Access to health care services in an Australian rural area – a qualitative case study
- Le, Quynh, Nguyen, Hoang, Auckland, Stuart, Hoang, Ha, Terry, Daniel
- Authors: Le, Quynh , Nguyen, Hoang , Auckland, Stuart , Hoang, Ha , Terry, Daniel
- Date: 2012
- Type: Text , Journal article
- Relation: International Journal of Annotative Interdisciplinary Research Vol. 1, no. 3 (2012), p. 29-36
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- Description: The study is aimed at investigating access to primary health care by examining various access parameters such as availability, accessibility, and affordability in Meander Valley, Northern Tasmania, Australia. Qualitative research design and data analysis were adopted. Semi-structured interviews were conducted with 30 people that were recruited through convenience sampling. The findings indicated that participants generally expressed relative satisfaction with local health care service provision, although a number of participants cited satisfaction with some services and dissatisfaction with others. The main issues of concern were the absence of specialised, dental and after-hours care, high cost of services, and issues of access to transport. The resourcefulness of people with chronic health issues and their carers emerged as important, as was the relationship between lifestyle choices, alternative and mainstream health care options. This study revealed major barriers to health care access by residents in rural Australia, which calls for urgent corrective measures. Further research should be directed to the exploration of the experience and expertise of carers and health professionals so as to obtain a more complete picture of access to health care services in rural settings. In addition, the study recommends a thorough investigation of the alternative health care options.
- Authors: Le, Quynh , Nguyen, Hoang , Auckland, Stuart , Hoang, Ha , Terry, Daniel
- Date: 2012
- Type: Text , Journal article
- Relation: International Journal of Annotative Interdisciplinary Research Vol. 1, no. 3 (2012), p. 29-36
- Full Text:
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- Description: The study is aimed at investigating access to primary health care by examining various access parameters such as availability, accessibility, and affordability in Meander Valley, Northern Tasmania, Australia. Qualitative research design and data analysis were adopted. Semi-structured interviews were conducted with 30 people that were recruited through convenience sampling. The findings indicated that participants generally expressed relative satisfaction with local health care service provision, although a number of participants cited satisfaction with some services and dissatisfaction with others. The main issues of concern were the absence of specialised, dental and after-hours care, high cost of services, and issues of access to transport. The resourcefulness of people with chronic health issues and their carers emerged as important, as was the relationship between lifestyle choices, alternative and mainstream health care options. This study revealed major barriers to health care access by residents in rural Australia, which calls for urgent corrective measures. Further research should be directed to the exploration of the experience and expertise of carers and health professionals so as to obtain a more complete picture of access to health care services in rural settings. In addition, the study recommends a thorough investigation of the alternative health care options.
Continuity of carer in the public hospital system in the eyes of rural women and maternity health providers in Tasmania, Australia
- Hoang, Ha, Le, Quynh, Terry, Daniel, Kilpatrick, Sue, Stuart, Jacqueline
- Authors: Hoang, Ha , Le, Quynh , Terry, Daniel , Kilpatrick, Sue , Stuart, Jacqueline
- Date: 2013
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 1, no. (2013), p. 1-6
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- Description: This study investigates Tasmanian maternity health providers’ and rural women’s experiences and views of continuity of care in the public health system and the feasibility of this model is explored. Semi-structured interviews were conducted with 22 women who had childbirth experiences in six rural areas in Tasmania in the past five years. In addition 20 multidisciplinary maternity health providers currently employed by the health care system were also interviewed. Multidisciplinary maternity health providers and rural women believed that continuity of carer would help them build up relationship with each other and contribute to their satisfaction with care. However, both Tasmanian maternity health providers and rural consumers recognised the challenges of providing continuity of carer in the current public health system due to the constraints of human resources. Given the human resource constraints in the public hospital system, women would be happy with the quality of care provided by the team of health professionals.
- Authors: Hoang, Ha , Le, Quynh , Terry, Daniel , Kilpatrick, Sue , Stuart, Jacqueline
- Date: 2013
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 1, no. (2013), p. 1-6
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- Description: This study investigates Tasmanian maternity health providers’ and rural women’s experiences and views of continuity of care in the public health system and the feasibility of this model is explored. Semi-structured interviews were conducted with 22 women who had childbirth experiences in six rural areas in Tasmania in the past five years. In addition 20 multidisciplinary maternity health providers currently employed by the health care system were also interviewed. Multidisciplinary maternity health providers and rural women believed that continuity of carer would help them build up relationship with each other and contribute to their satisfaction with care. However, both Tasmanian maternity health providers and rural consumers recognised the challenges of providing continuity of carer in the current public health system due to the constraints of human resources. Given the human resource constraints in the public hospital system, women would be happy with the quality of care provided by the team of health professionals.
Factors influencing community nursing roles and health service provision in rural areas : a review of literature
- Barrett, Annette, Terry, Daniel, Lê, Quynh, Hoang, Ha
- Authors: Barrett, Annette , Terry, Daniel , Lê, Quynh , Hoang, Ha
- Date: 2016
- Type: Text , Journal article
- Relation: Contemporary Nurse Vol. 52, no. 1 (2016), p. 119-135
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- Description: Aims: This review sought to better understand the issues and challenges experienced by community nurses working in rural areas and how these factors shape their role. Methods: Databases were searched to identify relevant studies, published between 1990 and 2015, that focussed on issues and challenges experienced by rural community nurses. Generic and grey literature relating to the subject was also searched. The search was systematically conducted multiple times to assure accuracy. Results: A total of 14 articles met the inclusion criteria. This critical review identified common issues impacting community nursing and included role definition, organisational change, human resource, workplace and geographic challenges. Conclusion: Community nurses are flexible, autonomous, able to adapt care to the service delivery setting, and have a diversity of knowledge and skills. Considerably more research is essential to identify factors that impact rural community nursing practice. In addition, greater advocacy is required to develop the role. © 2016 Informa UK Limited, trading as Taylor & Francis Group.
- Authors: Barrett, Annette , Terry, Daniel , Lê, Quynh , Hoang, Ha
- Date: 2016
- Type: Text , Journal article
- Relation: Contemporary Nurse Vol. 52, no. 1 (2016), p. 119-135
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- Description: Aims: This review sought to better understand the issues and challenges experienced by community nurses working in rural areas and how these factors shape their role. Methods: Databases were searched to identify relevant studies, published between 1990 and 2015, that focussed on issues and challenges experienced by rural community nurses. Generic and grey literature relating to the subject was also searched. The search was systematically conducted multiple times to assure accuracy. Results: A total of 14 articles met the inclusion criteria. This critical review identified common issues impacting community nursing and included role definition, organisational change, human resource, workplace and geographic challenges. Conclusion: Community nurses are flexible, autonomous, able to adapt care to the service delivery setting, and have a diversity of knowledge and skills. Considerably more research is essential to identify factors that impact rural community nursing practice. In addition, greater advocacy is required to develop the role. © 2016 Informa UK Limited, trading as Taylor & Francis Group.
Living in a regional area : access, utilisation and health care quality
- Lê, Quynh, Auckland, Stuart, Nguyên, Hoang, Terry, Daniel, Hoang, Ha
- Authors: Lê, Quynh , Auckland, Stuart , Nguyên, Hoang , Terry, Daniel , Hoang, Ha
- Date: 2013
- Type: Text , Journal article
- Relation: International Journal of Innovative Interdisciplinary Research Vol. 2, no. (2013), p. 20-32
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- Description: Primary health care plays a significant role in the well-being of individuals and communities, yet access to these services can vary. Factors such as socio-economic status and location of residence can impact this access. A study was conducted to investigate the relationship between location, utilisation, quality and health outcomes of primary health care services in the Meander Valley municipality of Tasmania, Australia. This paper reports the findings of the study which adopted a mixed-methods approach with multiple sources of data including government reports, survey questionnaires and interviews. The regional socio-economic disadvantage reflected not only the health disparities and poorer health conditions, but also the affordability to seek care. This was compounded by the lower levels of available health services and private health insurance. The lack of local services or their low quality was the main motivation for many to seek care outside of the region, which was unaffordable and at times logistically impossible. On the basis of the findings, a number of recommendations are provided to guide the current and future health care services and to improve the well-being of the Meander Valley community.
- Authors: Lê, Quynh , Auckland, Stuart , Nguyên, Hoang , Terry, Daniel , Hoang, Ha
- Date: 2013
- Type: Text , Journal article
- Relation: International Journal of Innovative Interdisciplinary Research Vol. 2, no. (2013), p. 20-32
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- Description: Primary health care plays a significant role in the well-being of individuals and communities, yet access to these services can vary. Factors such as socio-economic status and location of residence can impact this access. A study was conducted to investigate the relationship between location, utilisation, quality and health outcomes of primary health care services in the Meander Valley municipality of Tasmania, Australia. This paper reports the findings of the study which adopted a mixed-methods approach with multiple sources of data including government reports, survey questionnaires and interviews. The regional socio-economic disadvantage reflected not only the health disparities and poorer health conditions, but also the affordability to seek care. This was compounded by the lower levels of available health services and private health insurance. The lack of local services or their low quality was the main motivation for many to seek care outside of the region, which was unaffordable and at times logistically impossible. On the basis of the findings, a number of recommendations are provided to guide the current and future health care services and to improve the well-being of the Meander Valley community.
Migrants' perceptions of health promotion messages in rural Tasmania: Negotiating and communicating health risk
- Terry, Daniel, Lê, Quynh, Hoang, Ha
- Authors: Terry, Daniel , Lê, Quynh , Hoang, Ha
- Date: 2012
- Type: Text , Journal article
- Relation: Health, Risk and Society Vol. 14, no. 7-8 (2012), p. 639-653
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- Description: Asian migrants living in rural Tasmania experience a social and cultural environment dissimilar to larger Australian cities. This study investigated Asian migrants' lived experiences, their intercultural views with a focus on health risk behaviours within the challenge of a new rural environment. Certain health risks were identified and possible social and cultural connections. This exploratory study used a qualitative approach focussing on the personal experience of the Asian migrants living in rural Tasmania, Australia. Interviews were conducted from October to December 2011 with 36 Asian migrants residing in rural Tasmania, recruited through purposive sampling. Sub-populations such as Asian migrants residing in less dense culturally and linguistically diverse communities, including Tasmania, continue to maintain health and health risk beliefs from their culture. Migrant sub-population selectively adapted to their new environment, with longer term migrants acquiring western health conditions. The research provided insights about Asian migrant's views regarding non-communicable health issues in less dense culturally and linguistically diverse communities. In addition to adding to existing knowledge, the study provided some specific insights for better understanding of the relationship between health, risk and society and hopefully for improving primary health care access and delivery of care in rural and other small communities where sparse and less cohesive culturally and linguistically diverse communities exist. © 2012 Copyright Taylor and Francis Group, LLC.
- Authors: Terry, Daniel , Lê, Quynh , Hoang, Ha
- Date: 2012
- Type: Text , Journal article
- Relation: Health, Risk and Society Vol. 14, no. 7-8 (2012), p. 639-653
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- Description: Asian migrants living in rural Tasmania experience a social and cultural environment dissimilar to larger Australian cities. This study investigated Asian migrants' lived experiences, their intercultural views with a focus on health risk behaviours within the challenge of a new rural environment. Certain health risks were identified and possible social and cultural connections. This exploratory study used a qualitative approach focussing on the personal experience of the Asian migrants living in rural Tasmania, Australia. Interviews were conducted from October to December 2011 with 36 Asian migrants residing in rural Tasmania, recruited through purposive sampling. Sub-populations such as Asian migrants residing in less dense culturally and linguistically diverse communities, including Tasmania, continue to maintain health and health risk beliefs from their culture. Migrant sub-population selectively adapted to their new environment, with longer term migrants acquiring western health conditions. The research provided insights about Asian migrant's views regarding non-communicable health issues in less dense culturally and linguistically diverse communities. In addition to adding to existing knowledge, the study provided some specific insights for better understanding of the relationship between health, risk and society and hopefully for improving primary health care access and delivery of care in rural and other small communities where sparse and less cohesive culturally and linguistically diverse communities exist. © 2012 Copyright Taylor and Francis Group, LLC.
Rural community nurses : insights into health workforce and health service needs in Tasmania
- Terry, Daniel, Lê, Quynh, Hoang, Ha, Barrett, Annette
- Authors: Terry, Daniel , Lê, Quynh , Hoang, Ha , Barrett, Annette
- Date: 2015
- Type: Text , Journal article
- Relation: The International Journal of Health, Wellness, and Society Vol. 5, no. 3 (2015), p. 109-120
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- Description: Abstract: Community nurses often work in isolation, particularly in rural areas where many other non-government adjunct health services are absent. At times, they feel overwhelmed, stressed and undervalued while undertaking diverse responsibilities. The study aimed to examine the benefits and challenges community nurses experience when working in rural and remote areas of Tasmania, Australia while determining the specialty skills and practices to meet rural health needs. An explorative research design using a phenomenological approach was adopted. Data were collected through semi-structured interviews with a convenient sample of 15 community nurses from the North and North-west areas of Tasmania. This yielded insight into the rural workforce challenges, gaps in services and the community nurses' lived experience of providing adequate health services to these communities. The results indicated significant variations in the structure and type of community nursing services and a number of key challenges were identified within the profession. Despite these challenges community nurses interviewed indicated high levels of job satisfaction and long term employment. Given the diversity in both community nursing roles and factors impacting on the role further research is required to examine the exact roles and levels of integration between specialist and generalist community nursing roles while exploring and more clearly defining the role of the contemporary community nurse in Australia. Consideration should also be given to embracing community nursing diversity which is an important aspect of best practice for future community nursing.
- Authors: Terry, Daniel , Lê, Quynh , Hoang, Ha , Barrett, Annette
- Date: 2015
- Type: Text , Journal article
- Relation: The International Journal of Health, Wellness, and Society Vol. 5, no. 3 (2015), p. 109-120
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- Description: Abstract: Community nurses often work in isolation, particularly in rural areas where many other non-government adjunct health services are absent. At times, they feel overwhelmed, stressed and undervalued while undertaking diverse responsibilities. The study aimed to examine the benefits and challenges community nurses experience when working in rural and remote areas of Tasmania, Australia while determining the specialty skills and practices to meet rural health needs. An explorative research design using a phenomenological approach was adopted. Data were collected through semi-structured interviews with a convenient sample of 15 community nurses from the North and North-west areas of Tasmania. This yielded insight into the rural workforce challenges, gaps in services and the community nurses' lived experience of providing adequate health services to these communities. The results indicated significant variations in the structure and type of community nursing services and a number of key challenges were identified within the profession. Despite these challenges community nurses interviewed indicated high levels of job satisfaction and long term employment. Given the diversity in both community nursing roles and factors impacting on the role further research is required to examine the exact roles and levels of integration between specialist and generalist community nursing roles while exploring and more clearly defining the role of the contemporary community nurse in Australia. Consideration should also be given to embracing community nursing diversity which is an important aspect of best practice for future community nursing.
- Terry, Daniel, Hoang, Ha, Peck, Blake, Lê, Quynh
- Authors: Terry, Daniel , Hoang, Ha , Peck, Blake , Lê, Quynh
- Date: 2021
- Type: Text , Journal article
- Relation: Health and history Vol. 23, no. 1 (2021), p. 61
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- Description: Recruitment of International medical graduates (IMGs) continues to be central to health workforce planning in Australia with the highest number of IMGs per capita globally. Australia's effort to increase IMG numbers is due to shortages and poor distribution of health workforce caused in the 1990s, however there is a need to consider the historical contexts that have embedded IMG recruitment and movement. Using primary and secondary sources of data, this paper examines history to help understand the circumstances and issues surrounding IMGs in contemporary Australia as it grapples with meeting the ever-growing demand for IMGs, particularly in rural areas where the greatest health disadvantage occurs. The analysis reveals that despite Australia's reliance on IMGs, as a group they encounter ongoing stigma, anti-competitive behaviour, public debate, and embargos.
The shortage-surplus paradox : a literature review of primary health care accessibility
- Terry, Melissa, Terry, Daniel, Hoang, Ha, Hannah, Chona
- Authors: Terry, Melissa , Terry, Daniel , Hoang, Ha , Hannah, Chona
- Date: 2013
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 1, no. 3 (2013), p. 40-50
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- Description: The National Primary Health Care Strategy in Australia recommends primary health care services need to be clinically and culturally appropriate and delivered in a timely and affordable manner. However simultaneously recognised, access is still inequitable in among various population groups and many areas of Australia. Geographical Information System (GIS) have been used to explore geographical health disparities, planning health care service delivery and provide data in a meaningful way to inform public health strategies. Moreover, GIS has also been used to spatially analyse, measure and provide insight into a population’s accessibility to health care services. A literature search was conducted to identify studies which examined primary health care accessibility using GIS techniques among various urban and rural populations. A limited number of studies demonstrated in addition to distance; time; and location, low socioeconomic status, Culturally and Linguistically Diverse (CALD) background among other factors influences health care access. In addition, other factors were identified to impact health care access, which is an individualised process, influenced by individual characteristics, beliefs, attitudes, and an individual’s activity space. As health care accessibility becomes more prominent within policy, among practitioners and increasingly researched, it has the potential to move beyond recognising areas of poor accessibility among individuals and communities. With a greater integration of both spatial and aspatial data, the process has the likelihood, to provide greater insight into patient behaviour, public perception, amelioration service quality and improve population health and wellbeing.
- Authors: Terry, Melissa , Terry, Daniel , Hoang, Ha , Hannah, Chona
- Date: 2013
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 1, no. 3 (2013), p. 40-50
- Full Text:
- Reviewed:
- Description: The National Primary Health Care Strategy in Australia recommends primary health care services need to be clinically and culturally appropriate and delivered in a timely and affordable manner. However simultaneously recognised, access is still inequitable in among various population groups and many areas of Australia. Geographical Information System (GIS) have been used to explore geographical health disparities, planning health care service delivery and provide data in a meaningful way to inform public health strategies. Moreover, GIS has also been used to spatially analyse, measure and provide insight into a population’s accessibility to health care services. A literature search was conducted to identify studies which examined primary health care accessibility using GIS techniques among various urban and rural populations. A limited number of studies demonstrated in addition to distance; time; and location, low socioeconomic status, Culturally and Linguistically Diverse (CALD) background among other factors influences health care access. In addition, other factors were identified to impact health care access, which is an individualised process, influenced by individual characteristics, beliefs, attitudes, and an individual’s activity space. As health care accessibility becomes more prominent within policy, among practitioners and increasingly researched, it has the potential to move beyond recognising areas of poor accessibility among individuals and communities. With a greater integration of both spatial and aspatial data, the process has the likelihood, to provide greater insight into patient behaviour, public perception, amelioration service quality and improve population health and wellbeing.
Women's access needs in maternity care in rural Tasmania, Australia : a mixed methods study
- Hoang, Ha, Le, Quynh, Terry, Daniel
- Authors: Hoang, Ha , Le, Quynh , Terry, Daniel
- Date: 2014
- Type: Text , Journal article
- Relation: Women and Birth Vol. 27, no. 1 (2014), p. 9-14
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- Description: Objectives: This study investigates (i) maternity care access issues in rural Tasmania, (ii) rural women's challenges in accessing maternity services and (iii) rural women's access needs in maternity services. Methods: A mixed-method approach using a survey and semi-structured interviews was conducted. The survey explored women's views of rural maternity services from antenatal to postnatal care, while interviews reinforced the survey results and provided insights into the access issues and needs of women in maternity care. Findings: The survey was completed by n=210 women, with a response rate of 35%, with n=22 follow-up interviews being conducted. The survey indicated the majority of rural women believed antenatal education and check-ups and postnatal check-ups should be provided locally. The majority of women surveyed also believed in the importance of having a maternity unit in the local hospital, which was further iterated and clarified within the interviews. Three main themes emerged from the interview data, namely (i) lack of access to maternity services, (ii) difficulties in accessing maternity services, and (iii) rural women's access needs. Conclusion: The study suggested that women's access needs are not fully met in some rural areas of Tasmania. Rural women face many challenges when accessing maternity services, including financial burden and risk of labouring en route. The study supports the claim that the closure of rural maternity units shifts cost and risk from the health care system to rural women and their families. © 2013 Australian College of Midwives.
- Authors: Hoang, Ha , Le, Quynh , Terry, Daniel
- Date: 2014
- Type: Text , Journal article
- Relation: Women and Birth Vol. 27, no. 1 (2014), p. 9-14
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- Description: Objectives: This study investigates (i) maternity care access issues in rural Tasmania, (ii) rural women's challenges in accessing maternity services and (iii) rural women's access needs in maternity services. Methods: A mixed-method approach using a survey and semi-structured interviews was conducted. The survey explored women's views of rural maternity services from antenatal to postnatal care, while interviews reinforced the survey results and provided insights into the access issues and needs of women in maternity care. Findings: The survey was completed by n=210 women, with a response rate of 35%, with n=22 follow-up interviews being conducted. The survey indicated the majority of rural women believed antenatal education and check-ups and postnatal check-ups should be provided locally. The majority of women surveyed also believed in the importance of having a maternity unit in the local hospital, which was further iterated and clarified within the interviews. Three main themes emerged from the interview data, namely (i) lack of access to maternity services, (ii) difficulties in accessing maternity services, and (iii) rural women's access needs. Conclusion: The study suggested that women's access needs are not fully met in some rural areas of Tasmania. Rural women face many challenges when accessing maternity services, including financial burden and risk of labouring en route. The study supports the claim that the closure of rural maternity units shifts cost and risk from the health care system to rural women and their families. © 2013 Australian College of Midwives.
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