Field, Pat, Franklin, Richard C., Barker, Ruth, Harrington, Jillian, and Leggat, Peter (2024) Health systems model for chronic disease secondary prevention in rural and remote areas - Chronic disease: Road to health. Australian Health Review, 48 (3). pp. 240-247.

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Abstract

Objectives: Cardiac rehabilitation (CR) provides evidence-based secondary prevention for people with heart disease (HD) (clients). Despite HD being the leading cause of mortality and morbidity, CR is under-utilised in Australia. This research investigated healthcare systems required to improve access to CR in rural and remote areas of North Queensland (NQ).

Methods: A qualitatively dominant case study series to review management systems for CR in rural and remote areas of NQ was undertaken. Data collection was via semi-structured interviews in four tertiary hospitals and four rural or remote communities. An audit of discharge planning and CR referral, plus a review of community-based health services, was completed. An iterative and co-design process including consultation with healthcare staff and community members culminated in a systems-based model for improving access to CR in rural and remote areas.

Results: Poorly organised CR systems, poor client/staff understanding of discharge planning and low referral rates for secondary prevention, resulted in the majority of clients not accessing secondary prevention, despite resources being available. Revised health systems and management processes were recommended for the proposed Heart: Road to health model, and given common chronic diseases risk factors it was recommended to be broadened into Chronic disease: Road to health.

Conclusion: A Chronic disease: Road to health model could provide effective and efficient secondary prevention for people with chronic diseases in rural and remote areas. It is proposed that this approach could reduce gaps and duplication in current healthcare services and provide flexible, client-centred, holistic, culturally responsive services, and improve client outcomes.

Item ID:	83883
Item Type:	Article (Research - C1)
ISSN:	1449-8944
Keywords:	cardiac rehabilitation, client centred, culturally appropriate, health systems, management, remote, rural, secondary prevention, social determinants
Related URLs:	https://www.scopus.com/inward/record.uri...
Copyright Information:	© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Date Deposited:	29 Oct 2024 01:48
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