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Australian, and 20.5% for non-Indigenous Austra-
lian (D'Souza, Jeffreys, & Cook, 2007). Among
various factors which make up the differences
between the two groups, geographic issues and
level of healthcare service utilization can be the
major ones.
In Australia, all states and territories showed
a growth in their aged population (over 65 years
old) in the year ended 30 June 2010. Over the last
20 years, the elderly population has increased by
170.6%, compared with a total population growth
of 30.9% (ABS, 2010). On the other hand, the on-
set of Epilepsy in the elderly population is higher
than any other group. The incidence of the first
seizure increases from over 0.052% in the age
group of 40-59 to 0.127% in the group of over 60
years old (Hauser, 1997). This may be explained
by the changes in physiology factors including
reduction in protein binding and blood flow, low
albumin, and renal insufficiency, and changes in
lifestyle as people age. This can be the basis for
a forecast of the increase of Epilepsy incidences
in Australia in the coming years.
Australia has a ratio of neurologist to patients
higher than that of UK (Hooker, et al, 2003) but
it does not ensure an adequate healthcare service
for Epilepsy. There have been various studies and
researches mentioning about the inadequateness in
the whole model of care for Epilepsy in Australia
from basic diagnosis, treatment, emergency, to
the policy for Epilepsy management at state and
federal levels (Department of Health, Western
Australia, 2008). Two important factors which
affect Epilepsy management in Australia are the
distances between central business districts and
the wide distribution of a small population across
the whole country of over 8 million square kilome-
ters. Unfortunately, the avoidable hospitalization
for convulsions and Epilepsy generally increases
in accordance with the distances or remoteness
(Pages, et al, 2007). It is almost impossible to have
access to adequate healthcare facilities outside
the central business districts (CBD) even in the
most populous states. Epilepsy patients have a lot
of difficulties in accessing to healthcare facilities
due to remote locations (especially indigenous
Australian), the inability to travel (a lot of Epilepsy
patients cannot travel on their own), and consult-
ing and hospitality costs (JECA, 2009). Therefore,
Epilepsy patients in Australia have to take the
disadvantages of the healthcare services systems
which are different between regions and states.
The lack of experienced practitioners on Epi-
lepsy fields is not a problem of only Australia.
Similar to situation in UK where practitioners do
not have enough experiences with Epilepsy due
to its small number of incidence compared with
that of many other illnesses (Brown, et al, 1998),
it is difficult for general practitioners in Austra-
lia to develop their skills in Epilepsy treatment.
However, Epilepsy patients still have to rely on
general practitioners as the primary key source of
information for treatment (Panelli, 2010).
In fact, Epilepsy is a treatable condition, and
affordable medication is available. However, gen-
eral practitioners do not have enough specialized
knowledge and skills to manage the conditions
(ILAE, 2010). According to The Department of
Health, Western Australia (2008), a substantial
proportion of Epilepsy diagnoses conducted by
non-epilepsy specialist were incorrect. This is also
a factor which can sometimes discourage people
with Epilepsy and their families from seeking for
necessary diagnosis and treatment. In Australia,
about 30%- 40% of Epilepsy people do not have
full control of their seizures, and these people and
their carers still need a variety of support measures
to help them manage their seizures and everyday
life activities (Walker, 2007; JECA,2009).
In a survey by Joint Epilepsy Council Australia
(2009) with the participation of 467 individuals
with Epilepsy and 496 Epilepsy carers, the results
suggest that people with Epilepsy who live in met-
ropolitan areas have better access to specialists and
general practitioners. About 36% of people with
Epilepsy who live in regional areas have either
no or poor access to a general practitioner. Again,
transportation is still an issue for Epilepsy people
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