FQ3: What role do healthcare facilities and services play in achieving better health for all Australians?

Question 1

What is the range of health facilities and services in Australia?

Answer 1

Primary care focuses on:
- Diagnosing
- Treatment
- Rehabilitation
- Care
- Early intervention

DONE THROUGH THE GOV:
Health promotion
3 levels - federal, state, local

RANGE: INSTITUTIONS - private and public

Question 2

What are the types of health facilities and services in Australia?

Answer 2

Hospitals - public and private
Nursing homes
Psychiatric hospitals
Medical services
Health-related services
Pharmaceuticals
Community support

EXAMPLES: GPs, Dental, Chiropractor, Radiographer, Specialists, Oncologists → cancer or suspected cancer, Psychologists/Psychiatrists → mental health treatment

Question 3

Which health faculties/services are institutional and which are non-institutional?

Answer 3

Institutional:
1. public hospital
2. private hospital
3. psychiatric hospital
4. nursing homes

non-institutional
1. medical services
2. health-related services
3. pharmaceuticals (PBS)
4. community supports - there is no info on this

Question 4

Describe the services provided by a public hospital and what barriers exist or are overcome.

Answer 4

SERVICES:
- Serve a greater proportion of elderly and very young
- Provide increasing highly specialised and complex services
- same-day surgery
- Take most of the non-admitted patients
- Emergency services available

BARRIERS:
- Covered completely by Medicare
- Individuals are provided a doctor and a bed without extra cost associated
- Large wait times for elective surgeries
- People abusing the emergency system, long wait times for non-essential treatment
- Funding - affect the number of nurses/doctors allocated to work shifts (May reduce number of patients that can be attended to)
- Language barriers for patients from NESB
- Rural and remote areas (isolated communities) - limited access to a fully equipped hospital (Distance from major settlements)

Question 5

Describe the services provided by a private hospital and what barriers exist or are overcome.

Answer 5

SERVICES:
- Same-day surgery
- Perform more short-stay services
- Elective procedures
- Less complex procedures

BARRIERS:
- Must be able to pay or have private health care
- Not subsidised by Medicare
- Low SES - unable to afford access to these services due to limited funds available
- Rural and remote areas (isolated communities) - limited access to a fully equipped hospital (Distance from major settlements)

Question 6

Describe the services provided by a psychiatric hospital and what barriers exist or are overcome.

Answer 6

SERVICES:
- Both hospital services → continuing care within community
- GPs, private psychiatrists, community-based public mental-health services, specialised residential mental healthcare facilities

BARRIERS:
- Accessible to all (Covered by Medicare due to increased importance + awareness on mental health)
- Fewer psychiatric hospitals due to reduction in extended hospitalisations, limited access for patients, limited access for rural and remote
- Language + cultural barriers for patients from NESB

Question 7

Describe the services provided by nursing homes and what barriers exist or are overcome.

Answer 7

SERVICES:
- Care & long term nursing attention for those unable to care for themselves
- Some care for people with disability (young)
- Aged-care assessment teams
- Placement in patrons outside of institutions

BARRIERS:
- Public homes take 85% of the residents pension in return for services
- Private homes - require money from the patients’ own savings or a family member
- Limited based on income of families = Limited access for low SES
- Aged care assessment teams (Ensures only highly dependent people are placed in residential care, Limited access)

Question 8

Describe medical services and what barriers exist or are overcome.

Answer 8

SERVICES:
- Doctors, specialists, often health professionals
- GP consultation reimbursed by Medicare

BARRIERS:
- All australians are eligible to claim refunds for their specialist service payments outside of private hospital expenses from Medicare
- Still need to pay up front - difficult for low SES
GPs have the option of Bulk Billing or charging up front (Option: claiming back from Medicare)
- Language barrier for NESB - translator required
- Cultural barrier - e.g. females not seeing male doctors
- Limited access in rural or remote areas

Question 9

Describe health-related services and what barriers exist or are overcome.

Answer 9

SERVICES:
- Ambulance work
- Chiropractors
- Dentistry
- Health inspection
- Nursing
- Occupational therapy and speech therapy
- Pharmacy
- Physiotherapy

BARRIERS:
DENTISTRY
- State and government provide public dental services to primary and secondary school children
- Disadvantaged adults are also provided with dental care
- Cost of services - prevents many from utilising
- Limited access in rural or remote areas + ATSI
Availability of services

PHYSIOTHERAPISTS
- Health funds will cover part of the cost, but the rest is out of pocket expense
- Cost of using service may be considered too high for average person to use

OPTOMETRISTS
- Consultation is covered by Medicare (Bulk Billing)
- Purchase or optometry aids (glasses) is covered either by Health Funds or out of pocket expenses)

Question 10

Describe the responsibility for health facilities and services under the Commonwealth government.

Answer 10

1. Formation of national health policies
2. Control of financing through taxes
3. Provides funds to State and Territory Governments → influences decisions + deliveries
4. Direct responsibility for special community services - war veterans, ATSI communities
5. Contribute major funds to: Residential care, Medical services, Research, Public hospitals, Pharmaceuticals (PBS) - scheme, Community controlled ATSI primary health care
6. Regulates private health insurance
7. Organises health services for veterans
8. Responsible for Medicare - Subsidising medical services, Joint funding with states and territories of public hospital services
9. Major funder of health and medical research - e.g. National Health and Medical Research Council
10. Regulated medicines, devices and blood

Question 11

Describe the responsibility for health facilities and services under the state/territory governments.

Answer 11

Prime responsibility for providing health and community services: Hospital, Mental health, Family, Health promotion, Rehab

Responsible for: (in terms of premises, institutions and personnel): Regulation, Inspection, Licensing, Monitoring, Ambulance services, Handling health complaints

Deliver preventative services
E.g: cancer screening, immunisation programs

Question 12

Describe the responsibility for health facilities and services under the private sector.

Answer 12

Provide wide range of services - Private hospitals, Alternative health services (dental, physiotherapy, chiropractic)

Generally privately owned, funded and operated through Businesses, Charity, Religious groups

E.g. NSW Cancer Council
Receive funding from both State and Governments and the Commonwealth Government

Question 13

Describe the responsibility for health facilities and services under local governments.

Answer 13

1. Responsible for implementing state health policies
2. Controlling local environment issues (e.g. - maintenance of recreational facilities, e.g. - waste disposal, water fluoridation, water supply, food safety monitoring)
3. Deliver some community-based and home-based health and support services
4. Deliver some public health and health promotion activities
5. Responsible for providing a range of care services: Personal, Preventive, Home care (E.g. waste disposal, Meals on Wheels)

E.g. most councils have Mother’s Group - mothers who have just given birth
Increase social networks + interactions
E.g. marathons to raise money for cancer

Question 14

Describe the responsibility for health facilities and services under community groups.

Answer 14

Responsible for promoting health within a more concentrated/focus area of health

Formed on local needs basis → address problems specific to an area/region

E.g. Asthma Foundation, Diabetes Australia

Question 15

Describe the SHARED responsibility for health facilities and services between local, state and territory and Commonwealth government.

Answer 15

1. Regulation of health workforce
2. Education and training of health professionals
3. Regulation of pharmaceuticals and pharmacies
4. Support improvements in safety and quality of health care
5. Funding of public health programs and services
6. Funding of ATSI health services

Question 16

What factors can impact an individual’s access to healthcare facilities and services?

Answer 16

SES
knowledge of available services
geographic isolation
cultural and religious beliefs

shortages of qualified staff
lack of funding or equipment
patient waiting lists for surgery or other treatment in public hospitals
waiting times in outpatient clinics or emergency departments

Question 17

Explain how Medicare, as a government initiative, has improved equity of access to healthcare facilities and services.

Answer 17

accessible to all Australians = not limited by factors such as low SES, rural areas, etc.

provides basic, necessary level of healthcare that prioritises improving health of all Australians = equitable access and treatment

subsidises certain appointments to help alleviate economic burden on individual, which will overall decrease health burden on country in the long-term

Question 18

Explain how PBS, as a government initiative, has improved equity of access to healthcare facilities and services.

Answer 18

discounted prices in the PBS Safety Net = provides affordable appropriate healthcare –> equity and support

Question 19

Explain how the Royal Flying Doctor Service, as a government initiative, has improved equity of access to healthcare facilities and services.

Answer 19

1. Increase health education
2. Health practitioners and services to rural and remote populations - ATSI-specific healthcare

SERVICES:
Aeromedical Emergency Services
Primary health services (GP, Allied Health, Nursing, etc)
Non-Emergency transportation of patients
Research to improve health outcome of those in rural and remote areas

BARRIERS:
Equity and support → rural and remote areas
Affordable and appropriate healthcare

EVALUATION:
Providing extensive primary healthcare
24-hour emergency services + medical equipment

Question 20

How has the decreasing supply of skilled health workers impacted people’s access to health facilities and services? Refer to the nursing industry, psychiatrists and aged care.

Answer 20

NURSES:
460 000 nurses and midwives in AUS, 75% consider leaving - nurses are asked to undertake tasks beyond their skill level as the ratio of appropriately qualified nurses to patients is too low

MENTAL HEALTH:
access to psychiatrists has become more demanding as demand for health care (anxiety, depression - 1/3 of AUS experiences) has increased

AGED CARE:
over 1 mil people use aged care services, however there is a clear skill shortage in age d care workers = shortage of adequate care –> leads familiies to choose self-managed aged care and palliative care

Question 21

How does the geographical size and nature of Australia impact people’s access to health facilities and services?

Answer 21

People living in rural and remote areas have higher rates of hospitalisations, deaths, injury and also have poorer access to, and use of, primary health care services

Question 22

How has the increase in those suffering from chronic diseases and conditions impacted people’s access to health services and facilities?

Answer 22

• Increased demand for healthcare services (Strain on the healthcare system = increased health burden)
• Leading to longer wait times, crowded facilities + difficulties in accessing healthcare
• Higher healthcare costs
• Workforce shortages - especially due to COVID-19
• Impact on primary care - reducing availability of appointments for routine or preventative care
• Health promotion and education

Question 23

Explain why funding should be increased for early intervention and prevention health strategies.

Answer 23

COST EFFECTIVENESS
Preventing illness and injury would result in huge savings in funds and resources used for acute healthcare

IMPROVEMENT TO QOL
Positive health outcomes for individuals that result from prevention include improvements in morbidity rates and longevity — that is, a longer and healthier life

CONTAINMENT OF INCREASING COSTS
prevention is the best way of containing the continually increasing costs of healthcare
Otherwise, these costs could result in adequate health care being unaffordable for ordinary Australians

MAINTENANCE OF SOCIAL EQUITY
a policy of prevention helps to provide greater equity (in the health-care system), which otherwise would be under threat as health costs continue to rise significantly.

USE OF EXISTING RESOURCES
prevention activities use existing and accessible community structures (such as general practitioners) rather than relying on special services and technological procedures.
General practitioners are in a good position to measure risk factors and educate their patients on illness prevention and health promotion.

REINFORCEMENT ON INDIVIDUAL RESPONSIBILITY FOR HEALTH
the use of prevention strategies empowers individuals to take control of their personal health by modifying their behaviour

Question 24

Describe the impact of emerging new treatments and technologies on healthcare, including an example.

Answer 24

1. Improvements in medical technology and treatment assist in decreasing the burden of disease by improving Early detection, Treatment of diseases, illnesses and injuries
2. Potential to improve health outcomes - Specific treatments are continually added to the Medicare Benefits Scheme

e.g. keyhole surgery (less pain, shorter hosptial stay, faster recovery, reduced risks), Cleft Lip and Palate Scheme, Child Dental Benefits Schedule $1000, cancer screening programs

Question 25

Explain the difference between Medicare and Private health insurance in terms of who pays and how it is paid.

Answer 25

MEDICARE:
paid by commonwealth gov and tax payers
paid through medicare levy and tax linked to salary

PRIVATE:
paid by commonwealth gov and private contributors
paid through monthly premiums for various forms of cover

Question 26

Discuss Medicare.

Answer 26

ADVANTAGES:
- Basic medical services (doctor and specialists
- Choice of GP
- Basic hospital services in public hospitals
Specialist health care
- Cover for 85% of the scheduled fee for medical services

DISADVANTAGES:
- No choice for in hospital care
- Long waiting list for elective (non-emergency surgery)
- Does not cover all health services: e.g. Alternative therapies (chiro, acupuncture), Allied health services (physio), Ancillary services (dental, optical, ambulance)

Question 26

Explain the difference between complementary and alternative medicine. Provide an example for each.

Answer 26

Complementary Medicine:
Healing practices and products that work in CONJUNCTION with traditional medicine
E.g: cancer patient receiving chemotherapy may also undergo acupuncture to manage side effects of nausea.

Alternative Medicine:
SUBSTITUTE for traditional therapy
E.g.: cancer patient who forgoes recommended chemotherapy and instead chooses to treat the disease with specific dietary changes

Question 26

Discuss private health insurance.

Answer 26

ADVANTAGES:
- Hospital cover
- Hospital services
- Doctor of choice
- Hospital of choice
- Private or public hospital
- Ancillary services (Dental, optical, chiro, physio, massage)
- Insurance cover while overseas
- ‘Lifetime Health Cover’

DISADVANTAGES:
- Promotes health insurance for the people with higher socioeconomic status
- Health insurance fees are more costly for the individual than public health insurance
- SOCIAL JUSTICE PRINCIPLES: there can be a ‘gap’ where the insurance doesn’t cover the whole fee and the patient has to pay the difference
- Policies can be hard to understand and create confusion
- Qualifying periods apple for certain conditions, which means for a certain time frame, no benefits are payable

Question 26

Provide reasons for the growth of CAM products and services.

Answer 26

1. influx of migration = exposure to more traditional therapies
2. diversity
3. increased pathways to become qualified in complementary medicines (e.g. Bachelor of Chinese Traditional Medicine in Western Sydney University)
4. more coverage by private health insurance companies
5. societal trends towards individualism - exerting greater control over health by having increased choice of treatment options
6. WHO supports research into alternative health approaches - e.g. herbal medicine prep

Question 27

Describe 2 CAM.

Answer 27

ACUPUNCTURE
Ancient system of healing
Traditional medicine of Eastern countries
Inserting very fine needles into skin
Either briefly or for up to 20-30 minutes
Claimed to be effective in a wide range of conditions
Stimulating mind & body’s natural healing responses

AROMATHERAPY
Use of pure essential oil to influence or modify the mind, body or spirit
Acts in accordance with holistic principles by strengthening the person’s vital energies + self-healing capabilities
Vaporisers
Baths and massage
Treatment of depression, sleep disorders, stress symptoms, anxiety

CHIROPRACTIC
Relationship between spine and functioning of the nervous and musculoskeletal system
‘Adjust’ the spine
Specific rapid thrusts
Hands or small instruments
Aimed at correcting subluxations
Removing interference to normal nervous system control over bodily function
Promoting healing and better health

NATUROTHERAPY
Treating the whole person by harnessing the body’s natural ability to heal itself
Variety of needs tailored to meet individual needs
Massage
Relaxation techniques
Herbal medicine
Nutrition

OSTEOPATHY
Manual deep-tissue massage and the manipulation of the spine, joints and surrounding tissue to alleviate back pain, joint problems and muscular disorders
Wellbeing of an individual depends on the skeleton, muscles, ligaments and connective tissues functioning together smoothly

Question 28

How can individuals make informed consumer choices?

Answer 28

What is the treatment you offer? How can it benefit me?
What experience and training do you have?
What are your qualifications?
University degree
plague/certificate
How much will the treatment cost?
Can this treatment be combined with conventional medication?

E.g.: Australian Natural Therapists Association has a list of accredited practitioners who have signed a code of ethics
E.g.: Bowen Therapy Academy of Australia offers an introductory course followed by a six-month practitioner course to obtain accreditation