The Poche Centre for Indigenous Health, Faculty of Medicine and Health, Edward Ford Building A27, The University of Sydney, Camperdown, NSW 2006, Australia.
School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia.
Int J Environ Res Public Health. 2021 Mar 15;18(6):3014. doi: 10.3390/ijerph18063014.
Australia's healthcare system is complex and fragmented which can create challenges in healthcare, particularly in rural and remote areas. Aboriginal people experience inequalities in healthcare treatment and outcomes. This study aimed to investigate barriers and enablers to accessing healthcare services for Aboriginal people living in regional and remote Australia.
Semi-structured interviews were conducted with healthcare delivery staff and stakeholders recruited through snowball sampling. Three communities were selected for their high proportion of Aboriginal people and diverse regional and remote locations. Thematic analysis identified barriers and enablers.
Thirty-one interviews were conducted in the three communities ( = 5 coastal, = 13 remote, and = 13 border) and six themes identified: (1) Improved coordination of healthcare services; (2) Better communication between services and patients; (3) Trust in services and cultural safety; (4) Importance of prioritizing health services by Aboriginal people; (5) Importance of reliable, affordable and sustainable services; (6) Distance and transport availability. These themes were often present as both barriers and enablers to healthcare access for Aboriginal people. They were also present across the healthcare system and within all three communities.
This study describes a pathway to better healthcare outcomes for Aboriginal Australians by providing insights into ways to improve access.
澳大利亚的医疗体系复杂且碎片化，这给医疗保健带来了挑战，尤其是在农村和偏远地区。原住民在医疗待遇和结果方面存在不平等。本研究旨在调查居住在澳大利亚偏远地区的原住民获得医疗服务的障碍和促进因素。
通过滚雪球抽样，对医疗服务提供者和利益相关者进行半结构化访谈。选择了三个社区，因为它们的原住民比例较高，且位于不同的偏远地区。主题分析确定了障碍和促进因素。
在三个社区（=5 个沿海社区，=13 个偏远社区，=13 个边境社区）进行了 31 次访谈，并确定了 6 个主题：（1）改善医疗服务的协调；（2）服务和患者之间更好的沟通；（3）对服务的信任和文化安全性；（4）原住民优先考虑卫生服务的重要性；（5）可靠、负担得起和可持续服务的重要性；（6）距离和交通便利性。这些主题通常是原住民获得医疗服务的障碍和促进因素。它们也存在于整个医疗体系中，以及所有三个社区中。
本研究通过提供改善获取途径的见解，描述了改善原住民澳大利亚人医疗保健结果的途径。
