HSH 211 AT1 Case Study Part 1

Miranda Fritz
S223275949
Word Count: 1641
Introduction
Central Bayside Community Health Services (CBCHS) focuses on the Melbourne
community’s health and wellbeing through a variety of services and programs. This report
focuses on the Paediatric services offered by CBCHS in terms of health models and systems,
health system core values, and vital statistics.
Paediatrics models and systems
The CBCHS Annual Report (2021-2022) defines itself as “a not-for-profit organisation
that provides a wide range of integrated health, wellbeing, disability, and support services to the
community.” CBCHS has multiple locations to serve the Melbourne community, but the only
location with Paediatricians οn site is Parkdale. Paediatricians specialise in the diagnosis of
illness, minor injuries, and infectious diseases in infants, children, and adolescents (Better Health
Channel, 2021). A GP may refer children to a Paediatrician when they require a specialist
opinion on child growth and development, or if they require specialised treatment for a condition
(Raising Children Network, 2019). The Paediatrics service at CBCHS targets children who may
require expert knowledge in the area of child health, especially when diagnosing issues such as
developmental delays, learning problems, and asthma (Raising Children Network, 2019). At
such a young age, children may be unable to articulate certain struggles they are having or
identify developmental delays, which further emphasises the importance of a Paediatrician
(Raising Children Network, 2019). For example, the Australian Institute of Health and Welfare
reports that 7.4% of children (age 0-14) were diagnosed with a disability, with 4% of those being
considered severe (2022). The most common types of disability in children aged 0-14 were
intellectual and sensory/speech, which highlights the importance of Paediatricians because they
are specially trained to identify and create treatment plans for those conditions and more
(Australian Institute of Health and Welfare, 2022). At CBCHS, Paediatricians work with a
network of other health professionals such as Speech Pathologists, Occupational Therapists,
Physiotherapists, and Children & Family Psychologists to create a comprehensive health plan
and ensure the wellbeing of their patients (CBCHS, 2023). Access to a Paediatrician ensures that
children are able to receive treatment for potential developmental delays or disabilities, and can
progress toward recovery or disease management (Better Health Channel, 2021). In order to see
a Paediatrician at CBCHS, the child must have an appointment at the Parkdale location, which
means they must have access to a phone or computer to book the appointment, and a reliable
form of transport (CBCHS, 2023). Additionally, the child would require a parent or guardian to
book and accompany them to the appointment (CBCHS, 2023).
Health System Core Values Related to Paediatrics
The four core values of any health system are universalism, access, equity and efficiency.
Paediatric services at CBCHS are available to all children who have an appointment with a
Paediatrician and are able to attend that appointment (CBCHS, 2023). Additionally, the CBCHS
makes it clear on their website that Paediatrician appointments are bulk billed through Medicare,
so no fees apply (CBCHS, 2023). However, since Paediatricians are only available at the
Parkdale location, appointments are limited and at time of writing, CBCHS Paediatricians are not
accepting new patients (CBCHS, 2023). In terms of universalism, this means that not every
patient in need of a Paediatrician at CBCHS would be able to make an appointment. In order to
ensure that this service is available to all patients in need, CBCHS could increase the number of
Paediatricians on staff in order to accommodate new patients (Keleher & MacDougall 2011, p.
321).
The concept of increasing the number of Paediatricians on staff also lends itself to the
core value of access, which is defined using multiple dimensions (Willis & Keleher 2020, p.
142). CBCHS makes its paediatric services extremely approachable by advertising them clearly
on their website, and by outlining what paediatric services can be used for. The acceptability of
the paediatric services at CBCHS are aligned in the sense that they cater toward infants, children,
and adolescents by employing medical professionals who specialise in the needs of younger
patients. Culturally, however, CBCHS does not account for differences within its patient
population. The Royal Australasian College of Physicians reported that Aboriginal and Torres
Strait Islander children in Australia are more prone to disease and typically have poorer health
than their non-Indigenous paediatric counterparts (2020). They attribute this to the fact that
Indigenous children have much higher rates of infection and are more at risk of developmental
vulnerabilities (The RACP Indigenous Child Health Working Group, 2020). To help combat
these issues, CBCHS could choose to employ Paediatricians who have a special focus on
Indigenous children in order to be more aware of the culture differences that affect the overall
health outcomes of their Paediatric patients (The RACP Indigenous Child Health Working
Group, 2020). Paediatricians at CBCHS can be considered affordable due the fact that they are
Bulk Billed, and appropriate given that the medical professionals are trained to evaluate the
health of infants, children, and adolescents (CBCHS, 2023). The accommodation of CBCHS
Paediatrics is subpar, considering it is only available at the Parkdale location, despite serving the
Melbourne community (CBCHS, 2023). By having Paediatricians at multiple clinics, Paediatric
services would be more accessible to a larger portion of their population (Willis & Keleher 2020,
p. 142).
The third core value is equity, which can be broken down into two components (Willis &
Keleher 2020, p. 142). Horizontal equity deals with ensuring rural and metropolitan patients have
access to similar health services and outcomes (Willis & Keleher 2020, p. 142). Since CBCHS
focuses on the Melbourne area, it is easier for those closer to Melbourne to access the Paediatric
services, which leaves the rural clientele at a disadvantage. To become more equitable, CBCHS
could open Paediatric clinics in the more rural areas of their patient base, and expand to offering
Paediatric services via TeleHealth methods in order to give rurally based patients more access to
the care (Willis & Keleher 2020, p. 142). Vertical equity is more values based and involves the
consideration of marginalised groups when making decisions in healthcare (Willis & Keleher
2020, p. 142). This theme can be tied to the suggestion of including Paediatricians at CBCHS
that specialise in Indigenous care, so that Aboriginals and Torres Strait Islanders would receive
care catered to their specific needs the same way their non-Indigenous counterparts do (Willis &
Keleher 2020, p. 142).
Finally, the fourth core value of healthcare is efficiency, which is broken down into three
subcategories. CBCHS has the potential to improve on its allocative efficiency by distributing its
Paediatric services across multiple clinics, rather than keeping all Paediatricians consolidated at
the Parkdale location. Doing so would improve paediatric outcomes by allowing more patients
more convenient access to the service. Technical efficiency can be seen within CBCHS
Paediatrics when the Paediatricians communicate with other Child Development specialists to
create the best care plan and ensure the best health outcomes for their patients (Duckett &
Willcox 2015, p. 325). Finally, dynamic efficiency can be seen in the CBCHS system as a whole,
as they adapt and add more Paediatric services as the needs of the Paediatric population evolve
(Duckett & Willcox 2015, p. 325). For example, CBCHS includes Child Psychologist therapy
and groups to help best treat mental health as it is seen more in paediatric patients (CBCHS,
2023).
Health Status and Vital Statistics
 An example of a vital statistic regarding Paediatrics in Australia is the number of children
with a disability, which was touched on previously when highlighting the importance of
paediatric care. The Australian Institute of Health and Welfare reports that the ABS 2015 Survey
of Disability, Ageing and Carers (SDAC) showed 7.4% of Australian children (age 0-14) as
having some type of disability (2022). For reference, that is 329,000 Australian children that
have a disability, the most common being intellectual and sensory/speech (Australian Institute of
Health and Welfare, 2022). The proportion of disability was slightly higher in males than in
females, with severe disabilities being higher in inner-regional areas and low-income households
(Australian Institute of Health and Welfare, 2022). Disabilities in this population group are
diagnosed by Paediatricians and treated by a team of Child Development specialists who work
with the parent and child throughout treatment (Garth et al., 2009). Health inequity is defined as
an observable difference in health status within population groups that may be described by
culture, socioeconomic status, or where they live (Willis & Keleher 2020, p. 76). In the case of
child disability, it can be seen that children who come from a lower socioeconomic status and
more rural areas do happen to be more likely to have a disability (Australian Institute of Health
and Welfare, 2022). This gap could be avoided if there was more access to Paediatric care in
rural areas, so that families in those more remote areas would be able to receive care as
conveniently as those living in an urban area (Duckett & Willcox 2015, p. 38). Furthermore,
those children with a disability living in low socioeconomic conditions may not be able to afford
some of the Child Development services that require additional fees, which would also leave
them receiving less care for their disability than their higher socioeconomic status counterparts
(Australian Institute of Health and Welfare, 2022). Due to the health gap created by
socioeconomic status and area of residence, it is clear that the amount of children with a
disability represents a health inequity.
Conclusion
This case study has focused on the Paediatric services offered by CBCHS, which are
extremely important because infants, children, and adolescents experience a wide variety of
conditions that require a specialist to diagnose and treat. The Paediatric services at CBCHS
reflect the core values of healthcare at a base level and have room to improve and provide an
even better standard of care for paediatric patients. Finally, the Paediatric services at CBCHS are
set up to effectively treat childhood disability, which is a vital statistic related to the field of
paediatrics.
 References
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