Investigating Access to Allied Health by Australians with Parkinson’s Disease

Abstract

The aim of this thesis was to explore access to allied health in people with early-stage Parkinson’s disease living in Australia. The first study focused on management from the perspective of general practitioners, neurologists and Parkinson’s nurse specialists. Five main themes were identified relating to factors that influenced allied health referral. All clinicians reported difficulty locating approachable, available, affordable and appropriate allied health services. Clinicians perceived that their patient’s ability to interact with health services also impacted their access. Overall, allied health referrals were delayed and made to individual disciplines rather than teams. The next study explored allied health access from the lived experience perspective. Themes were identified relating to barriers and facilitators encountered when accessing allied health. Allied health service approachability and appropriateness varied, as did participants’ ability to perceive care needs. All participants had the ability to seek and engage in care, but health service availability, limited ability to pay and being unable to drive restricted access. Traditional medicine was often found to be more acceptable by culturally and linguistically diverse participants. Overall, no structured approach was identified for people with Parkinson’s disease to be referred to allied health. The final study explored health service utilisation by women with Parkinson’s disease in Australia at a population level. Analysis was conducted on surveys and linked administrative health data to determine the number of women with Parkinson’s disease and the health services they utilised around diagnosis. There were 1,770 women with Parkinson’s disease identified and 74% utilised allied health within six-years of diagnosis. Allied health usage was low, with median visit numbers of zero for most disciplines. Overall, women with Parkinson’s disease did not receive early allied health access as recommended.