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Advancing Health Services and Health Systems for Vulnerable Peoples including Those with Chronic Conditions

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: 15 August 2024 | Viewed by 6143

Special Issue Editors

School of Health, University of the Sunshine Coast, Petrie, QLD 4502, Australia
Interests: cardiac; clinical research; diabetes; self-efficacy; self-management; telehealth; synthesis of literature review
Special Issues, Collections and Topics in MDPI journals
UQ Poche Centre for Indigenous Health, The University of Queensland, Brisbane, QLD 4066, Australia
Interests: behavioural epidemiology; social epidemiology; health system research; health program evaluation; emergency medicine; paramedicine; mental health
Special Issues, Collections and Topics in MDPI journals
School of Public Health, Southeast University, Nanjing 210009, China
Interests: social epidemiology; health policy; health economics; chronic diseases management; chronic diseases epidemiology; health programs/policy evaluation; healthcare services and management; healthcare for vulnerable populations; healthy aging research
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

People with chronic conditions, including chronic diseases, usually experience multimorbidity. Globally, this plays a major role in the burden of diseases in both developed and developing countries. To address this major challenge for healthcare systems, this Special Issue of IJERPH is dedicated to celebrating our achievement and progress in this significant area by sharing international research findings, including (but not limited to) findings in the fields of risk factors, self-management and support, adherence to medications/treatment, family/carer and community support, participation in prevention services, access to primary/secondary/tertiary care, clinical information systems, case management, life expectancy and deaths, models of care, coordination of care, patient-centred care, transitional care (for example, between primary and secondary/tertiary care), cultural safety/competency for vulnerable populations, health system design/re-design, rehabilitation services, surveillance system, telehealth, and policy and procedures in the health system.

It is our intention and hope that this Special Issue will provide the most recently updated and high-quality evidence to guide our practice worldwide to benefit people with chronic conditions, their families, communities, and society in general.

Dr. Chiung-Jung (Jo) Wu
Dr. Xiang-Yu (Janet) Hou
Dr. Lijun Fan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • health system
  • health policy
  • health services
  • health programs
  • health evaluation
  • patients
  • patient-centred care
  • primary healthcare
  • hospital care
  • tertiary healthcare
  • transitional healthcare
  • chronic diseases
  • chronic conditions
  • treatment
  • medication
  • surgery self-management
  • cancer
  • cardiovascular diseases
  • mental health
  • diabetes
  • dementia
  • overweight and obesity

Published Papers (4 papers)

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Research

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14 pages, 352 KiB  
Article
Cancer Survivors’ Experiences of Navigating the Australian Health Care System for Physical and Mental Health Care Needs
Int. J. Environ. Res. Public Health 2023, 20(5), 3988; https://doi.org/10.3390/ijerph20053988 - 23 Feb 2023
Cited by 1 | Viewed by 1090
Abstract
People living with cancer experience many impacts on their health and mental health, and are thus likely to require ongoing health care. The aim of the current study was to investigate the health and mental health care experiences and needs of Australian cancer [...] Read more.
People living with cancer experience many impacts on their health and mental health, and are thus likely to require ongoing health care. The aim of the current study was to investigate the health and mental health care experiences and needs of Australian cancer survivors. A total of 131 people (119 female, 12 male) with lived experience of a cancer diagnosis (at least 12 months ago) participated in an online survey collecting qualitative and quantitative data, advertised via social media groups and paid advertising. Analysis of the written responses was conducted using inductive qualitative content analysis. The findings showed that a major issue facing cancer survivors was difficulties around access to and management of services for both their mental and physical health. There was also a strong preference for increasing access to allied health care, such as physiotherapy, psychology, and remedial massage. There appear to be some inequities in the experiences of cancer survivors, particularly in accessing care. Improving the experiences of health care for physical and mental health cancer survivors should focus on increasing access to and improving the management of services, specifically allied health, through a variety of avenues, including reducing costs, increasing transport, and providing closer and more co-located services. Full article
11 pages, 546 KiB  
Article
Cumulative Health Drivers of Overnight Hospitalization for Australian Working-Age Adults Living Alone: The Early Warning Potential of Functionality
Int. J. Environ. Res. Public Health 2022, 19(22), 14707; https://doi.org/10.3390/ijerph192214707 - 09 Nov 2022
Viewed by 723
Abstract
There is a need to better understand the drivers of hospital utilization for the large and growing number of adults living alone. The cumulative effect of health drivers can be assessed by initially considering clinically advised information, then considering issues that a general [...] Read more.
There is a need to better understand the drivers of hospital utilization for the large and growing number of adults living alone. The cumulative effect of health drivers can be assessed by initially considering clinically advised information, then considering issues that a general practitioner or the person themselves may know. Logistic regression analyses were conducted on longitudinal data from the Household, Income, and Labor Dynamics in Australia (HILDA) survey with three time points over four years (n = 1019). The significant predictors of overnight hospitalization were the presence of a long-term health condition (Time 1), hospitalization severity and comorbidity (Time 1), work ability (Time 2), physical functioning (Time 2), being separated/divorced and having one or more health care cards. Health issues were predictive up to four years before the hospitalization window. That baseline risk of hospitalization was modified as symptoms and relatively salient changes in functionality accumulated. Specific sub-groups of hospital users had access due to insurance or special coverage. The impact of living alone on hospitalization may be able to be partly addressed through interventions such as improving access to primary care and using early warning triggers such as decreasing functionality to seek primary care before seeking hospitalization. Full article
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9 pages, 920 KiB  
Article
Incidence Characteristics and Histological Types of Head and Neck Cancer among Adults in Central Sudan: A Retrospective Study
Int. J. Environ. Res. Public Health 2022, 19(21), 13814; https://doi.org/10.3390/ijerph192113814 - 24 Oct 2022
Viewed by 1410
Abstract
Head and neck cancers (HNCs) are prevalent in Sudan, but the reasons for this and the incidence of different types of HNCs are not well understood. A cross-sectional retrospective study was conducted to provide baseline data on the epidemiology of HNCs among patients [...] Read more.
Head and neck cancers (HNCs) are prevalent in Sudan, but the reasons for this and the incidence of different types of HNCs are not well understood. A cross-sectional retrospective study was conducted to provide baseline data on the epidemiology of HNCs among patients treated at the National Cancer Institute (NCI) in central Sudan. All cancer cases from 2016 to 2020 were retrieved from the NCI records. Of the 9475 new cancer patients who were registered at the NCI during the study period, 1033 (11%) had HNCs, of whom 767 (74.2%) were adults. The mean age of the adult patients was 54.5 years (standard deviation 15.8) and 449 (58.5%) patients were male. The annual incidence in adults was 4/105 population. The most common HNC sites were the nasopharynx (25.3%), hypopharynx (22.8%), and oral cavity (22.2%). Carcinoma was the most common diagnosis (87.6%), followed by lymphoma (5.6%). Most patients’ tumors were at a locally advanced (22%) or metastatic stage (47%) of HNCs at the time of presentation. Further studies to identify risk factors for HNCs, particularly for the most prevalent types in central Sudan, are needed. In addition, Sudan requires capacity building for cancer, including a national cancer registry. Full article
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Review

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13 pages, 388 KiB  
Review
Indigenous Australians’ Experiences of Cancer Care: A Narrative Literature Review
Int. J. Environ. Res. Public Health 2022, 19(24), 16947; https://doi.org/10.3390/ijerph192416947 - 16 Dec 2022
Cited by 1 | Viewed by 2128
Abstract
To provide the latest evidence for future research and practice, this study critically reviewed Indigenous peoples’ cancer care experiences in the Australian healthcare system from the patient’s point of view. After searching PubMed, CINAHL and Scopus databases, twenty-three qualitative studies were included in [...] Read more.
To provide the latest evidence for future research and practice, this study critically reviewed Indigenous peoples’ cancer care experiences in the Australian healthcare system from the patient’s point of view. After searching PubMed, CINAHL and Scopus databases, twenty-three qualitative studies were included in this review. The inductive approach was used for analysing qualitative data on cancer care experience in primary, tertiary and transitional care between systems. Three main themes were found in healthcare services from Indigenous cancer care experiences: communication, cultural safety, and access to services. Communication was an important theme for all healthcare systems, including language and literacy, understanding of cancer care pathways and hospital environment, and lack of information. Cultural safety was related to trust in the system, privacy, and racism. Access to health services was the main concern in transitional care between healthcare systems. While some challenges will need long-term and collective efforts, such as institutional racism as a downstream effect of colonisation, cultural training for healthcare providers and increasing the volume of the Indigenous workforce, such as Indigenous Liaison Officers or Indigenous Care Coordinators, could effectively address this inequity issue for Indigenous people with cancer in Australia in a timely manner. Full article

Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: Discharge against medical advice at Queensland hospital emergency department among Indigenous patients in 2016 -2021
Authors: Xiang-Yu (Janet) Hou
Affiliation: UQ Poche Centre for Indigenous Health, The University of Queensland, Brisbane QLD 4066, Australia

Title: Australian Doctors’ Decision Making During the First Wave of the COVID-19 Pandemic in Line With the Principles of Choosing Wisely
Authors: Megan GILES; Morne TERBLANCHE; Liang WANG; Chiung-Jung (Jo) WU
Affiliation: 1. Principal Advisor – Quality Improvement, Safety Quality & Innovation, Sunshine Coast Hospital and Health Service, Queensland 4575, Australia; 2. Medical Lead, Safety Quality & Innovation, Sunshine Coast Hospital and Health Service; 3. Nursing Laboratory Technician, School of Health, University of the Sunshine Coast, Queensland, Australia; 4. School of Health, University of the Sunshine Coast, Australia; Honorary Research Fellow, Royal Brisbane and Women’s Hospital (RBWH), Australia
Abstract: Background: Pandemic policies and clinical protocols constantly evolved following the Australian government’s declaration of a national emergency response to the COVID-19. This study sought to understand the impact of doctors’ decision-making processes and considerations in line with the Choosing Wisely principles to reduce low value tests and treatments amongst Australian doctors working in regional hospital and healthcare services during the first wave of the COVID-19 pandemic. Methods: A semi-structured interview was conducted, using open-ended questions. A total of 12 less- and experienced doctors across disciplines were interviewed to reach data saturation. Interview data were analysed considering the Choosing Wisely principles. Results: Five main themes emerged around prioritising care and treatment, uncertainty regarding best practice as a result of rapidly changing guidelines, organisational challenges to clinical decision making, the use of telehealth, and consumer engagement with health services. Conclusion: Despite the disruption caused by COVID-19, doctors were mindful of necessary care and worked to ensure that core care was not compromised during the first wave of the pandemic. The need for doctors to protect both their own safety and that of their colleagues arose as an additional factor which influenced doctors’ decision-making process during COVID-19 pandemic.

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