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Type: Journal article
Title: Caring for a marginalised community: the costs of engaging with culture and complexity
Author: Rogers, G.
Barton, C.
Pekarsky, B.
Lawless, A.
Oddy, J.
Hepworth, R.
Beilby, J.
Citation: Medical Journal of Australia, 2005; 183(10):S59-S63
Publisher: Australasian Med Publ Co Ltd
Issue Date: 2005
ISSN: 0025-729X
Statement of
Gary D Rogers, Christopher A Barton, Brita A Pekarsky, Ann C Lawless, Joy M Oddy, Rebecca Hepworth and Justin J Beilby
Abstract: The Care and Prevention Programme (CPP) began in 1998. It is based on the philosophy of primary health care, and has improved health among homosexually active men, including about a third of HIV-positive South Australians. The CPP was assessed using financial analysis and qualitative methods. Participants wanted to access care where they could feel comfortable and safe to talk about issues of sexuality and lifestyle. The CPP model is "economically" sustainable, but not "financially" sustainable within the Medicare Benefits Schedule. It is vulnerable to changes in political environment. The financing model for the CPP has been adapted by including state funding. General practitioners have adapted by lowering their personal incomes (but not quality of care). These adaptations have achieved fragile financial viability. Facilitators of sustainability for the CPP included: It is part of the community that it serves; The creation of deeply integrated networks of diversity-competent service providers; and "Virtuous non-adaptability" of service providers in refusing to compromise care standards despite financial pressure to do so. Threats to sustainability included: Difficulty maintaining a diversity-competent workforce skilled in HIV medicine; Marginal financial viability; and Political vulnerability.
Keywords: Humans
HIV Infections
Program Evaluation
Attitude to Health
Homosexuality, Male
Life Style
Family Practice
Quality of Life
Needs Assessment
Health Care Costs
Financing, Government
National Health Programs
Primary Health Care
Delivery of Health Care, Integrated
Health Services Accessibility
Quality of Health Care
South Australia
Description: The document attached has been archived with permission from the editor of the Medical Journal of Australia. An external link to the publisher’s copy is included.
DOI: 10.5694/j.1326-5377.2005.tb07181.x
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