Developing A Business Case For Enhancing Healthcare Accessibility For Aboriginal Queenslanders

Assessment of the Situation

Racial segregation in the Australian healthcare sector has had a detrimental impact on the Aboriginals and Torres Islanders populace. Recent studies have exposed the factors that prevent this population from accessing high quality care (Thurber, et al., 2018). Various issues have been listed including racism, social dispossession, unemployment, and illiteracy among others. According to Thurber and colleagues (2018), these dynamics have resulted in systemic marginalization. Consequently, the country has witnessed an increase in diabetes and mortality rates among the indigenous people. At the moment, this population is twice more likely than its non-aboriginal counterpart to develop diabetes (Rahiri, et al., 2018). Moreover, aboriginals have a life-expectancy rate that is 10 years lower than the rest of the Australian population. These trends are also reflected in a broad range of complications including myopia, asthma, arthritis, hyperopia, auditory impairments, respiratory infections, and high sugar levels. Note that recent investigations have uncovered intense correlation between the mentioned conditions and the indigenous population of Queensland and Australia at large. Rahiri and associates add that the trend is quite amendable and avoidable (2018). For this reason, they recommend investment in resource-building to resolve the current industrial impediments. Also, the conditions are highly linked to diabetes.

As an organization that understands its population, SimHealth is highly likely to transform the current healthcare trends towards a positive end. At this point, the reader can acknowledge that something ought to be done to resolve the problem faced by indigenous Queenslanders. SimHealth’s profile best positions it as a socially responsible corporate actor.

Aboriginal Queenslanders have reported a plethora of challenges with respect to the accessibility of mainstream healthcare services. Some of these issues include lack of transport, unwelcoming hospital setting, inflexible treatment options, a sense of alienation, and mistrust of the care providers. As far as the issue of transport is concerned, approximately 86 percent of Queensland aboriginals live in remote areas (Azzopardi, et al., 2018). This issue curtails their ability to access care providers in emergency scenarios including diabetes-induced heart attacks and strokes. On the other hand, the strong sense of alienation results from the passive racial segregation. It is not uncommon for an indigenous Queenslander to enter an unwelcoming hospital setting. Such a scenario sparks mistrust among aboriginals; thus, preventing them from seeking care when in need. When viewed from an analytical lens, it is clear that the poor quality healthcare experienced by the aboriginals results from marginalization.

An observer once remarked that the major cause of healthcare disparities in Australia is the system’s inability to respond to the economic, infrastructural, social, and cultural requirements of aboriginal people. This sentiment was affirmed by one James Sandy (A diabetic Indigenous Queenslander) when he claimed that the deaths of his nine siblings resulted from the disconnection between the system and the indigenous populations (Alston, et al., 2017). According to him (Sandy) community fails to equally distribute the necessary resources required by diabetes management. As a result, fewer and fewer indigenous individuals access healthcare. Alston and colleagues conclude that such a scenario is one among the widely publicized grievances (2017).

Problem Statement

Inequality. By now, it is apparent that the indigenous Queenslanders are a high-risk population with respect to preventable life-threatening conditions such as diabetes. As a matter of fact, there is a nationwide campaign towards the alleviation of this healthcare phenomenon. The Australian government has allocated significant amount of resources and initiatives towards the same. The ‘Closing the Gap (CtG) initiative is quite exemplary at this juncture. This campaign was initiated by the national body COAG – the Council of Australian Governments’ -, through the funding system created under the National Partnership Agreements (NPA). The fact that the system inequalities have attracted nationwide concerns validates this argument.

Cause of the Inequality. This paper has also acknowledged that the described inequality is caused by social, economic, and cultural factors that can be resolved through community-based interventions. In light with the current public concerns, a broad range of investigations have been implemented with the aim of understanding the healthcare challenge facing Australia. Researchers agree that the disparity stems from various factors including racism, illiteracy, and unemployment among others (Thurber, et al., 2018). Racial marginalization has emerged in most academic reports. There is a strong belief that most of the region’s hospital settings are not designed to facilitate indigenous people’s needs. Such a systemic failure results from bias services, lack of cultural diversity, and lack of supportive infrastructure. The first two causes explain why most indigenous individuals feel unwelcomed and distrustful when in various hospitals. As for the infrastructure, the lack of care facilities in remote areas jeopardizes the aboriginal Queenslanders’ ability to access high quality care. This factor inspires the idea that an appropriate solution is one that would strive for the creation and maintenance of a culturally-tolerant society (Thurber, et al., 2018).

Impacts of the Inequality. Inability to access high quality care reflects on the health performance of the indigenous people of Queensland. Unlike their non-aboriginal counterparts, individuals from this population are twice likely to develop diabetes (Brands, et al., 2018). They also have a significantly lower life expectancy rates than the rest of the population. These observations are advanced by the trends noted by SimHealth’s research department. The study found that indigenous Australians had higher prevalence rates in diabetes-related conditions such as hyperopia (30 vs. 25), asthma (18 vs. 10), arthritis (17 vs. 13), and auditory impairments (16 vs. 12) (Worry, n.d). Note that the rates for diabetes across the two groups were 14 (indigenous) and 4 (non-indigenous).

Key Performance Indicators (KPIs). KPIs are essential in defining a problem through quantification and categorization. Some of the key performance indicators in the current case include BMI, Alcohol consumption, smoking status, and diagnosis rates. As far as the mentioned KPIs are concerned, the indigenous people of Queensland record high rates than non-aboriginals.

Considering the nature of the problem faced by Indigenous Queenslanders and the solution pursued by SimHealth, one can agree that this proposal is deeply ingrained in the concept of cultural competence. As the world continues to attain globalization, societies are becoming more diverse, thus necessitating inclusion in the public healthcare sector (Angell, et al., 2017). Queensland’s challenges result from the lack of a culturally competent healthcare system. If this proposal will be granted, the people will have a chance to enjoy the wide range of cultural competence benefits. By default, these merits are categorized as social, health, and business.

Evidence of the Problem

Social Benefits. Healthcare ought to be approached from a community-based perspective. Such a strategic move allows the industry to include all people regardless of social, economic, and political differences (Lai, Taylor, Haigh, & Thompson, 2018). The advocates of the community-based healthcare approach acknowledge the fact that the differences can enhance operations across the industry. Once such a goal is attained, the industry experiences trust, increased public/family/individual participation, and mutual respect and understanding (Durey, 2010). The approval of this proposal will lead to a collaborative process whereby indigenous Queenslanders will be included in the delivery of care to fellow natives.

Health Benefits. The overall health of Queenslanders is also bound to benefit from this proposal. As noted, major disparities characterize the Australian healthcare sector. A culturally diverse system will improve the treatment of preventable conditions such as diabetes (Lai, Taylor, Haigh, & Thompson, 2018). For instance, investment in public awareness and cultural inclusion will ensure that the diabetic Queenslanders face little or no barriers in to care.

Economic Benefits. From an economic standpoint, cultural competence enhances organizational diversity, which in turn improves the decision-making process. Such a factor implies that the proposed project might enhance the economic performance of Queensland’s healthcare sector by facilitating an innovative environment.

Measurement Description	Baseline Measure What is the current state?	Target Measure (Include interim targets. Consider $, FTE, rates, target budget, etc.)	When will measurement occur?
What is the measure?	Start Date	Frequency	End Date
· Diagnosis and prevalence Rates · Health check-ups · Public awareness · The number of indigenous practitioners	· At the moment, the diagnosis rates for obesity among indigenous Queenslanders is twice that of non-aboriginals · Almost 40 percent of aboriginals aged 55-years and above are affected · Very few aboriginals participate in their medical care due to cultural and industrial barriers · Very few aboriginals are hired as care practitioners	· The diagnosis rates should be at par or lower considering the relatively low native populace (1:1 ratio). · Reduce the rate by 10 percent · Increase the rates of hospital visits by10 percent. · Reach over 100,000 individual through the online consultancy portal · Train and hire at least 1,000 aboriginals into relevant positions including nurses,  receptionists, and consultants.	· 2019	· 5-years	· 2026

Current Option (Status Quo) – Currently, very little is being done to promote a culturally competent healthcare sector. Most hospitals have no aboriginals working as providers. The few indigenous individuals that are working in Australia’s healthcare sector are in non-provider roles such as janitors and errand boys/girls (Lai, Taylor, Haigh, & Thompson, 2018). Apart from that, very few facilities have been designed to accommodate the cultural and traditional preferences of the indigenous patients (Anderson, et al., 2017). This factor explains the feeling of dispossession highlighted earlier in the paper. Most importantly, limited resources have been directed towards public enlightenment of the indigenous populations. Like most native populations, Australia’s aboriginals and Torres Islanders have a negative perception of modern treatment options (Jacobs, et al., 2018). This trend is influenced by their strong cultural values, beliefs, and approaches to health (Jacobs, et al., 2018). Others lack sufficient knowledge regarding the management of diabetes. Such a factor is highly attributed to the low investment in public education. If SimHealth chooses to apply this option, all the funds will be invested in additional facilities in the remote areas to reach the aboriginals.

The Preferred Option – Queensland’s healthcare industry participants should embrace cultural competence. As a socially responsible organization, SimHealth proposes a public inclusion campaign that will involve enhancement of public awareness and the involvement of aboriginals in the provision of care. Below is a detailed description of its implementation:

This goal will be reached through the training and hiring program suggested in the preceding section. SimHealth will create one training facility so as to accommodate at least 400 trainees per training period (1 year). The construction costs are expected to be around 10 million dollars. The trainees will be equipped with essential care skills including nursing and consultancy. The estimated cost of training each individual is 13,400 dollars. If successful, SimHealth will train and hired over 1,000 care providers by the end of the 5-year period. Note that five million dollars will be set aside for maintaining the training site.

Impacts of the Inequality

This goal will be attained through the creation of an online portal for aboriginal healthcare consultants to reach their fellow tribesmen. This approach will enhance participation among the indigenous Australians since they are highly likely to acknowledge the advice from aboriginal professionals. The portal will be created as a social networking platform to enhance participation.

Portal Development and Maintenance. The portal will be developed and maintained by SimHealth’s Financial and Business Development department. The development stage is expected to cost approximately 10 million dollars. The maintenance team will include a network manager, a cryptographer, and a web designer. Each of them will receive monthly compensation of around 48,000 dollars. This figure rounds up to 1,728,000 dollars on an annual basis: 8,640,000 dollars by the end of the five-year period.

Target. The network will include a minimum of 1,000 consultants: some will be trained by SimHealth while others will be outsourced from other institutions. These consultants will be expected to reach over 100 people so that the 100,000 target can be attained. Note that the consultants will charge reasonable fees for their services. 

Compare the options by summarising the benefits, risk, costs, timeframes and other relevant criteria.

Criteria	Option 1	Option 2
Benefits · Community or patients · Staff · Organisation	The current option involves expansion into remote areas. It will benefit native Queenslanders by bringing healthcare services close to them. It will also expand SimHealth’s market reach.	Unlike the first option, this one will apply a systematic approach to the alleviation of systemic inequalities. The indigenous community will benefit from the training and hiring process (a solution to the current unemployment). The workers will have multiple perspectives, which will improve decision-making.  As for the patients, they will benefit from the communication platforms offered to aboriginal consultants. SimHealth’s brand value will also grow due to the community-based approach.
Risk · Community or patients · Staff · Organisation	While this option fosters geographic penetration into native regions, it does not include the aboriginals in care provision. Therefore, it is highly likely to fail due to lack of appeal. Note that most aboriginals feel uncomfortable in the predominantly white settings.	The only challenge with this option is the low internet usage among indigenous Australians. One cannot be sure whether the digital platform will serve the indigenous people as desired.
Costs: · Project · Recurrent · Savings/Revenue	The project will cost at least 47 million dollars in the developmental stage. Recurrent expenses will be resolved by the facilities’ operating capital and profits.	Like the previous option, this one will consume almost 47 million dollars. As stated, it is a multitier approach that involves investment in educational resources (materials and facilities) and an online platform.
Time to implement	It will take a minimum of five years to create a facility (or two) in each of Queensland’s remote towns. Their sustainability will depend on the organizational leadership at any given point.	This too can be implemented within 5 years. Note that the educational resources are bound to attract financial support. The funds will be essential in the maintenance of the online platform.

• Investment in an online portal for public awareness. This option is based on the fact that few indigenous Queenslanders are familiar with diabetes treatment and other healthcare issues. The patients will benefit from such a solution since the portals will include a network of consultants. This project will take a maximum of two years to complete. The set-up costs might round up to 10 million. The recurrent costs will be met by the funds collected from philanthropists as it is a noble course.
• Training and hiring natives. This approach will benefit not only the community but also SimHealth. A diverse workforce will allow the organization to work towards the fulfilment of the whole society’s needs. Success will be measured by an increase in the number of visits by indigenous people. This process might take up to five years. The set-up and recurrent costs will be dependent on the number of natives that will enrol in the program. For instance 1,000 individuals will cost at least 1 million dollar per year: the recurrent expenses will be in the form of salaries once they are hired.  

	Non-recurrent (set up costs)	Recurrent (ongoing running costs)
Estimated expenditure · Labour Costs · Non-labour Costs · Capital Acquisitions	Labour Costs N/A Non-Labour Costs 10 million dollars (portal development Capital Acquisitions Facilities: 10 million dollars	Labour Costs Training: 13,360,000 dollars (3,360 per trainee). Web Portal Maintenance: 8,640,000 dollars Training site Maintenance: 5,000,000
Estimated revenue / cost savings (if any)	N/A	N/A
Estimated net cost to simHealth	20,000,000 dollars	27,000,000 dollars

References

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Anderson, I., Lyons, J. G., Luke, J. N., & Reich, H. S. (2017). Health determinants and educational outcomes for indigenous children. In Indigenous Children Growing Up Strong (pp. 259-285). London, UK: Palgrave Macmillan.

Angell, B., Laba, T. L., Lung, T., Brown, A., Eades, S., Usherwood, T., & Tonkin, A. (2017). Healthcare expenditure on Indigenous and non-Indigenous Australians at high risk of cardiovascular disease. International journal for equity in health, 16(1), 108.

Azzopardi, P. S., Sawyer, S. M., Carlin, J. B., Degenhardt, L., Brown, N., Brown, A. D., & Patton, G. C. (2018). Health and wellbeing of Indigenous adolescents in Australia: a systematic synthesis of population data. The Lancet, 391(10122), 766-782.

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Rahiri, J. L., Tuhoe, J., MacCormick, A., Hill, A., & Harwood, M. (2018). A narrative review of bariatric surgery in Indigenous peoples. Obesity Research & Clinical Practice 1(1).

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