Tag: primary health care

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Equity in Primary Health Care Provision: More than 50 years of the Inverse Care Law

I guest edited a special issue of the Australian Journal of Primary Health with Dr Liz Sturgiss that reflects on more than 50 years of the Inverse Care Law.

The Inverse Care Law was first coined by Julian Tudor Hart in 1972 to refer to availability of good medical and social care varying inversely with the needs of the population served .

As we note in the editorial:

…we cannot forget the importance of income inequality as one of the primary manifestations of disadvantage. Poverty remains one of the principal determinants of how the inverse care law plays out in primary health care and it is a cross-cutting issue that affects all disadvantaged groups to varying degrees. All approaches to improve the access to primary care would benefit from specific attention to how the needs of those living in poverty are served.

The special issue includes a range of articles on the Inverse Care Law itself, Aboriginal and First Nations health, care for transgender people, access for people from culturally diverse backgrounds, and general practice. Most are open access – please take a look.

References

Harris-Roxas, B., & Sturgiss, E. (2023). Equity in primary health care provision: more than 50 years of the inverse care law. Australian Journal of Primary Health, 29(2), i–ii. https://doi.org/10.1071/PY23062
Tudor Hart, J. (1971). The inverse care law. The Lancet, 7696, 405–412. http://er1.library.unsw.edu.au/er/cgi-bin/eraccess.cgi?url=http://dx.doi.org/10.1016/S0140-6736(71)92410-X
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Still time to submit your article: Equity in Primary Health Care Provision – More than 50 years of the Inverse Care Law

Dr Liz Sturgiss and I are guest editing a special issue of the Australian Journal of Primary Health on Equity in Primary Health Care Provision – More than 50 years of the Inverse Care Law.

There’s still time to submit your EOI for inclusion in the special issue, in the form of abstracts are due by 30 March 2022. Full submissions are due by 15th July 2022.

Key areas

We welcome submissions of primary research as well as commentary and review papers from anywhere in the world. We particularly seek submissions based on:

  • Comprehensive primary health care for specific populations, including
    – prison populations
    – Aboriginal and Torres Strait Islander health and First Nations
    – culturally and linguistically diverse communities
    – people living in poverty
    – populations experiencing homelessness and unhoused people
    – rural and remote health
  • Models of care and health services research
  • Team based care and exploration of scope of practice
  • Policy innovations and funding models
  • Community-based responses to the needs of marginalised and oppressed groups

More information on the Australian Journal for Primary Health website.

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“The availability of good medical care tends to vary inversely with the need of the population served” – Submit your article to our special issue marking fifty years of the inverse care law

Dr Liz Sturgiss and I are guest editing a special issue of the Australian Journal of Primary Health on “Equity in Primary Health Care Provision: More than 50 years of the Inverse Care Law”.

Tudor Hart, J. (1971). The inverse care law. The Lancet, 297(7696), 405–412.

The special issue will cover a range of topics, including:

  • Comprehensive primary health care for specific populations, including
    – prison populations
    – Aboriginal and Torres Strait Islanders, and First Nations
    – culturally and linguistically diverse communities
    – people living in poverty
    – populations experiencing homelessness and unhoused people
    – rural and remote health.
  • Models of care and health services research.
  • Team based care and exploration of scope of practice.
  • Policy innovations and funding models.
  • Community-based responses to the needs of marginalised and oppressed groups.

There’s more information on the special issue and the Australian Journal of Primary Health herehttps://www.publish.csiro.au/py/content/CallforPapers#1. Final submissions are due by 15 July 2022 but we’re asking that people submit EOIs in the form of an abstract by 30 March 2022.

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Reflecting on 2021 for the Australian Journal of Primary Health

The past year has also seen significant changes in academic publishing. There has been an emphasis on rapid dissemination of research findings during the pandemic, increasing the prominence of pre-publication manuscripts and reinforcing the need for timely peer review. There has been a significant increase in the volume of manuscripts submitted, including to the AJPH.

At the same time, it is more difficult than ever to find peer reviewers for submitted articles. There has been a significant increase in the pressures on people’s time, through their paid jobs, but also because of juggling caring responsibilities during multiple lockdowns. Many people have been redeployed to support health systems and organisations to respond to the COVID-19 pandemic. The Australian Government’s decision to not provide any financial support to universities during the pandemic has led to thousands of jobs being lost across the sector over the past year, with more losses likely to come. Precarious employment has become even more entrenched and fewer people are in jobs that include service to the profession as part of their roles. This leads to fewer people being able to undertake reviews at the time we need high-quality peer review most.
— Read on www.publish.csiro.au/py/Fulltext/PYv27n6_ED

It’s been a pleasure being an Associate Editor for AJPH, and it was good to have this opportunity to reflect on the pst year with Virginia Lewis and Jenny Macmillan as I’m stepping down.

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Primary health care provider–focused interventions for improving outcomes for people with type 2 diabetes

In brief

The greatest opportunities to enhance diabetes care in the Australian primary health care setting seem to be:

  1. delivering culturally tailored programs involving community health workers (a strong interest of mine)
  2. incorporating diabetes decision support into practice software.

About the paper

Colleagues at the Centre for Primary Health Care and Equity and I did a rapid review on what works to improve outcomes for people with Type 2 diabetes in primary health care , which is available now.

We identified (1) computerised decision support, (2) feedback and benchmarking on diabetes care quality, (3) culturally tailored programs (usually delivered by community health workers), and (4) enhanced practice nurse involvement in diabetes care as interventions that had a positive impact across several outcome measures. These outcomes included:

  • clinical outcomes (blood pressure, and body mass index, or weight)
  • biochemical outcomes (glycosylated haemoglobin [HbA1c], lipid profile, or renal function)
  • psychological outcomes (anxiety, depression, diabetes-related distress, perceived seriousness and vulnerability, self-efficacy, or self-care)
  • health-related quality of life measures from participant self-report.

The evidence about the use of decision aids (e.g. when to commence statins) was equivocal in terms of their impact on HbA1c, lipid profile and renal function. One high quality integrated care study on a virtual clinic, which brought together nurses, diabetologists and GPs, showed improvements in blood pressure but not renal function. No single intervention improved all the outcome measures that were considered.

References

Faruqi, N. et al. (2019) ‘Primary health care provider–focused interventions for improving outcomes for people with type 2 diabetes: a rapid review’, Public Health Research and Practice, 29(4), p. e29121903. Available at: https://doi.org/10.17061/phrp29121903.