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ACTIONS FOR POLICY AND IMPLEMENTATION
To reduce disparities in health outcomes for older Australians living in rural and regional areas, we need to ensure they can receive reliable and appropriate healthcare in their own homes
Models for in-home care exist but we need to test how well these models, and associated technologies, work for rural health services and patients
Building embedded and sustainable health research capabilities in rural health systems will support rapid adaptation and implementation of acceptable, effective, and sustainable in-home care
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RESEARCH CONTEXT
Australians living in rural, regional, and remote communities face unique challenges due to their geographic location. They frequently experience higher rates of hospitalisation and death, with poorer access to healthcare services. Older people often have more complex health needs including frailty, multi-morbidity, and cognitive impairment; resulting in a higher need for care and reduced capacity to access care, compounded in rural settings by large travel distances, variable infrastructure, and reduced availability of specialist care. Improving the care of older Australians in rural areas is a significant unmet need, resulting in potentially avoidable hospitalisations, of which there are currently 750,000/year in Australia, with rates increasing with age and remoteness.
The delivery of home-based care is growing, often using virtual care technologies, and aiming to reduce potentially avoidable hospitalisations, improve patients’ experiences of care, and contain healthcare costs. For older people, healthcare delivered at home can reduce the large disparities in healthcare quality and outcomes experienced by rural populations, and address barriers such as geography and social structures that impact negatively on health service access. However, existing home-based care efforts are often disconnected and ad hoc, with services unable to accommodate the heterogeneity in patient needs and contexts.
A new five year, $9M research partnership, DELIVER, aims to improve health outcomes for older Australians in regional, rural and remote areas with feasibility-tested interventions to improve the timeliness, accessibility to, and integration of home-based care. Led by the Western Alliance Academic Health Science Centre (Western Alliance), in partnership with healthcare consumers, regional and rural health services, universities and primary healthcare providers across western Victoria, the project will identify, tailor and build a suite of programs to extend and improve in-home care, to improve health outcomes for older people living in rural areas. This will be achieved and sustained by embedding capabilities of a learning health system by placing consumers at the centre of the design process, and upskilling clinicians working in rural and regional health services to effectively use routine health service data to enable rapid, iterative cycles of knowledge generation and improvement.
DELIVER is funded through a Medical Research Futures Fund Rapid Applied Research Translation grant, available only for research in rural areas. This targeting of funding is critical to build research capacity and solutions relevant to rural communities. Through a focus on building research capabilities with the health services across the region, DELIVER aims to develop a streamlined process for rural healthcare providers to rapidly access and test relevant evidence to help them make decisions about which digital and non-digital solutions could be embedded into home-based care to improve service delivery, patient experience, and health outcomes for the communities they serve.
The project partners include:
- Australian Healthcare and Hospitals Association
- Ballarat Health Services
- Barwon Health
- Beaufort and Skipton Health Service
- Central Highlands Rural Health
- Colac Area Health
- Consumers Health Forum of Australia
- Deakin Rural Health
- Deakin University
- East Grampians Health Service
- Edenhope and District Memorial Hospital
- Federation University Australia
- Maryborough District Health Service
- Melbourne Academic Centre for Health
- Monash Partners
- National Ageing Research Institute
- Rural Northwest Health
- South West Healthcare
- St John of God Health Care
- Stawell Regional Health
- Terang and Mortlake Health Service
- Victorian Collaborative Healthcare Recovery Initiative
- Victorian Department of Health
- West Wimmera Health Service
- Western District Health Service
- Western Victoria Primary Health Network
- Wimmera Health Care Group
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