Housebound Australians back to obscurity after telehealth cuts

Australians who are bedridden or housebound will again become invisible to our health system due to cut-backs to telehealth services on July 20.

The exact number of housebound Australians is unknown, as there is no mechanism to gather data on all patients who are confined to their homes due to disease, frailty, disability or any non-COVID-19 medical condition.

People in this situation face many challenges, the biggest being accessing standard medical services.

GP telehealth services will be cut on 20 July for people who have not attended a face-to-face appointment in the last 12 months, despite these telehealth iniaitives set up temporarily during the pandemic being life-changing for many.

This will result in many people again being excluded from primary healthcare services.

Dr Maria Alejandra Pinero de Plaza, researcher at Flinders University’s Caring Futures Institute, is leading a new study into the experiences of the homebound population in Australia, regardless of their condition.

“With the recent National Health Plan, Australia had rapidly overcome the most common barriers to the expansion of telehealth, including regulatory, financial, cultural, technological, and workforce impediments,” she says.

“Telehealth services must be continued for those who have not seen a GP face-to-face in the last 12 months who are homebound for non-COVID-19 medical reasons.

“Our study is investigating the needs of people who are housebound to highlight the nature and extent of their experiences, primarily through a survey that is open this month. We hope the outcome will be a catalyst to improve health practice, initiate policy change and further research.”

According to Dr Pinero de Plaza, cutting such services could impact negatively on the development of new avenues to improve the health, social and economic outcomes for people who are homebound.

“For example, studies of similar populations around the world have reported an increment of suicide rates in older people because of barriers to accessing health services,” she says.

“The pandemic response has supported the disadvantaged groups I am investigating. They have gained significant benefits such as increased autonomy and equity, however with the withdrawal of these benefits, I am worried.”

Ms Penelope McMillan, an experienced health consumer advocate and retired psychologist, is collaborating with the Caring Futures Institute study, ‘Making the invisible visible: Exploring the experiences of frail, homebound and bedridden people’ as a consumer co-researcher.

“People who are housebound have long felt they were fighting alone for access to primary healthcare; that the requirement to attend appointments was an immovable construct in the health system,” Ms McMillan says.

“What COVID-19 discussions have brought to light is that clinicians also support telehealth as a way to provide healthcare to people unable to attend appointments,” she says.

“In the past, clinicians only met clients when the person was well enough to attend an appointment. With the introduction of telehealth for GP services, we could meet with them when our symptoms were too severe to allow us to leave home. The understanding of our illness severity and the nature of our impairments was dramatically improved.”

As Chair of ME/CFS South Australia (Myalgic Encephalomyelitis/ Chronic Fatigue), Ms McMillan’s role in the study is valuable, in line with the Caring Futures Institute’s approach to include consumers as partners in research to maximise relevance and social impact.

“The pandemic is highlighting the healthcare, social and mental health needs of able-bodied people during the lockdown, and yet there are so many people who live like that every day,” she says.

The findings of the study will be shared through an innovative exhibition. Survey participants can sharing an anonymous photograph of their hands touching something that represents their world. These will be professionally curated and shared as a mobile exhibition across Australia in community spaces including libraries, MP’s offices and museums.

The survey is open until the end of July and can be accessed here.

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