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Table 1 Summary of included studies

From: Issues of accessibility to health services by older Australians: a review

Publication Study design Population Location Service type Main finding
Abed et al. (2013) [24] Systematic review Older Arab migrants Australia Healthcare for older Arab migrants. We need ‘more culturally competent care’
Abed et al. (2014) [30] Editorial Older Arab migrants Australia Health services ‘Increase our awareness of cultural attributes, migration experiences, and health perceptions’
Allen et al. (2012) [31] Self-reported postal survey Aged 55 years and over New South Wales Social support ‘Not being married or de facto relationship, lower education and decreased social support significantly predicted psychological distress’
Anderson et al. (2006) [20] Opinion piece Aboriginal Australians Australia Health services ‘There is still no needs-based expenditure (in global terms) for Aboriginal health in Australia’
Aoun et al. (2013) [32] Longitudinal study Terminally ill people. Western Australia Hospice care ‘The ability to die in the place of choice should be looked at as a possible quality measure in end-of-life care’
Banbury et al. (2014) [17] Systematic literature Rural and remote communities Australia E-health ‘E-health has the potential to increase access to services in rural and remote communities’
Bhar (2016) [33] Survey Residential aged care staff Australia Psychological services ‘Access to psychologists and psychological services remains poor within Australian residential aged care facilities’
Brand et al. (2011) [34] Review People with osteoarthritis of the hip and knee Australia Health services needed for patients with osteoarthritis of the hip and knee. ‘Clinicians have evidence-based recommendations for OA management but are poorly supported by service models to deliver these effectively and efficiently’
Cornell (2016) [35] Opinion piece Older Australians Australia Housing ‘Seeking to optimise outcomes for older people in the context of choice, independence, housing security, participation in community life and wellbeing and assist them to age in place’
Davis (2016) [11] Systematic review Older people Australia Aged care ‘There is limited high-quality research investigating the effectiveness of interventions at the health and aged care interface of subacute care’
Dellemain et al. (2013) [13] Opinion piece Rural people Australia Case management ‘There is confusion on the definition of case management, thereby limiting its accessibility to emerging rural services’
Drummond et al. (2011) [14] Survey West African refugee women Perth, Western Australia Health care services ‘Shame or fear of what family and friends might think, fear of being judged by the treatment provider, fear of hospitalization, and logistical difficulties were significant impediments to accessing health care services’
Evans (2013) [36] Cross-sectional survey design Older Australians South Australia Respite services ‘The Findings clearly highlight the dual client focus of respite, although there are differences in the nature of the service that is provided to clients’
Feist et al. (2010) [29] Survey Aged 55 years and over Murray Lands, South Australia (rural area) Technology to link older people to community ‘Attitudes to new technologies varied by age, but positive attitudes were expressed across all ages’
Giles et al. (2009) [10] Analysis of secondary data Older Australians Australia Aged care ‘Overall the distribution of services available to older persons in uneven across Australia. It will not be adequate to address the increasing needs associated with the ageing of the Australian population’
Greaves et al. (2009) [16] Longitudinal qualitative, interpretive study using a case study approach with in-depth interviewing. Socially isolated and unwell older people. Metropolitan Brisbane. Community-based aged care. ‘Fear emerged as a common experience embracing aspects of daily life such as depletion of social networks, being dependent on others, loss of mobility and diminishing ability to drive. Inadequate or unreliable public transport resulted in extended waiting times to attend medical appointments’
Harris et al. (2012) [37] Secondary analysis of a survey Primary care practitioners Australia General practice ‘Improving after-hours access requires a comprehensive approach which includes incentives, improvements to information management and organised systems of care with review if data on clinical outcomes’
Hassett et al. (1999) [27] Cross-sectional study Non-English-speaking backgrounds and English-speaking backgrounds North-west and western metropolitan Melbourne Acute psychogeriatric ‘Under recognition of disorders such as depression and reluctance to accept necessary inpatient management are two possible factors that should concern mental health service providers for the ethnic elderly’
Hiruy et al. (2014) [38] Case study Africans in Australia Australia Palliative care ‘The importance of paying sufficient attention to a diverse range of factors including the migration history when providing palliative and hospice care for patients’
Hughes (2007) [39] In-depth narrative interviews Older gays and lesbians Blue Mountains (rural area) Health and aged care services ‘In addition to direct discrimination, participants reported a more indirect form of discrimination in providers’ assumption of heterosexuality among clients and their failure to provide lesbian or gay-friendly services’
Hughes (2011) [23] Critical review Australians Australia Aged care, social work ‘There is a need for greater leadership among social work and its representative groups to assert its contribution to aged care, and more broadly to promote the health and wellbeing of all older people’
Hurley et al. (2013) [15] Telephone interviews with formal service providers, and interviews and focus groups with Greek elders. Greek elders Adelaide, South Australia Community-based services ‘Formal service providers need to ensure that services are promoted and delivered to take account of the important role of family in informal support while also addressing the access, challenges posed by language and literacy’
Jeon et al. (2012) [19] Semi-structured interviews via postal survey Members of National Seniors Australia over 50 years of age Australia Chronic care services ‘… findings highlight the degree to which people whose resources are constrained are prepared to go to maintain access to private hospital care’
Jiwa et al. (2013) [40] Opinion piece Australians Australia General practitioner ‘Australians have greater access to the internet than ever before. With a little more investment this technology could facilitate online video-consultations with general practitioners’
Joo et al. (2013) [41] Integrative review of literature Whole population International including Australia Community-based settings ‘Community based case management significantly reduced hospital access outcomes, especially readmissions and increased cost effectiveness, patient clinical outcomes and patient satisfaction’
Lau et al. (2012) [25] Opinion piece Older people Australia Palliative care ‘Ethnic minorities, older people and patients with non-cancer diseases are found to be at a greatest risk for underutilisation of palliative care. Barriers to access palliative care by these groups in the community are complex and often overlapping’
Lowe (2011) [42] Editorial Women Australia Cardiovascular health services ‘Perhaps in a health system that fails to deliver cardiovascular prevention well for anyone, women, who are not only more likely to be older and frailer, but also more likely to be economically and educationally disadvantaged than men, are less likely to get preventative care’
Lowthian et al. (2012) [18] Exploratory descriptive study of structured interviews Lower urgency community-dwelling patients aged 70+ years Metropolitan Melbourne, Australia Public hospital emergency department ‘Emergency departments should be redesigned and/or integrated community-based models of care developed to meet the specific needs of this age group who have growing demand for acute care’
Moorin et al. (2012) [43] Cross-sectional study using administrative records Australians (including those aged ≥ 65 years) Australia Cancer service ‘Cancer services are not provided uniformly (horizontal equity) across strata of socio-economic status’
Muir-Cochrane et al. (2014) [12] Semi-structured interviews Older people (aged 65 and over) Rural Australia Mental health ‘This study offers new insight into the difficulties that arise from the separation of physical and mental health systems for older people with multiple needs, and the impact of living in a rural region on unmet mental health care needs of older people’
Rosenwax et al. (2015) [44] Retrospective population-based cohort study People in their last year of life Western Australia Emergency department ‘Decedents with dementia who were not receiving community-based palliative care attended hospital emergency departments more frequently than people receiving community-based palliative care’
Russi (2014) [45] Opinion piece People living with disability Australia Disability ‘Many inequities faced by people living with disability could be reduced by the introduction of the National Disability Incentive Scheme through the equitable access to services and supports and removal of financial barriers’
Schofield (2008) [46] Opinion piece Australians Australia Health services ‘Research and policy tools for analysing, understanding and fixing the problem are crucial’
Tabrizi et al. (2008) [21] Cross-sectional study Type II diabetics Queensland, Australia Clinical care ‘Service quality including choice of care provider, accessibility, prevention, continuity, timeliness and safety were identified to be of inadequate quality’
Tang et al. (2011) [26] Narrative review Older Australians Australia Respite ‘Respite care needs to move away from a custodial model to a more psychological model of care, and that more natural and flexible models (e.g. host family respite), integrated with increased post-respite support and psychosocial education’
Tilse (2002) [47] Semi-structured interviews Management, families and residents Rural Australia Aged care facilities ‘The complexity of current financial arrangements, access to appropriate financial advice at the time of entry, and the potential for an informal two-tier system in relation to the allocation of amenities are identified as developing policy issues’
Walker (2012) [22] Literature search People with multiple conditions Australia Chronic conditions health services ‘Services and policies require specific reforms to better meet the needs of people with multiple conditions’
Warburton et al. (2015) [48] Multistage mixed-methods Practitioners Rural Australia Specialist service organisations ‘The challenges of rural assessment, are both demand-driven and supply issues’
Ward et al. (2011) [49] Mixed methodology including quantitative and qualitative methods 35 to 75 years of age South Australia Bowel screening ‘The main system-related barriers were the lack of awareness of colorectal cancer or screening. The problems with language due to most of the information being in English and the lack of recommendation by a doctor’
Wark et al. (2015) [50] Semi-structured interviews Older adults and carers Rural Australia Disability services ‘An understanding of the needs of older adults with learning disability resident in rural areas is important to ensure that both aged-care and disability support structures are built on individuals’ needs’
Wark et al. (2015) [28] Delphi conducted over three rounds Disability workers who support people with learning disability Rural New South Wales, Australia Non-government disability services ‘A thematic analysis indicated three main themes of access to services; time constraints and funding’