Healthcare complexities during community crises: Recommendation for access to healthcare for Australians with multiple sclerosis

Yvonne C Learmonth; Hunter Assunta; Petra Skeffington; Walker Diana; Allan G Kermode; Claudia H Marck

doi:10.1016/j.msard.2023.104531

Healthcare complexities during community crises: Recommendation for access to healthcare for Australians with multiple sclerosis

Mult Scler Relat Disord. 2023 Mar:71:104531. doi: 10.1016/j.msard.2023.104531. Epub 2023 Jan 24.

Authors

Yvonne C Learmonth¹, Hunter Assunta², Petra Skeffington³, Walker Diana⁴, Allan G Kermode⁵, Claudia H Marck²

Affiliations

¹ Discipline of Exercise Science, Murdoch University, Perth, WA, Australia; Centre for Molecular Medicine and Innovative Therapeutics, and Centre for Healthy Ageing, Murdoch University, WA, Australia; Perron Institute for Neurological and Translational Science, Perth, WA, Australia. Electronic address: learmonth@murdoch.edu.au.
² Disability and Health Unit, Melbourne School of Population and Global Health, University of Melbourne, VIC, Australia.
³ Discipline of Psychology, Murdoch University, Perth, WA, Australia.
⁴ University of Western Australia, Crawley, WA, Australia.
⁵ Centre for Molecular Medicine and Innovative Therapeutics, and Centre for Healthy Ageing, Murdoch University, WA, Australia; Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, University of Western Australia, Perth, WA, Australia.

PMID: 36709575
DOI: 10.1016/j.msard.2023.104531

Abstract

Background: In 2019 and 2020, over 17 million hectares of Australia burned, and half of the Australian population was affected by toxic bushfire smoke. Then in 2020, restrictions designed to curtail the spread of COVID-19 resulted in significant changes to healthcare access. There is no Australian emergency management standard for persons with disabilities, including those with multiple sclerosis (MS). Persons with MS often require multidisciplinary and complex care, with continuity of treatment essential to prevent disease progression.

Objective: To identify limitations in access to healthcare from the perspective of persons with MS as well as MS care providers during recent crises and make recommendations for policy to improve MS healthcare access during a crisis.

Method: In mid-2020, we undertook online surveys and interviews with persons with MS, their carers, healthcare professionals and staff of MS service providers (i.e., care providers). We used descriptive analysis for quantitative, and a general inductive approach for qualitative data.

Results: One-hundred and thirteen persons with MS and a total of 63 MS care providers, who were close carers, healthcare professionals and service providers provided survey responses. For participants with MS, limited access to general practitioners and medical tests were of the most significant concern during the bushfires and the pandemic. In contrast, during the pandemic accessing physiotherapy was another top concern. Twenty-nine people participated in in-depth interviews, revealing that reduced healthcare access during the bushfire and the pandemic caused concern. The use of telehealth received both positive and negative reviews. All participants indicated a need for preparation and planning for healthcare access before a crisis. Persons with MS recommended centralised information sources, prioritised access to healthcare and increased levels of MS nurses and other allied healthcare. Care providers recommended centralised information sources, more nursing and mental health care access, and increased opportunities for multidisciplinary telehealth delivery.

Conclusions: We recommend the involvement of the MS community in creating and designing disaster preparation plans, which should cater to a range of disaster types, to improve disaster preparedness in a community that is vulnerable to increasingly common community crises.

Keywords: Bushfire; COVID-19 pandemic; Healthcare access; Multiple sclerosis; Public health; Qualitative research (mixed-methods).

MeSH terms

Australia
COVID-19*
Health Personnel
Health Services Accessibility
Humans
Multiple Sclerosis* / therapy