Audit of country clients accessing metropolitan podiatry services in South Australia

Abstract

Background The purpose of the audit was to take a snapshot in time (8 week period) of the number of people from Country Health SA (CHSA) receiving podiatry services from the Adelaide Health Service (AHS), and to trace their usage of local services. The audit also aimed to identify strate- gies to reduce travel and improve patient journey. Methods Results In the 8 week audit period there were 232 occasions of service for 130 people from CHSA postcodes accessing AHS podiatry services. The main clinical presentation of people from Country Health SA accessing the Adelaide Health Service is diabetic foot complications (e.g. ulcera- tion, amputation). Approximately half of the people accessing services (51%) were registered CHSA clients, and only a small proportion (13%) were both registered CHSA clients and CHSA podiatry clients. The other half of people were not registered CHSA clients (49%), a small proportion (14%) were previously registered CHSA clients. Of the clients that were registered CHSA clients but not CHSA podiatry clients, two-thirds of the clients accessed community nursing. Diabetes education and dietetics were also accessed by this client group. Only 8% of people from CHSA postcodes accessing AHS podiatry services were referred directly from CHSA podiatry. The remaining 92% of referrals came from medical specialists, GPs, CHSA community nur- sing, private podiatry and inpatient admissions. Of the 232 AHS podiatry appointments for 130 CHSA post- code clients, the majority (71%) had 1-3 appointments in the 8 week audit period. The remaining 29% of cli- ents had 4 or more appointments in an 8 week period, resulting in fortnightly to weekly follow-up appoint- ments at AHS podiatry clinics. Of the clients accessing AHS podiatry, the majority of clients are from inner CHSA locations. The top 4 CHSA locations for AHS podiatry service usage also had the highest podiatrist to population ratio. Conclusions