Background
The World Health Organization considers that access barriers to medicines contribute to health disparities. Aboriginal and Torres Strait Islander People, particularly those from remote locations, have a significant gap in life expectancy and increased co-morbidities compared to non‑Indigenous Australians. Multiple national programs exist to remove barriers to accessing medicines. However, unaligned program rules have introduced new barriers.
Aim/Objective(s)
To understand barriers, demographics, and health system impacts created by medicine access program rules.
Methods
A 7-day snapshot audit of presenting patients across 9 specialty units in two regional hospitals was conducted. Quantitative and qualitative
data collected included demographic and geographic information, cause of medicine access issues relating to program rules, and clinician time to rectify
medicine access.
Results
59 cases of medicines access issues were identified; 29 were included for data analysis as they related to the project definition of program rule barriers. The majority of cases (86%, n=25) were people living remotely and most identified as Aboriginal and Torres Strait Islander People (94%, n=27). The most common barriers were remote people being temporarily situated in an urban location (72%, n=21) and issues accessing primary health care (n=7, 24%). These access barriers resulted in hospital presentations to obtain medicines, and more than half (52%, n=15) required admission to hospital for treatment due to missed medicines. Clinicians spent an average of 59 minutes per patient to restore medicines access.
Discussion
This audit highlights disproportionate medicines access barriers faced by remote Aboriginal and Torres Strait Islander People. Resolving medicine access issues places additional burden on clinicians in an already overstretched public health system. Much advocacy work has been undertaken nationally to improve interconnectivity of medicine access programs. Whilst some improvements have occurred, further reforms are required to ensure a more patient-centric approach to improve health outcomes and reduce the health system burden.