Abstract
The access to healthcare services has been the source of massive concern in healthcare over the world, the Australian setting not being an exception. The problem of healthcare access is especially challenging to resolve for rural areas and the vulnerable groups living in the specified environment. In their 2020 study, Maurice et al. (2020) consider the problem of providing access to healthcare services to residents of rural areas in Australia by implementing e-health and, particularly, telehealth opportunities.
The study conducted by Maurice et al. (2020) has several advantages, including the clear focus on the problem at hand, a well-defined research question, and an elaborate methodology for answering it. In addition, the authors perform a substantial review of the latest literature on the topic, thus embracing every opportunity for improving e-health services in the rural Australian setting. According to the research results, the application of telehealth as the tool for increasing the accessibility of nursing and healthcare services is sufficiently effective.
The main weakness of the study comes from the methodology, namely, the application of the Likert-type scale for patients to utilize in order to measure their experiences. Due to the high probability of subjective assessments, the outcomes of the survey could be seen as requiring adjustments and removal of obvious bias. Nevertheless, the research has managed to convey critical information with enough precision and prove the point that the authors strived to make.
The results of the research can be considered an important piece of information for improving the current state of Australian e-health. Namely, the management of the needs of rural area residents can be improved with the help of this study. As a result, multiple public health issues will be managed more effectively.
Introduction
The recent developments in the management of public health issues have made it possible to embrace a wider range of audiences and extend support to vulnerable groups. However, certain concerns in the provision of health-related services have remained unchanged, which suggests that further measures are to be introduced. The problem of health accessibility is one of such concerns, which becomes even more prominent in rural areas. Due to the uniquely unfortunate combination of the rural infrastructure and poor economic conditions, residents of the rural setting often lack access to high-quality healthcare (Johnson & Mahan, 2020). Moreover, even basic health services may remain unavailable to the specified population (Johnson et al., 2018). In their article, Maurice et al. (2020) provide solutions to the lack of access to bariatric surgery for patients in rural areas of Australia. Although the authors’ conclusions that telehealth improves the accessibility of post-surgery services for patients, the study could have benefitted significantly from a wider range of settings being explored in it.
Definition
The efficacy of telehealth as a tool for improving the accessibility of care, especially for patients that have difficulties accessing respective services physically, has been the subject of multiple discussions in the contemporary healthcare context. The study by Maurice et al. (2020) addresses the issue further by examining the effects that telehealth provides for managing the concern in question. The specified topic can be defined as that one of rather high importance given the large number of areas in Australia where access to healthcare services may be complicated, including rural areas (Jones et al., 2018). Thus, the research question that the authors ask, namely, “Is telehealth a useful option for patients who underwent bariatric surgery in Australian rural areas?,” furthers the discussion of the efficacy of telehealth. The study provides important conclusions about the role that telehealth plays in the management of patients’ needs and the improvement in access to healthcare for people living in remote areas.
Overview
The issue of access to healthcare services in the rural context of the Australian environment has been a contentious issue in the target environment for a substantial amount of time. Due to the large number of rural areas and the challenges associated with the development of an effective infrastructure, the level of access to healthcare in the specified environment is quite low for Australian residents (Van Spijker et al., 2019). According to the report published recently by the Australian Institute of Health and Welfare, the complications in accessing healthcare services for rural residents lead to a reduction in their life expectancy (Callander et al., 2017). Namely, the research posits that “On average, Australians living in rural and remote areas have shorter lives, higher levels of disease and injury and poorer access to and use of health services, compared with people living in metropolitan areas” (Australian Institute of Health and Welfare, 2020, para. 1). Although further research shows that the drop in life expectancy rates is attributed to a variety of factors, including differences in the lifestyle, the access to health is a crucial contributor to the specified statistics.
Therefore, addressing the problem of access to health in the Australian rural context is essential. Namely, specific factors obstructing people’s ability to use healthcare services must be identified, and the strategies for removing these obstacles must be delineated. In their study, Maurice et al. (2020) focus on one of the crucial aspects of the specified concern, namely, the provision of access to bariatric surgery and the related services to rural Australian patients. Thus, the study contributes to the management of the issue to a significant extent. Moreover, the outcomes of the analysis may inform approaches toward increasing access to other healthcare services, including basic ones (Avci & Gözüm, 2018). The paper is specifically important for nurses since it provides insights into the types of technology to be incorporated into the hospital setting to provide patients with the needed support and assistance.
Discussion
Setting
The choice of the setting in which the study was conducted was quite sensible given the nature of the research. Namely, the authors correctly selected the environment of the Queensland rural area and the Bariatric Telehealth Clinic as the main venue for performing the study. However, the fact that the authors chose only two hospitals in the Australian rural environment may have led to the development of certain bias within the research (Moon et al., 2020). Namely, the sample used in the study may have been not as representative of the current situation with the accessibility of healthcare in rural Australia as the researchers may have intended (Song et al., 2018). Since only two hospitals were included into the analysis, the difficulties that other healthcare settings face in the specified context could have been understudied, which could have led to inaccuracies in the conclusions provided by the authors (Toews et al., 2016). Thus, the generalizability of the setting in question could be considered as questionable given the specificity of the selected environment.
Sample
The approach toward sampling that the authors of the research selected for the analysis is also worth discussing as one of the possible source of research biases. On the one hand, the application of the qualitative research design does not require a large sample for data representation. Quite the contrary, the qualitative method typically implies a rather small sample due to the abundance of qualitative information that it provides (Mohajan, 2018). Therefore, the use of 85 respondents for the collection of data and the further analysis of it appears to be reasonable.
On the other hand, the fact that only 85 patients were considered in the course of the analysis signifies possible issues with the accuracy, generalizability, and overall applicability of research results. In light of the fact that the authors have selected descriptive statistics as one of the methods of analyzing their data, the inclusion of a sample of 85 participants might appear to be quite small (Johnson et al., 2020). Nonetheless, given the opportunities for generalizability that the study provides, the selection of the sample is appropriate for the objectives of the research under analysis (Sykes et al., 2018). By considering 85 studies in their assessment, Maurice et al. (2020) made it possible to embrace enough patients to prove the presence of a trend in the promotion of access to healthcare, at the same time representing the problem that is specific to the Australian rural setting.
Methodology
As established above, the authors have decided to scrutinize the problem of low access to healthcare and the effects that telehealth produces on the management of it in the Australian rural setting from a qualitative perspective. Thus, the qualitative research method has been adopted as the main tool for studying the issue. Specifically, the authors have selected a specific population without adding any comparison cohort since it was not demanded by the goals set in the study (Maurice et al., 2020). Therefore, the case under analysis was represented by the qualitative method and the descriptive statistics as the main analysis tool. Overall, the methodology aligned entirely with the objectives of the paper and helped to shed light on the problem of increasing the accessibility of health services to the residents of rural areas in Australia.
The accurate and explicit statement of the research methodology is another strength of the article under analysis. Maurice et al. (2020) should be credited for outlining the methods that they utilized in the study in great detail, justifying every choice that they made in regard to the selection of their methodology and the associated tools for data collection and analysis. The integration of the Likert-type scale for collecting key information was an impeccable strategy for collecting the data needed for the descriptive statistics analysis (Durcikova et al., 2018). While the specified approach could have been seen as insufficient with the quantitative study design, it served its purpose perfectly in the specified setting with the focus on the qualitative analysis.
Examining other possible routes that the authors could have taken with the choice of heir research methodology, one might want to view the quantitative approach as another option. Namely Maurice et al. (2020) could have researched the effects of applying telehealth by conducting a randomized controlled trial in the target setting. Specifically, the effects of telehealth on the management of patients’ needs could have been considered alongside with another strategy or the absence thereof. Although the latter option seems slightly underwhelming, it is likely to be quite plausible in the rural setting, where the lack of healthcare availability may lead to certain members of Australian population being underserviced (Fennell et al., 2018). With the use of the randomized controlled trial as the main tool for amazing the obtained results, Maurice et al. (2020) would have also obtained quite compelling results.
Further Research/Practice
The outcomes of the analysis conducted by Maurice et al. (2020) also allows making further steps toward performing other studies on the subject matter. Namely, since the outcomes of the research have proven the importance of telehealth on the management of needs of post-surgery patients, the effects of the specified approach outside of the context of the bariatric surgery may need to be examined (Dawson et al., 2017). Specifically, further analysis may encompass the effects of telehealth on managing the needs of patients living in remote areas, in general. Alternatively, a different context that is crucial to the Australian setting, such as the access to healthcare for rural patients with complex issues, may have to be centered in the next research expanding the specified concern.
Moreover, strategies for delivering telehealth services will also have to be considered in further studies. For example, the challenges associated with patient education and the need to teach target audiences to address their health needs in the context of their homes will have to be studied closely (Shrivastava et al., 2019). For this purpose, approaches that telehealth can offer in regard to patient education and training will be examined and compared. The outcomes of the specified research will allow selecting the most promising opportunities for further research and implementing them accordingly.
Finally, the outcomes of the study conducted by Maurice et al. (2020) have provided enough grounds for improving the current practice strategies. Namely, telehealth tools will have to be applied to address the health issues faced by patients after surgeries involving bariatric issues. The specified framework will have to be deployed in rural settings first so that the most vulnerable groups could receive access to the specified services. Indeed, due to the challenges that the rural infrastructure provides, a wide range of patients do not erective post-surgical services needed to recuperate successfully (Ireland et al., 2020). As a result, the risks of readmission increase exponentially for the specified demographic (Doran & Hornibrook, 2016). Therefore, incorporating the application of telehealth technology into the target context is an essential addition to the current healthcare practices adopted in Australia rural settings, as well as the global rural setting, in general..
Conclusion
Due to the elaborate selection of the research method, data type, and assessment techniques, Maurice et al. (2020) have managed to conduct a study that addresses an important concern in the Australian healthcare context and provides feasible solutions. The research aimed at examining the effects of telehealth application in the rural Australian setting has proven that the use of the described services allows increasing the rates of recovery in patients and reduce the levels of readmission significantly. Therefore, the incorporation of telehealth into the context of the Australian healthcare environment should be considered the issue of the first order in the Australian healthcare environment.
The authors of the study have performed a comprehensive investigation of the problem of access to healthcare services and, particularly, the opportunities for receiving bariatric surgery, as well as post-surgical assistance. According to the results of the study, the opportunities for improving the current healthcare accessibility rates are quite large given the options that technological advances provide. However, due to the challenges that the rural infrastructure contains, additional expense will have to be taken to address the current concern of healthcare access. Overall, the study results can be considered credible, trustworthy, and applicable to the target setting. Moreover, the outcomes of the research inform the approaches toward healthcare access improvement in other contexts as well.
References
Australian Institute of Health and Welfare. (2020). Rural & remote health. Web.
Avci, Y. D., & Gözüm, S. (2018). Health service delivery models and tele-health for the elderly living in rural areas. Turkish Journal of Family Medicine and Primary Care, 12(1), 56-67. Web.
Callander, E. J., Corscadden, L., & Levesque, J. F. (2017). Out-of-pocket healthcare expenditure and chronic disease–do Australians forgo care because of the cost?Australian Journal of Primary Health, 23(1), 15-22. Web.
Dawson, S., Gerace, A., Muir-Cochrane, E., O’Kane, D., Henderson, J., Lawn, S., & Fuller, J. (2017). Carers’ experiences of accessing and navigating mental health care for older people in a rural area in Australia.Aging & Mental Health, 21(2), 216-223. Web.
Doran, F. M., & Hornibrook, J. (2016). Barriers around access to abortion experienced by rural women in New South Wales, Australia. Rural and Remote Health, 16, 1-12.
Durcikova, A., Lee, A. S., & Brown, S. A. (2018). Making rigorous research relevant: Innovating statistical action research. MIS Quarterly, 42(1), 241-263. Web.
Fennell, K., Hull, M., Jones, M., & Dollman, J. (2018). A comparison of barriers to accessing services for mental and physical health conditions in a sample of rural Australian adults. Rural and Remote Health, 18(1). Web.
Ireland, S., Belton, S., & Doran, F. (2020). ‘I didn’t feel judged’: exploring women’s access to telemedicine abortion in rural Australia.Journal of Primary Health Care, 12(1), 49-56. Web.
Johnson, K. F., & Mahan, L. B. (2020). Interprofessional collaboration and telehealth: Useful strategies for family counselors in rural and underserved areas.The Family Journal, 28(3), 215-224. Web.
Johnson, Q., Mund, B., & Joudrey, P. J. (2018). Improving rural access to opioid treatment programs.The Journal of Law, Medicine & Ethics, 46(2), 437-439. Web.
Jones, D. M., McAllister, L., & Lyle, D. M. (2018). Rural and remote speech-language pathology service inequities: An Australian human rights dilemma.International Journal of Speech-Language Pathology, 20(1), 98-101. Web.
Maurice, A. P., Punnasseril, J. E. J., King, S. E., & Dodd, B. R. (2020). Improving access to bariatric surgery for rural and remote patients: Experiences from a state-wide bariatric telehealth service in Australia.Obesity Surgery, 1(1), pp. 1-10. Web.
Mohajan, H. K. (2018). Qualitative research methodology in social sciences and related subjects.Journal of Economic Development, Environment and People, 7(1), 23-48. Web.
Moon, K., Brewer, T. D., Januchowski-Hartley, S. R., Adams, V. M., & Blackman, D. A. (2016). A guideline to improve qualitative social science publishing in ecology and conservation journals.Ecology and Society, 21(3). Web.
Shrivastava, R., Power, F., Tanwir, F., Feine, J., & Emami, E. (2019). University-based initiatives towards better access to oral health care for rural and remote populations: A scoping review.Plos One, 14(5), 1-8. Web.
Song, Y., Tan, Y., Song, Y., Wu, P., Cheng, J. C., Kim, M. J., & Wang, X. (2018). Spatial and temporal variations of spatial population accessibility to public hospitals: A case study of rural–urban comparison.GIScience & Remote Sensing, 55(5), 718-744. Web.
Sykes, B. L., Verma, A., & Hancock, B. H. (2018). Aligning sampling and case selection in quantitative-qualitative research designs: Establishing generalizability limits in mixed-method studies.Ethnography, 19(2), 227-253. Web.
Toews, I., Glenton, C., Lewin, S., Berg, R. C., Noyes, J., Booth, A.,… Meerpohl, J. J. (2016). Extent, awareness and perception of dissemination bias in qualitative research: An explorative survey.PLoS One, 11(8), 1-11. Web.
Van Spijker, B. A., Salinas-Perez, J. A., Mendoza, J., Bell, T., Bagheri, N., Furst, M. A.,… Salvador-Carulla, L. (2019). Service availability and capacity in rural mental health in Australia: Analysing gaps using an Integrated Mental Health Atlas.Australian & New Zealand Journal of Psychiatry, 53(10), 1000-1012. Web.