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Using GIS to Improve Accessibility to Phase 2 Cardiac Rehabilitation Programs Using GIS to Improve Accessibility to Phase 2 Cardiac Rehabilitation Programs

Using GIS to Improve Accessibility to Phase 2 Cardiac Rehabilitation Programs - PowerPoint Presentation

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Using GIS to Improve Accessibility to Phase 2 Cardiac Rehabilitation Programs - PPT Presentation

Deborah van Gaans Centre for Research Excellence in the Prevention of Chronic Conditions in Rural and Remote Populations School of Population Health The research reported in this presentation has been supported by the Australian Primary Health Care Research Institute which is supported by a gran ID: 930471

rehabilitation cardiac phase accessibility cardiac rehabilitation accessibility phase research health patients nearest australia programs program model care australian 2008

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Slide1

Using GIS to Improve Accessibility to Phase 2 Cardiac Rehabilitation Programs

Deborah van GaansCentre for Research Excellence in the Prevention of Chronic Conditions in Rural and Remote PopulationsSchool of Population Health

The research reported in this presentation has been supported by the Australian Primary Health Care Research Institute, which is supported by a grant from the Commonwealth of Australia as represented by the Department of Health and Ageing.  The information and opinions contained in it do not necessarily reflect the views or policy of the Australian Primary Health Care Research Institute or the Commonwealth of Australia (or the Department of Health and Ageing).

Slide2

An Australian Research Council Funded Linkage Project with the Following Collaborating Partners :

The University of Adelaide - Mr. Neil Coffee Alphapharm Pty Ltd. - Mr. Peter Astles, Ms. Marian MilliganUniversity of South Australia - Dr. Robyn Clark

University of Queensland - Professor David Wilkinson,

Dr.

Kerena EckertMonash University - Professor Andrew Tonkin The Baker Heart Research Institute - Professor Simon Stewart

Slide3

The Problem

Death by Major Cause, Group and Sex, 2008 (ABS 3303.0 - Causes of Death, Australia, 2008).

Slide4

The Answer : Cardiac Rehabilitation

Introduced into Australia by the National Heart Foundation in 1961.

By 1986, cardiac rehabilitation had advanced sufficiently for it to be seen as an important component of cardiac care.

Defined benefits include reduced mortality and reduced risk of further cardiac events; improvements in physical and social functioning, risk factor profiles and quality of life; and reduced prevalence of

depression.

Source: Bunker, S,J, and Goble, A, J 2003, ‘Cardiac rehabilitation: under-referral and underutilisation’, MJA 2003; 179 (7): 332-333

Slide5

The Bigger Problem!

Despite the evidence to support cardiac rehabilitation, existing services remain underutilised.   Accessibility is a major factor in the underutilisation of Phase 2 Cardiac Rehabilitation Programs.

Slide6

Do Patients Access Their Nearest Cardiac Rehabilitation Program?

5 Phase 2 Cardiac Rehabilitation Centres provided information: Royal Adelaide Hospital, Flinders Medical Centre, Northfield Centre for Physical Ageing, Lyell McEwin

Hospital, Queen Elizabeth Hospital.

2007/2008 only.

857 patients.

Patient addresses were shortened to street and suburb only to maintain confidentiality.

Slide7

Patient Locations and Cardiac Rehabilitation Programs

Slide8

Calculating Nearest Cardiac Rehabilitation Program

Slide9

Patients Attending Nearest Cardiac Rehabilitation Program

571 attending nearest

286 not attending nearest

Total 857 patients

Slide10

Source:

Cromley

, EK,

McLafferty

, SL, 2002, ‘GIS and Public Health’, The Guilford Press, New York, pp.233-300.

In reality, people trade off geographical and

nongeographical

factors in making decisions about health service use (

Cromley

and McLafferty 2002).

Slide11

Source :

Penchansky

, R, Thomas, JW 1981, ‘The Concept of Access: Definition

and Relationship to Consumer Satisfaction’,

Medical Care

, vol. 19, no. 2, pp.127-140.

Penchansky and Thomas (1981) identify five important dimensions of access:Availability

AccessibilityAccommodationAffordabilityAcceptability

Slide12

Addresses of Cardiac Rehabilitation Programs were obtained from the

Australian Cardiac Rehabilitation Association. Pilot survey undertaken via email.2 postal surveys were conducted.

Follow-up phone calls were made to non-respondents.

83.95% return rate.

Cardiac Rehabilitation Accessibility Survey

Slide13

The Accessibility of Phase 2 Cardiac Rehabilitation

Slide14

“This is highlighted by the fact that attendees lived an average of 15.4km from the facility providing the CR program whereas non-attenders lived an average of 40.4kms from the facility.”

De Angelis (2008)

Slide15

The Accessibility of Phase 2 Cardiac Rehabilitation to Rural and Remote Population Centres as Defined by ARIA

Slide16

Model validation

Patients with higher accessibility ratings from the Spatial Model of Accessibility to Phase 2 Cardiac Rehabilitation were found to have been more likely to have attended cardiac rehabilitation (Pearson Correlation 0.308 (P>0.0001, 95% CI 0.1350 to 0.4632).

Slide17

Conclusion

GIS was used to throughout this project:

to highlight the initial problem

to create a model for better understanding of the current situation

to validate the model

And most importantly to highlight where improved accessibility to Phase 2 Cardiac Rehabilitation Programs should occur.

Slide18

Deborah van Gaans

Centre for Research Excellence in the Prevention of Chronic Conditions in Rural and Remote PopulationsSchool of Population HealthEmail: Deborah.vangaans@unisa.edu.au

Thank you