DSpace Community: Scholarly work of Flinders staff, organised by department/school.

'Faking til you make it': Social capital accumulation of individuals on low incomes living in contrasting socio-economic neighbourhoods and its implications for health and wellbeing

2013-05-13T01:25:43Z

Title: 'Faking til you make it': Social capital accumulation of individuals on low incomes living in contrasting socio-economic neighbourhoods and its implications for health and wellbeing Authors: Browne-Yung, Kathryn; Ziersch, Anna Marie; Baum, Frances Elaine Abstract: People on low-income living in low socio-economic neighbourhoods have poorer health in comparison with those living in advantaged neighbourhoods. To explore neighbourhood effects on health and social capital creation, the experiences of low-income people living in contrasting socio-economic neighbourhoods were compared, in order to examine how low-income status and differing levels of neighbourhood resources contributed to perceived health and wellbeing. Quantitative and qualitative data were analysed: survey data from 601 individuals living in contrasting socio-economic areas and in-depth interviews with a new sample of 24 individuals on low-incomes. The study was guided by Bourdieu's theory of practice, which examines how social inequalities are created and reproduced through the relationship between individuals' varying resources of economic, social and cultural capital. This included an examination of individual life histories, cultural distinction and how social positions are reproduced. Participants' accounts of their early life experience showed how parental socio-economic position and socially patterned events taking place across the life course, created different opportunities for social network creation, choice of neighbourhood and levels of resources available throughout life, all of which can influence health and wellbeing. A definition of poverty by whether an individual or household has sufficient income at a particular point in time was an inadequate measure of disadvantage. This static measure of ‘low income’ as a category disguised a number of different ways in which disadvantage was experienced or, conversely, how life course events could mitigate the impact of low-income. This study found that the resources necessary to create social capital such as cultural capital and the ability to socially network, differed according to the socio-economic status of the neighbourhood, and that living in an advantaged area does not automatically guarantee access to potentially beneficial social networks.

The relationship between in-hospital location and outcomes of care in patients of a large general medical service

2013-05-13T01:25:23Z

Title: The relationship between in-hospital location and outcomes of care in patients of a large general medical service Authors: Perimal-Lewis, Lua; Li, Jordan Y; Hakendorf, Paul Haylett; Ben-Tovim, David Isaac; Qin, Shaowen; Thompson, Campbell Henry Abstract: Background: The discrepancy between the number of admissions and the allocation of hospital beds means many patients admitted under the care of a general medical service can be placed in other departments’ wards. These patients are called “outliers” and their outcomes are unknown. Aims: To examine the relation between the proportion of time each patient spent in their “home ward” during an index admission and the outcomes of that hospital stay. Methods: Data from Flinders Medical Centre’s (FMC) patient journey database were extracted and analysed. The analysis was carried out on the patient journeys of patients admitted under the General Medicine units. Results: Outlier patients’ length of stay (LOS) was significantly shorter than that of the inlier patients (110.7 hours cf 141.9 hours; p < 0.001).They had a reduced risk of readmission within 28 days of discharge from hospital. Outlier patients’ discharge summaries were less likely to be completed within a week (64.3% cf 78.0%; p < 0.001). Being an outlier patient increased the risk-adjusted risk of in-hospital mortality by over 40%. 50% of deaths in the outlier group occurred within 48 hours of admission. Outlier patients had spent longer in the Emergency Department (ED) waiting for a bed (6.3 hours cf 5.3 hours; p < 0.001) but duration of ED stay was not an independent predictor of mortality risk. Conclusion: Outlier patients had significantly shorter LOS in hospital, but significantly greater in-patient death rates. Surviving outlier patients had lower rates of readmission but lower rates of discharge summary completion.

HIV among immigrants living in high-income countries: a realist review of evidence to guide targeted approaches to behavioural HIV prevention

2013-05-13T01:25:33Z

Title: HIV among immigrants living in high-income countries: a realist review of evidence to guide targeted approaches to behavioural HIV prevention Authors: McMahon, Tadgh; Ward, Paul Russell Abstract: Immigrants from developing and middle-income countries are an emerging priority in HIV prevention in high-income countries. This may be explained in part by accelerating international migration and population mobility. However, it may also be due to the vulnerabilities of immigrants including social exclusion along with socioeconomic, cultural and language barriers to HIV prevention. Contemporary thinking on effective HIV prevention stresses the need for targeted approaches that adapt HIV prevention interventions according to the cultural context and population being addressed. This review of evidence sought to generate insights into targeted approaches in this emerging area of HIV prevention.

Gaining insight from patient journey data using process-oriented analysis approach

2013-05-13T01:25:25Z

Title: Gaining insight from patient journey data using process-oriented analysis approach Authors: Perimal-Lewis, Lua; Qin, Shaowen; Thompson, Campbell Henry; Hakendorf, Paul Haylett Abstract: Hospitals are continually struggling to cater for the increasing demand for inpatient services. This is due to increased population, aging, and the rising incidence of chronic diseases associated with modern life. The high demand for hospital services leads to unpredictable bed availability, longer waiting period for acute admission, difficulties in keeping planned admission, stressed hospital staff, undesirable patient and family experience, as well as unclear long term impact on health care capacity. This study aims to derive some correlation between various factors contributing to ward occupancy rate and operation efficiency. The aim is also to discover the inpatient flow process model proposing to use process mining techniques combined with data analysis to depict the relationships among inpatients, wards and Length of Stay (LOS) in an effort to gain insight into factors that could be focused to relieve access block. Open source process mining software - ProM is used for this study. The study is done in collaboration with Flinders Medical Centre (FMC) using data from their Patient Journey Database as case study.