Equal Hearts study looks at how to make cardiac services more accessible

Interim findings from the Equal Hearts study, exploring how accessible cardiac services are for disadvantaged groups, highlight the need for better service integration and culturally safe care.

The Equal Hearts study commenced in 2022 with a grant from the Australian Government’s Medical Research Future Fund (MRFF),  to examine factors affecting the accessibility of cardiovascular care and then co-design and test an intervention that addresses these factors. In addition, the study hopes to develop an ‘equity tool’ that cardiac services can use to measure their accessibility. Accessibility means more than just availability of services, it also includes how approachable, acceptable and appropriate they are for the patients that use them.

Lead researcher Associate Professor Alison Beauchamp from Monash Rural Health stresses the importance of this research, given that heart disease is a leading cause of death in Australia and is more common in disadvantaged groups, such as rural Australians, people from culturally diverse backgrounds, and people with less education or lower income.

“Without knowing what the real barriers are for people from rural or culturally diverse communities in accessing cardiac care, we cannot begin to develop interventions that increase their uptake of cardiac care. By developing solutions that listen to what people and services actually need, we can ultimately make cardiac care more accessible to those that need them the most.”

To date, focus groups  with over 40 cardiac patients from four Victorian health services including Northern Health, Grampians Health, Colac Area Health and the Victorian Heart Hospital have been conducted.

Some of the key themes identified from this stage of the research include:

  • Difficult transitions from hospital to home. Participants said they would value a phone call from hospital staff within the first few days at home to ‘check in’ on progress.
  • Information provided in hospital is not personalised to each patient.
  • Poor communication between hospital and local health providers for ongoing care and medication management.
  • Strong benefits of cardiac rehabilitation (CR) programs, in particular, that the information provided was helpful and CR staff were friendly and knowledgeable - but referral to CR did not always happen smoothly, and some patients missed out or had to wait several months before starting.
  • Additional challenges for rural patients included distance to access specialists and Cardiac Rehabilitation programs, and difficulty making GP appointments.

Focus groups and interviews with clinicians in cardiac services to understand their perspectives are currently underway.

Five focus groups with members of the African and Sikh community were also held, to understand some of the additional barriers that culturally diverse communities face when accessing health services.

These groups identified significant language and communication barriers between participants and health professionals, a lack of understanding of their different cultures and religious customs, and perceived discrimination in hospital settings.

Research with culturally diverse communities continues, with additional focus groups with Pacifika and Arabic-speaking cardiac patients from Northern Health.

According to Associate Professor Alison Beauchamp, it is vital to improve services for rural patients and people from culturally diverse backgrounds, as these are often the people who need these services the most.

“Creating cardiac services that are ‘user friendly’ and equitable for everyone that uses them means making them culturally appropriate and acceptable, with information that is easy to understand, and help patients trust that their needs will be met.”