ArticleInternational journal of environmental research and public health2021
"You Can't Work with My People If You Don't Know How to": Enhancing Transfer of Care from Hospital to Primary Care for Aboriginal Australians with Chronic Disease.
Article in International journal of environmental research and public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 4 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Interventions to improve Cultural Safety in healthcare in CANZUS countries: a systematic mixed studies review of First Nations Peoples' experiences.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2026Pooled it
- Implementation Outcomes and Their Determinants for Hospital-Led Care Coordination Interventions Targeting Patients With Complex Care Needs: A Qualitative Systematic Review.Journal of clinical nursing · 2026Pooled it
- A rapid review to inform the policy and practice for the implementation of chronic disease prevention and management programs for Aboriginal and Torres Strait Islander people in primary care.Health research policy and systems · 2024Pooled it
- Discharge interventions for First Nations people with a chronic condition or injury: a systematic review.BMC health services research · 2023Pooled it
- Which Cultural Safety Strategies Are Making a Difference? Exploring Hospital Initiatives for First Nations Peoples in Australia. A Scoping Review.Journal of clinical nursing · 2026Review
- Pharmacist-Led Transition of Care Services in Patients with Cardiovascular Disease: A Systematic Scoping Review.Cardiology · 2026Article
- Coordination of care in health systems for users with diabetes and hypertension: a scoping review.Revista latino-americana de enfermagem · 2025Article
- Birang Daruganora: what do Aboriginal and Torres Strait Islander communities need in a new hospital? A qualitative study.BMJ open · 2024Article
- Cape York Kidney Care: service description and baseline characteristics of a client-centred multidisciplinary specialist kidney health service in remote Australia.BMC health services research · 2023Article
- The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe: Ensuring and Promoting Best Practice in Research.International journal of environmental research and public health · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Indigenous Australians experience significantly poorer health compared to other Australians, with chronic disease contributing to two-thirds of the health gap. We report on an evaluation of an innovative model that leverages mainstream and Aboriginal health resources to enable safe, supported transfer of care for Aboriginal adults with chronic conditions leaving hospital. The multisite evaluation was Aboriginal-led and underpinned by the principles of self-determination and equity and Indigenous research protocols. The qualitative study documented processes and captured service user and provider experiences. We found benefits for patients and their families, the hospital and the health system. The new model enhanced the patient journey and trust in the health service and was a source of staff satisfaction. Challenges included staff availability, patient identification and complexity and the broader issue of cultural safety. Critical success factors included strong governance with joint cultural and clinical leadership and enduring relationships and partnerships at the service delivery, organisation and system levels. A holistic model of care, bringing together cultural and clinical expertise and partnering with Indigenous community organisations, can enhance care coordination and safety across the hospital-community interface. It is important to consider context as well as specific program elements in design, implementation and evaluation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.