Introduction
Cardiovascular disorders (CVD), which include myocardial infarction (MI), stroke, and cardiogenic shock, are the primary causes of death among Australia’s aging population. This factor indicates that the need for reliable, efficient, and accessible Cardiology service is critical in enhancing care. However, there is a problem in the health system due to the complexity of the forces shaping the demand and supply of healthcare services (Australian Institute of Health and Welfare, 2022). Some factors affecting the health system include the epidemiological and demographic shift, rise in health expenditure to the customer price index, and reduced national tax base (Calder et al., 2019). Therefore, this study explores the state of cardiology service, measures implemented to enhance healthcare, and recommendations for future use.
Overview of Cardiology Services in Australia
The state of cardiology service systems in Australia is wanting, considering that it is affected by systemic limitations. Some systemic challenges include workforce shortage, limited infrastructure and equipment to cater to Cardiology patients’ needs, and a high average length of stay in hospital (Dixit and Sambasivan, 2018). These limitations do not align with the national standard metrics of quality. For instance, the WHO framework provides a list of benchmark standards that determine healthcare quality (Hamilton et al., 2018). A comparison of the Australian cardiology system against these benchmarks reveals systemic issues.
Service delivery is the first building block that requires healthcare organizations to ensure quality services. A strong service delivery encompasses comprehensiveness, coverage, continuity, and coordination (Hamilton et al., 2018). The Australian Cardiology industry is affected, considering that specific metrics that promote effective service delivery are strained. According to the Australian Institute of Health and Welfare (2021), only 101 coronary care units are allocated in the public sector. This data indicates that the cardiology system lacks enough medical equipment to provide excellent services.
Another integral determinant of health quality in the WHO framework is the availability of a health workforce. The Australian cardiology system has an inadequate workforce, including cardiologists, to provide specialized care. A shortage of health experts hinders coordinated care due to work overload, lack of interpersonal collaboration, and poor engagement (Hsu et al., 2021). The requirement for cardiology patients to have referral letters to access specialized care indicates that there is a lack of enough specialists to sustain the available demands (Hsu et al., 2021). This understaffing issue indicates that the system is strained to the core.
Access to medicines and financing are other indicators of an effective health system. However, the rise in health expenditure to the customer price index means that more cardiology patients cannot access medicines due to financial issues. The aging population has a low customer price index that makes them unable to afford some health products and services (Hsu et al., 2021). All these issues in financing and access to medicines signify a problem in the system.
Health information systems also enhance the quality of care by promoting better improvement initiatives for the underserved population. Although data management among patients with cardiac diseases has significantly improved due to technology, the synthesis of data to promote proactive measures in this health system is limited (Hsu et al., 2021). The reason is that some health codes, such as confidentiality and autonomy, restrict patient data sharing (Hsu et al., 2021). Therefore restricted dissemination of information is a significant setback to understanding the limitations.
Leadership and governance are also significant concepts in developing a sustainable health system (Hsu et al., 2021). The Australian administrative decentralization enables different health industry sectors to function as a single unit with its own leadership (Hsu et al., 2021). However, the current state of the cardiology service is filled with discrepancies, including high costs of drugs which indicate that the system is suffering from poor leadership structures. Therefore, the shortcomings in the system, including poor service delivery, financing, inefficient leadership, and understaffing, depict a decapitated system.
Applied Measures in Enhancing Quality Service in Cardiology
There is moderate success in the interventions placed by the Australian government to improve the quality of cardiology services among the aging population. One successful program is the retirement income support system. An example is the commonwealth system that provides medical and pharmaceutical benefits to the aging population. This program also supports respite and resource centers to ensure that advocacy for services and health promotion programs are enhanced (Calder et al., 2019). Additionally, community aged care packages are programs that provide tailored care services to the aging population at their homes, funded by the Commonwealth. These initiatives indicate that the system is functional within reasonable limits to promote better service delivery.
Medicare and the National Safety and Quality Health Service (NSQHS) guidelines are examples of the principles that govern the quality of care. Medicare is a publicly funded insurance program that operates above historically established healthcare organizations to give universal access to primary and acute medical coverage. To support Medicare, the government has established a multipayer system that enables cardiology patients to access funding for their medical bills through various systems, including public insurance, private cover, and out-of-pocket funding (Calder et al., 2019). The National Safety and Quality Health Service (NSQHS) also helps govern quality care provision by ensuring that services provided to cardiology patients are centered, safe, and effective (Calder et al., 2019). Violation of this requirement could attract sanction and reimbursement issues with Medicare. Such policies indicate that the government is prepared to create sustainable quality health services.
Additionally, the number of Medicare-subsidized specialist attendants has also increased in the past years due to the government’s effort to enhance quality. According to a report by the Australian Institute of Health and Welfare (2021, para. 9), 2.2 million patients received cardiology services from cardiology specialists. The Australian cardiology specialists ranked first in consultations indicating efficient delivery of healthcare (Australian Institute of Health and Welfare, 2021, para. 9). This factor indicates that cardiology services are readily available to patients who need these services, which shows significant improvement efforts.
At this rate of involvement, many would consider the government to be working excellently to enhance the quality of cardiology services in Australia. However, many systemic failures experienced show moderate government effort to enhance cardiology services. According to a report by the Australian Institute of Health and Welfare (2022, para 4), 38 cardiac surgery units in the public sector accommodate thousands of patients with cardiovascular disease as the primary diagnosis. The shortage in healthcare infrastructure and equipment indicates a systemic problem considering that these limitations reduce the quality of healthcare.
Another systemic problem justifying moderate government efforts in enhancing cardiology systems is the inaccessible services for Patients in remote areas. Due to COVID-19, face-to-face consultations reduced significantly, leaving patients with only online choices such as video conferencing (Mohanty et al., 2020). The number of video conferences and telephone consultations dropped significantly, creating a significant barrier to reaching out to patients in remote areas (Mohanty et al., 2020). Therefore, Australia’s cardiology sector is not prepared adequately to meet the increasing demands for cardiology services due to the numerous systemic limitations.
Responsiveness to the Needs of the Aging Population
Providing for the aging population’s needs is integral to enhancing economic stability, considering that a healthy nation results in a stable economy. The aging population’s health needs include health education, disease prevention, treatment, and terminal care (Brown, 2019). Various programs are placed in Australia to enhance responsiveness to the aging population’s needs. These include corporate governance of health equity and support for informal care systems. However, various limitations, including health literacy and inequality, are significant gaps in this system (Dixon, 2021). Therefore, specific improvement measures can help enhance the health processes in the system.
The State of Cardiology System
Strengths in Service, Decision Making, and Responsiveness to Needs of Vulnerable Population
The Australian medical system is governed by specific guidelines that guarantee health quality. A system that ensures standards are maintained includes the corporate governance strategy. This strategy is whereby companies are directed and controlled by a selected board. This system ensures that health management is centralized to enhance quality control (Dixon, 2021). However, maintaining a diverse system through a single body presents a daunting accountability challenge which is a significant gap in the system.
Weaknesses in Service, Decision Making, and Responsiveness to the Needs of Vulnerable Population
The availability of health infrastructure and clinical experts in remote areas is paramount in enhancing the quality of care. According to Hamilton et al. (2019, p.1), the Cardiac Rehabilitation (CR) attendance rate is close to 30% low in rural communities considering that these services are hospital-based. Most CR experts do not provide home-based services, restricting access to these services for people in urban areas. Decision-making is also centralized considering that corporate governance promotes board governance which can be overwhelming (Dixon, 2021). Additionally, most rural residents are unaware of facilities or resources available to support them financially or even advice on the best practices to enhance care. This factor indicates that most residents do not benefit from programs initiated to support patients suffering from cardiac diseases reducing responsiveness.
Opportunities in Service, Decision Making, and Responsiveness to the Needs of Vulnerable Population
The Australian health system has growth opportunities, considering that some significant gaps have been identified. Patients with cardiovascular diseases living in remote areas are underserved, considering that some services, such as cardiac surgery, are provided in hospital setups (Hsu et al., 2021). This gap presents an opportunity for the utilization of telemedicine since this will help enhance medical services in this sector (Hsu et al., 2021). Another improvement initiative is to enhance health education which will support awareness of the opportunities and resources available to promote wellness. Expanding the leadership system can also promote better decision-making and ace response to the needs of this population.
Threats to Service, Decision Making, and Responsiveness to Needs of Vulnerable Population
Various issues in the Australian health system undermine efforts placed to enhance quality. Health inequality among the non-indigenous population is a limitation in promoting accessible health services. Another threat is restricted medical research, whereby medical studies must be aligned with national health priorities, limiting its scope and creating bias in decision-making (Hsu et al., 2021). All these limitations indicate significant health challenges that could impact the sustainability of health standards reducing responsiveness to vulnerable populations.
Ethical Issues in Service Delivery, Decisions, and Vulnerable Populations
Some ethical issues in healthcare include enhancing equity, privacy and informed consent. Improving access to medical care is one of the issues that are pertinent in health provision. Ensuring everyone accesses care regardless of economic status is one ethical concern in service delivery (Taylor et al., 2021). Another challenge is maintaining patient confidentiality and informed consent. Medical experts must ensure that patient’s medical information is confidential, which could hinder decision-making (Taylor et al., 2021). Informed consent is another challenge considering that medical procedures procured without legal confirmation from the patient are treated as assault, and these can limit quick response to issues relating to high-risk situations. All these ethical issues must be considered to maintain health service standards.
Recommendations for Future Action
Various strategies will enhance health systems in Australia if they are effectively implemented. The first strategy is to change the payer system in healthcare from Medicare single payer to a multiplayer program. This program will encompass a new concept allowing people to fund their future medical expenses through saving (Dixit and Sambasivan, 2018). Another recommendation involves health literacy which is fundamental in enhancing awareness. The government should strengthen digital health literacy so that the aging population can access resources available to support them (Dixit and Sambasivan, 2018). For instance, they could use media outlets to broadcast information about cardiology services, how Medicare reimburses these services, and telemedicine options. This information will help the aging population make informed decisions on their health options.
The Australian government has promoted various improvement initiatives to promote quality health services for geriatric cardiology patients. Some of the programs include supporting retirement income support, Medicare, corporate governance, and accessibility to specialty medical systems. However, the system still experiences significant setbacks, including health inequality, changing demographics, and a low consumer index. Other ethical considerations such as confidentiality, informed consent, and equity derail the delivery of health services. However, some improvement initiatives could enhance cardiology services, including telemedicine, multiplayer systems, and health literacy. All these interventions may enhance the quality of healthcare service by enhancing efficiency, equity, and affordability.
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