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
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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).
Slide2An 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
Slide3The Problem
Death by Major Cause, Group and Sex, 2008 (ABS 3303.0 - Causes of Death, Australia, 2008).
Slide4The 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
Slide5The 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.
Slide6Do 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.
Slide7Patient Locations and Cardiac Rehabilitation Programs
Slide8Calculating Nearest Cardiac Rehabilitation Program
Slide9Patients Attending Nearest Cardiac Rehabilitation Program
571 attending nearest
286 not attending nearest
Total 857 patients
Slide10Source:
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).
Slide11Source :
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
Slide12Addresses 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
Slide13The 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)
Slide15The Accessibility of Phase 2 Cardiac Rehabilitation to Rural and Remote Population Centres as Defined by ARIA
Slide16Model 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).
Slide17Conclusion
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.
Slide18Deborah 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