experiencing homelessness. https://www.aihw.gov.au/reports/australias-health/health-of-people-experiencing-homelessness

Homelessness Australia. (2023). Home. https://homelessnessaustralia.org.au/

Kopanitsa, V., McWilliams, S., Leung, R., Schischa, B., Sarela, S., Perelmuter, S., Sheeran, E., Mourgue, L., Tan, G. C., & Rosenthal, D. M. (2023). A systematic scoping review of primary health care service outreach for homeless populations. Family Practice, 40(1), 138-151. https://doi.org/10.1093/fampra/cmac075

Lee, S., Thomas, P., Newnham, H., Freidin, J., Smith, C., Lowthian, J., Borghmans, F., Gocentas, R. A., De Silva, D., & Stafrace, S. (2019). Homeless status documentation at a metropolitan hospital emergency department. Emergency Medicine Australasia, 31, 639–645.

Miller, J. P., Hutton, J., Doherty, C., & Holmes, C. (2024). A scoping review examining patient experience and what matters to people experiencing homelessness when seeking healthcare. BMC Health Services Research, 24(492). https://doi.org/10.1186/s12913-024-10971-8

Morrison, D. S. (2009). Homelessness as an independent risk factor for mortality: Results from a retrospective cohort study. International Journal of Epidemiology, 38(3), 877–883. https://doi.org/10.1093/ije/dyp160

Queen, A. B., Lowrie, R., Richardson, J., & Williamson, A. E. (2017). Multimorbidity, disadvantage, and patient engagement within a specialist homeless health service in the UK: An in-depth study of general practice data. BJGP Open, 1(3). https://doi.org/10.3399/bjgpopen17X100941

Wood, L., Wood, N. J. R., Vallesi, S., Stafford, A., Davies, A., & Cumming, C. (2019). Hospital collaboration with a housing first program to improve health outcomes for people experiencing homelessness. Housing, Care and Support, 22(1), 27–39.