Development of an Australian national policy framework for paediatric cardiac aid work

Abstract

Background: Healthcare systems and services are receiving increasing numbers of aid-related referrals for cardiac surgical intervention. Paediatric cardiac interventions and surgery are high-cost, resource-intensive services, in demand for both non-funded and privately funded overseas patients. Current practice leads to competition and an individualistic approach to the provision of medical care and raises many ethical and practical issues. Methods: Paediatric clinical ethics services in Australia collaborated in discussions to develop a potential policy framework for onshore paediatric cardiac medical aid work. We used a narrativemedicine based approach to explore the stories of this patient group and the medical teams that work with them. We collected qualitative data from families regarding their experiences and their advice for improvements, and from their healthcare teams including social workers. Quantitative data were collected regarding the resourcing costs for different surgeries and the methods of funding from the administration departments of hospital networks and aid organisations involved in the processes. Results: The completed draft policy framework will be presented to the combined cardiac and cardiac surgical departments in public paediatric health care services in Australia for further discussion and ratification. The policy aims to reduce practice variability, improve outcomes and experiences for patients and families who receive care within the Australian Health-care system and improve distributive justice and rationalisation of limited public resources. Conclusion: We will present a discussion based on the ethics and practicalities of medical aid work and medical tourism for paediatric cardiac services in an Australian context. The draft framework will be used as the basis for the wider discussion of the provision of services and the ethical practicalities in different nations and health-care systems in the Asia-Pacific region.L6200776402018-01-09 <br />