Risk Factors Associated with Preventable Hospitalisation among Rural Community-Dwelling Patients: A Systematic Review

Ridge, Andrew; Peterson, Gregory M.; Nash, Rosie

doi:10.3390/ijerph192416487

Cited by 5 publications

(8 citation statements)

References 69 publications

(194 reference statements)

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“…Furthermore, remote regions frequently face a disadvantage in terms of healthcare provision, as their residents struggle with difficulties in accessing and navigating healthcare services [16,17], alongside challenges related to transportation difficulties [15]. Additionally, rural populations often exhibit lower levels of health literacy [18], which, in turn, exerts a profound influence on individuals' capacity to understand and apply health information, and its related to poorer health outcomes and reduced utilization of healthcare services [19].…”

Section: Introductionmentioning

confidence: 99%

Implementation of digital health in rural populations with chronic musculoskeletal conditions: A scoping review protocol

Campos,

Costa,

Donato

et al. 2023

PLoS ONE

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Musculoskeletal conditions are a major source of disability worldwide, and its burden have been rising in the last decades. Rural areas, in particular, are associated with higher prevalence of these conditions as well as higher levels of disability, which is likely related to other determinants that affect these communities. Although digital health has been identified as a potential solution to mitigate the impact of these determinants, it is also known that these populations may face barriers that limit the implementation of these interventions. Therefore, the aim of this scoping review is to comprehensively map the evidence regarding the implementation of digital health interventions in rural populations with chronic musculoskeletal conditions. We will include studies published from the year 2000; that report the use of digital interventions that promote prevention, treatment or monitoring of any chronic musculoskeletal condition or chronic pain from musculoskeletal origin, in patients that live in rural areas. This protocol follows the methodological framework for scoping reviews proposed by Arksey and O’Malley, as well as the Joana Briggs Institute (JBI) approach. We will conduct the search on Medline (PubMed), EMBASE, Web of Science and Scopus, as well as grey literature databases. Two independent reviewers will screen titles and abstracts followed by a full-text review to assess the eligibility of the articles. Data extracted will include the identification of the digital interventions used, barriers and enablers identified by the patients or healthcare providers, the patient-level outcomes measured, and the implementation strategies and outcomes reported. By mapping the evidence on the implementation of digital health interventions in rural communities with musculoskeletal conditions, this scoping review will enhance our understanding of their applicability in real-world settings.

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Section: Introductionmentioning

confidence: 99%

Implementation of digital health in rural populations with chronic musculoskeletal conditions: A scoping review protocol

Campos,

Costa,

Donato

et al. 2023

PLoS ONE

View full text Add to dashboard Cite

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“…Maximising local service performance suggests there are system-wide benefits in provision of palliative care via primary care, including a reduction in preventable hospitalisations associated with frequent palliative conditions (notably heart failure and COPD). 4 As noted in the TPE Framework, strengthening Tasmania's palliative care service system may incorporate improving community awareness of palliative care, providing access to enhanced services, identifying and supporting vulnerable populations, optimising use of modern technologies and introducing workforce reforms. 2 The authors of this commentary agree that health literacy surrounding palliative care is crucial for improving outcomes, but recommendations to address that issue are beyond the scope of this commentary.…”

Section: Discussionmentioning

confidence: 99%

“…Provision of community‐based services through the MBS is less expensive than hospital admissions. Maximising local service performance suggests there are system‐wide benefits in provision of palliative care via primary care, including a reduction in preventable hospitalisations associated with frequent palliative conditions (notably heart failure and COPD) 4 …”

Section: Discussionmentioning

confidence: 99%

“…2 Together with a high prevalence of chronic health issues, lower socioeconomic markers and maldistribution of the health workforce, access to prompt and appropriate health care can be challenging for Tasmania's decentralised population. [2][3][4] Australia's population is projected to reach between 37.4 and 49.2 million people by 2066, with life expectancy increasing by 5 years over the same period. 3 Each year, about 100 000 people die from a death that is predictable.…”

Section: Introductionmentioning

confidence: 99%

“…Tasmania has an older population with a high degree of chronic morbidity compared to other Australian states 2 . Together with a high prevalence of chronic health issues, lower socioeconomic markers and maldistribution of the health workforce, access to prompt and appropriate health care can be challenging for Tasmania's decentralised population 2–4 …”

Section: Introductionmentioning

confidence: 99%

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Using the Tasmanian Palliative and End of Life Care Policy Framework (2022) to assess service delivery in a rural general practice

Ridge,

Seidel

2024

Australian J Rural Health

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AimsThis commentary uses the Tasmanian Palliative and End of Life Care Policy Framework (2022; the TPE Framework) to reflect upon palliative care services delivered by a rural Tasmanian general practice.ContextRural populations have challenges in accessing many healthcare services, including palliative care. General practitioners (GPs) and other primary healthcare workers are frequently relied upon to deliver palliative care in rural Australia. Palliative care is often needed before the end‐of‐life phase and patients prefer this to be delivered in the community or at home. GPs face challenges and barriers in continuing to deliver home‐based palliative care services.ApproachAll Medical Benefit Scheme billings for after‐hours or home‐based palliative care provided by the practice, between September 2021 and August 2022, were identified and patient demographic and clinical details collated. To further understand this data, nine GPs were surveyed to explore their attitudes to provision of palliative care service to the local rural communities they serve. These data highlighted several priority areas of the TPE Framework. The TPE Framework is used here to add to the shared understanding of palliative care service delivery in a rural community, and to see if GP's responses align with the priorities of the TPE Framework. Of the 258 after‐hours and home‐visits delivered over a 12‐month period, almost 58% (n = 150) were for palliative care. Patients receiving palliative care were generally older than non‐palliative patients visited (79.9 years vs. 72.0 years respectively; p = 0.004). Patients not at imminent risk of death (64.0%) were more frequently recipients of home‐visits. Of the nine GPs responding to the survey, most intended to continue home visits for palliative patients. Disincentives to providing palliative care during home visits included a lack of time during the day (or after hours), low levels of interdisciplinary coordination or role‐definition, and inadequate remuneration.ConclusionExisting frameworks can be used as an implementation and evaluation guide to help understand local palliative care services. Using a Framework, a rural general practice in Tasmania reflected on their provision of palliative care services. Providing holistic palliative care services from a rural general practice is desirable and achievable with a coordinated, team‐based approach. Access to and integration with specialist services remains a key component of community‐based palliative care pathways.

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Promotion of a social prescribing pathway to general practitioners in a rural area (a feasibility study protocol)

Ridge,

Peterson,

Seidel

et al. 2024

JICA

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PurposePsychosocial problems, including social isolation and loneliness, are prevalent in rural communities and can impact the use of health services and health outcomes. Current approaches to managing patients with predominantly psychosocial issues may not be the most appropriate. Social prescribing (SP) is a relatively new way of linking patients with sources of non-medical support within the community. Emerging literature suggests that community-based, non-medical activities are an effective and preferred approach to managing psychosocial problems. However, there is little evidence describing the attitudes of general practitioners (GPs) towards formal SP pathways.Design/methodology/approachThis research will occur in a general practice in a rural area of Tasmania, Australia. The project will deliver an education module to rural GPs to highlight the benefits of SP and provide a streamlined pathway for referring patients to community support hubs. Existing community organisations will act as “link workers” to connect patients with suitable community activities. GPs will complete a baseline and follow-up survey to measure their perception of SP and the acceptability, feasibility and appropriateness of such an intervention.FindingsThe acceptability, feasibility and appropriateness of the pathway will be assessed using published measures. Free-text responses to open-ended questions will be used to complement the quantitative data. A hybrid effectiveness-implementation method will be used to gather information about the rate of uptake and quality of the SP referral process and identify barriers and facilitators of the process in a real-world setting.Research limitations/implicationsWhile qualitative data for SP programmes is predominantly positive, quantitative data is lacking. Although the planned project is relatively short, it will provide a basis for future SP programme implementation and guide the approach to data collection and implementation assessment.Social implicationsThe barriers to and facilitators of introducing a SP programme in a rural general practice setting may be used to guide the development and implementation of future large-scale SP interventions. This research is both timely and relevant as the problem of social isolation and loneliness, especially in rural areas of Australia, is becoming more well-recognised as a driver of poor health and unnecessary health service usage.Originality/valueUsing SP to address psychosocial risks may reduce healthcare burden and costs. Few SP programmes have been delivered and formally assessed in Australia, and the best way to implement SP locally remains unclear. By delivering a SP intervention in a rural setting and assessing GPs’ responses, future SP projects will be better able to design and integrate social and medical care services.

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Risk Factors Associated with Preventable Hospitalisation among Rural Community-Dwelling Patients: A Systematic Review

Cited by 5 publications

References 69 publications

Implementation of digital health in rural populations with chronic musculoskeletal conditions: A scoping review protocol

Implementation of digital health in rural populations with chronic musculoskeletal conditions: A scoping review protocol

Using the Tasmanian Palliative and End of Life Care Policy Framework (2022) to assess service delivery in a rural general practice

Promotion of a social prescribing pathway to general practitioners in a rural area (a feasibility study protocol)

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