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General Practitioners’ Roles in Disaster Health Management: Perspectives of Disaster Managers

Published online by Cambridge University Press:  03 December 2021

Penelope L. Burns*
Affiliation:
Australian National University Medical School - Academic Unit of General Practice, Woden, Australian Capital Territory, Australia Western Sydney University School of Medicine - Penrith South DC, New South Wales, Australia
Gerard J. FitzGerald
Affiliation:
Queensland University of Technology - School of Public Health, Brisbane, Australia
Wendy C. Hu
Affiliation:
Western Sydney University School of Medicine - Penrith South DC, New South Wales, Australia
Peter Aitken
Affiliation:
James Cook University Division of Tropical Health and Medicine - College of Public Health, Medical, and Veterinary Sciences, Townsville, Queensland, Australia
Kirsty A. Douglas
Affiliation:
Australian National University Medical School - Academic Unit of General Practice, Woden, Australian Capital Territory, Australia
*
Correspondence: Associate Professor Penelope L. Burns Academic Department of General Practice Level 2, Building 4, Canberra HospitalGarran, ACT, 2605Australia E-mail: pennyLburns@gmail.com

Abstract

Introduction:

General Practitioners (GPs) are inevitably involved when disaster strikes their communities. Evidence of health care needs in disasters increasingly suggests benefits from greater involvement of GPs, and recent research has clarified key roles. Despite this, GPs continue to be disconnected from disaster health management (DHM) in most countries.

Study Objective:

The aim of this study was to explore the perspectives of disaster management professionals in two countries, across a range of all-hazard disasters, regarding the roles and contributions of GPs to DHM, and to identify barriers to, and benefits of, more active engagement of GPs in disaster health care systems.

Methods:

A qualitative research methodology using semi-structured interviews was conducted with a purposive sample of Disaster Managers (DMs) to explore their perspectives arising from experiences and observations of GPs during disasters from 2009 through 2016 in Australia or New Zealand. These involved all-hazard disasters including natural, man-made, and pandemic disasters. Responses were analyzed using thematic analysis.

Results:

These findings document support from DM participants for greater integration of GPs into DHM with New Zealand DMs reporting GPs as already a valuable integrated contributor. In contrast, Australian DMs reported barriers to inclusion that needed to be addressed before sustained integration could occur. The two most strongly expressed barriers were universally expressed by Australian DMs: (1) limited understanding of the work GPs undertake, restricting DMs’ ability to facilitate GP integration; and (2) DMs’ difficulty engaging with GPs as a single group. Other considerations included GPs’ limited DHM knowledge, limited preparedness, and their heightened vulnerability.

Strategies identified to facilitate greater integration of GPs into DHM where it is lacking, such as Australia, included enhanced communication, awareness, and understanding between GPs and DMs.

Conclusion:

Experience from New Zealand shows systematic, sustained integration of GPs into DHM systems is achievable and valuable. Findings suggest key factors are collaboration between DMs and GPs at local, state, and national levels of DHM in planning and preparedness for the next disaster. A resilient health care system that maximizes capacity of all available local health resources in disasters and sustains them into the recovery should include General Practice.

Type
Research Report
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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References

Australian Institute of Resilience. Health and Disaster Management Handbook. East Melbourne: Australian Institute of Resilience; 2019. https://www.aidr.org.au/media/7381/aidr_handbookcollection_health-and-disaster-management_2019.pdf. Accessed July 7, 2021.Google Scholar
FitzGerald, GJ, Capon, A, Aitken, P. Resilient health systems: preparing for climate disasters and other emergencies. Med J Aust. 2019;210(7):304305.CrossRefGoogle ScholarPubMed
Ardagh, MW, Richardson, SK, Robinson, V, et al. The initial health-system response to the earthquake in Christchurch, New Zealand, in February, 2011. Lancet. 2012;379(9831):21092115.CrossRefGoogle Scholar
Commonwealth of Australia. Royal Commission into National Natural Disaster Arrangements Report. October 28, 2020. Canberra: Commonwealth of Australia; 2020. https://naturaldisaster.royalcommission.gov.au/publications/royal-commission-national-natural-disaster-arrangements-report. Accessed July 7, 2021.Google Scholar
Burns, P, Douglas, K, Hu, W, Aitken, P, Raphael, B. General practitioners in the field: a qualitative study of general practitioners’ experiences in disaster healthcare. Aust J Gen Pract. 2020;49(3):132138.CrossRefGoogle ScholarPubMed
Redwood-Campbell, L, Abrahams, J. Primary health care and disasters - the current state of the literature: what we know, gaps, and next steps. Prehosp Disaster Med. 2011;26(3):184191.CrossRefGoogle ScholarPubMed
Desborough, J, Dykgraaf, SH, Phillips, C, et al. Lessons for the global primary care response to COVID-19: a rapid review of evidence from past epidemics. Fam Pract. 2021.CrossRefGoogle Scholar
Kohsaka, S, Endo, Y, Ueda, I, Namiki, J, Fukuda, K. Necessity for primary care immediately after the March 11 tsunami and earthquake in Japan. Arch Intern Med. 2012;172(3):290291.CrossRefGoogle ScholarPubMed
Arrieta, MI, Foreman, RD, Crook, ED, Icenogle, ML. Providing continuity of care for chronic diseases in the aftermath of Katrina: from field experience to policy recommendations. Disaster Med Public Health Prep. 2009;3(3):174182.CrossRefGoogle ScholarPubMed
Greenough, PG, Lappi, MD, Hsu, EB, et al. Burden of disease and health status among Hurricane Katrina-displaced persons in shelters: a population-based cluster sample. Ann Emerg Med. 2008;51(4):426432.CrossRefGoogle ScholarPubMed
Brackbill, RM, Cone, JE, Farfel, MR, Stellman, SD. Chronic physical health consequences of being injured during the terrorist attacks on world trade center on September 11, 2001. Am J Epidemiol. 2014;179(9):10761085.CrossRefGoogle Scholar
Cacchione, PZ, Willoughby, LM, Langan, JC, Culp, K. Disaster strikes! Long-term care resident outcomes following a natural disaster. J Gerontol Nurs. 2011;37(9):1624.CrossRefGoogle ScholarPubMed
World Health Organization. Primary health care and health emergencies. World Health Organization; 2018. https://www.who.int/docs/default-source/primary-health-care-conference/emergencies.pdf?sfvrsn=687d4d8d_2. Accessed July 7, 2021.Google Scholar
World Health Organization. Three Months After the Indian Ocean Earthquake-Tsunami Report. Geneva, Switzerland: World Health Organization; 2004.Google Scholar
Fonseca, VA, Smith, H, Kuhadiya, N, et al. Impact of a natural disaster on diabetes: exacerbation of disparities and long-term consequences. Diabetes Care. 2009;32(9):16321638.CrossRefGoogle ScholarPubMed
Lee, DC, Gupta, VK, Carr, BG, et al. Acute post-disaster medical needs of patients with diabetes: emergency department use in New York City by diabetic adults after Hurricane Sandy. BMJ Open Diabetes Res Care. 2016;4(1):e000248.CrossRefGoogle ScholarPubMed
Brackbill, RM, Cone, JE, Farfel, MR, Stellman, SD. Chronic physical health consequences of being injured during the terrorist attacks on World Trade Center on September 11, 2001. Am J Epidemiol. 2014;179(9):10761085.CrossRefGoogle Scholar
Reay, E, Burns, P. The role of primary health networks and general practitioners in disasters: Nepean Blue Mountains Primary Health Network’s preparedness guide. Prehosp Disaster Med. 2019;34(S1):s67.CrossRefGoogle Scholar
World Association Disaster and Emergency Medicine. WADEM Primary Care Special Interest Group: WADEM; 2020. https://wadem.org/sigs/primary-care/. Accessed July 7, 2021.Google Scholar
Burns, PL, Aitken, PJ, Raphael, B. Where are general practitioners when disaster strikes? Med J Aust. 2015;202(7):356358.CrossRefGoogle ScholarPubMed
Burns, PL, Douglas, KA, Hu, W. Primary care in disasters: opportunity to address a hidden burden of health care. Med J Aust. 2019;210(7):297299.CrossRefGoogle ScholarPubMed
Gray, DE. “Theoretical Perspectives and Research Methodologies.” In: SAGE, (ed). Doing Research in the Real World. 3rd ed. Los Angeles, California USA: SAGE; 2009: 15-38.Google Scholar
Goodyear-Smith, F, Mash, B. How to Do Primary Care Research. WONCA, (ed). Boca Raton, Florida USA: CRC Press Taylor & Francis Group; 2019.Google Scholar
Chamaz, K. Constructing Grounded Theory. 2nd ed. Thousand Oaks, California USA: SAGE; 2014.Google Scholar
Crotty, M. The Foundations of Social Research. Meaning and Perspective in the Research Process. Unwin A, (ed). Crow’s Nest, NSW, Australia: Allen & Unwin; 1998.Google Scholar
McEntire, D. Learning More About the Emergency Management Professional. FEMA Higher Education Program: Utah Valley University; 2018.Google Scholar
Federal Emergency Management Agency. Principles of Emergency Management Supplement. USA: Federal Emergency Management Agency; 2007.Google Scholar
QSR International. NVivo Version for MAC 11.4.3. Melbourne, Victoria: NVivo; 2018. http://www.qsrinternational.com/nvivo/what-is-nvivo. Accessed July 7, 2021.Google Scholar
Australian Government. Review of Australia’s Health Sector Response to Pandemic (H1N1) 2009: Lessons Identified. Canberra: Commonwealth of Australia; 2011.Google Scholar
Burns, P, Manderson, K. Building GP Capacity in times of disaster. MJA Insight. 2020(3).Google Scholar
Nepean Blue Mountains Primary Health Network. Planning for Disaster Management: An Emergency Preparedness Guide of Primary Health Networks and Others Supporting the Local General Practitioner Response during Emergencies. Penrith: Nepean Blue Mountains Primary Health Network; Wentworth Healthcare; 2019.Google Scholar
Canterbury Primary Response Group. Health Emergency Response Christchurch: Canterbury Primary Response Group; 2019. http://www.primaryhealthresponse.org.nz/who-is-cprg/. Accessed July 7, 2021.Google Scholar
Schroeder, P, Roseveare, D, Coll, G. Primary Health Care Planning. World Association Disaster and Emergency Medicine Oceania Newsletter No 16. 2014:9-11.Google Scholar
Center for Research on the Epidemiology of Disasters. Human Cost of Disasters (2000-2019). Belgium: Center for Research on the Epidemiology of Disasters; 2020. https://www.undrr.org/publication/human-cost-disasters-2000-2019. Accessed July 7, 2021.Google Scholar
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