Todd Katherine, Eastwood John G, Fotheringham Penelope, Salinas-Perez Jose A, Salvador-Carulla Luis
Community Health Services, Sydney Local Health District, Level 9, King George V Building, Missenden Road, Camperdown NSW 2050 Australia.
School of Women's and Children's Health, The University of New South Wales, Sydney, NSW 2052 Australia.
Int J Integr Care. 2021 Jun 21;21(2):23. doi: 10.5334/ijic.5430.
Disadvantaged families experience many barriers to accessing health and social care. Initiative was developed to address these barriers, and ensure families have their complex needs met and are kept safe and connected to society.
A spatial epidemiology approach was taken, as part of the HHAN feasibility phase, to identify the geographical distribution of the "most vulnerable" families in Sydney Local Health District (SLHD). A literature review was conducted to identify indicators of family stress and disadvantage, and cluster and hotspot analyses were undertaken. Hotspots of family stress and disadvantage were mapped for SLHD and used to identify areas for HHAN place-based delivery, and for collaborative co-design.
The HHAN initiative called for consideration of context and the undertaking of collaborative design with communities. The spatial analysis provided a more accurate picture of family stress and disadvantage than previously available and provided a tool that could be used during consultation and planning activities.
When planning place-based integrated care initiatives, spatial analysis of small geographic scales can allow identification of areas of concentrated or complex disadvantage that may be masked when analysis is performed on larger areas, allowing for targeted, place-based delivery of programs to those most in need.
弱势家庭在获得医疗和社会护理方面面临诸多障碍。为此制定了一项倡议,以克服这些障碍,确保家庭的复杂需求得到满足,并保障其安全以及与社会保持联系。
作为HHAN可行性阶段的一部分,采用了空间流行病学方法,以确定悉尼地方卫生区(SLHD)中“最脆弱”家庭的地理分布。进行了文献综述,以确定家庭压力和弱势的指标,并开展了聚类和热点分析。绘制了SLHD家庭压力和弱势的热点图,并用于确定HHAN基于地点的服务提供区域以及协作式共同设计的区域。
HHAN倡议呼吁考虑背景情况并与社区进行协作设计。空间分析提供了比以往更准确的家庭压力和弱势情况描述,并提供了一种可在咨询和规划活动中使用的工具。
在规划基于地点的综合护理倡议时,小地理尺度的空间分析能够识别出在对较大区域进行分析时可能被掩盖的集中或复杂弱势区域,从而能够针对最有需求的人群进行有针对性的、基于地点的项目提供。