Stakeholders' perspectives of mobile x-ray services in support of healthcare-in-place in residential aged care facilities: a qualitative study.


Journal

BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548

Informations de publication

Date de publication:
23 08 2022
Historique:
received: 22 01 2022
accepted: 19 05 2022
entrez: 23 8 2022
pubmed: 24 8 2022
medline: 26 8 2022
Statut: epublish

Résumé

There is interest in reducing avoidable emergency department presentations from residential aged care facilities (RACF). Mobile x-ray services may enable the delivery of healthcare in residential aged care facilities. Accordingly, the Australian Government in November 2019 introduced a Medicare Benefit Schedule rebate providing for a 'call-out' fee payable to radiology service providers. This study aims to understand stakeholder perspectives on the benefits of mobile x-ray services and the factors influencing their adoption by RACFs. Twenty-two semi-structured interviews were conducted between October 2020 and February 2021 with a range of stakeholders involved in healthcare delivery to residents: a) general practitioners; b) emergency department clinicians; c) paramedic clinicians; d) a hospital avoidance clinician; e) radiology clinicians and managers; and f) aged care clinicians and managers. Thematic analysis was conducted. Mobile x-ray services were considered valuable for RACF residents. Lack of timely general practitioner in-person assessment and referral, as well as staffing deficits in residential aged care facilities, reduces optimal use of mobile x-ray services and results in potentially unnecessary hospital transfers. The use of mobile x-ray services, as a hospital avoidance strategy, depends on the capacity of RACFs to provide more complex healthcare-in-place. However, this requires greater access to general practitioners for in-person assessment and referral, adequate staffing numbers and appropriately skilled nursing staff within residential aged care facilities.

Sections du résumé

BACKGROUND
There is interest in reducing avoidable emergency department presentations from residential aged care facilities (RACF). Mobile x-ray services may enable the delivery of healthcare in residential aged care facilities. Accordingly, the Australian Government in November 2019 introduced a Medicare Benefit Schedule rebate providing for a 'call-out' fee payable to radiology service providers. This study aims to understand stakeholder perspectives on the benefits of mobile x-ray services and the factors influencing their adoption by RACFs.
DESIGN, SETTING, PARTICIPANTS
Twenty-two semi-structured interviews were conducted between October 2020 and February 2021 with a range of stakeholders involved in healthcare delivery to residents: a) general practitioners; b) emergency department clinicians; c) paramedic clinicians; d) a hospital avoidance clinician; e) radiology clinicians and managers; and f) aged care clinicians and managers. Thematic analysis was conducted.
RESULTS
Mobile x-ray services were considered valuable for RACF residents. Lack of timely general practitioner in-person assessment and referral, as well as staffing deficits in residential aged care facilities, reduces optimal use of mobile x-ray services and results in potentially unnecessary hospital transfers.
CONCLUSIONS
The use of mobile x-ray services, as a hospital avoidance strategy, depends on the capacity of RACFs to provide more complex healthcare-in-place. However, this requires greater access to general practitioners for in-person assessment and referral, adequate staffing numbers and appropriately skilled nursing staff within residential aged care facilities.

Identifiants

pubmed: 35999503
doi: 10.1186/s12877-022-03162-9
pii: 10.1186/s12877-022-03162-9
pmc: PMC9400207
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

700

Informations de copyright

© 2022. The Author(s).

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Auteurs

Joanne Dollard (J)

Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Woodville South, SA, Australia.
Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA, Australia.

Jane Edwards (J)

Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Woodville South, SA, Australia.
Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA, Australia.

Lalit Yadav (L)

Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Woodville South, SA, Australia.
Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA, Australia.

Virginie Gaget (V)

Surgical Specialties, University of Adelaide, The Queen Elizabeth Hospital, Woodville, SA, Australia.

David Tivey (D)

Surgical Specialties, University of Adelaide, The Queen Elizabeth Hospital, Woodville, SA, Australia.
Royal Australasian College of Surgeons, Adelaide, SA, Australia.

Maria Inacio (M)

Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
UniSA Allied Health and Human Movement, University of South Australia, Adelaide, SA, Australia.

Guy Maddern (G)

Surgical Specialties, University of Adelaide, The Queen Elizabeth Hospital, Woodville, SA, Australia.
Royal Australasian College of Surgeons, Adelaide, SA, Australia.

Renuka Visvanathan (R)

Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Woodville South, SA, Australia. renuka.visvanathan@adelaide.edu.au.
Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA, Australia. renuka.visvanathan@adelaide.edu.au.
Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, Australia. renuka.visvanathan@adelaide.edu.au.

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