Aust Health Rev
· 2025 Dec · PMID 41177542
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The integration of artificial intelligence (AI) into Australian healthcare promises to improve diagnostic accuracy, workflow efficiency, and personalised care, yet it also introduces critical cybersecurity vulnerabilitie...The integration of artificial intelligence (AI) into Australian healthcare promises to improve diagnostic accuracy, workflow efficiency, and personalised care, yet it also introduces critical cybersecurity vulnerabilities that threaten not only data privacy but also patient safety and health system trust. This perspective argues that cybersecurity must be recognised as a core dimension of healthcare quality and formally embedded in Australia's safety governance frameworks. Drawing on recent national incidents, regulatory gaps, and international comparisons, we propose five policy actions to align AI-enabled innovation with secure, ethical, and resilient healthcare delivery. Embedding cybersecurity within clinical governance and system reform agendas is vital to ensure sustainable digital transformation.
Aust Health Rev
· 2025 Dec · PMID 41134119
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OBJECTIVE: This study aimed to explore the perspectives of Australian medical students on medical and surgical specialty training program selection criteria and examine their influence on career intentions. METHODS: A cr...OBJECTIVE: This study aimed to explore the perspectives of Australian medical students on medical and surgical specialty training program selection criteria and examine their influence on career intentions. METHODS: A cross-sectional online survey of Australian medical students assessed perspectives on the criteria utilised to select applicants into Australian specialty training programs for 2025. Likert-scale and free-text responses were collected. Quantitative analysis used the Wilcoxon signed-rank test, and free text responses underwent automated textual analysis using natural language processing techniques to classify sentiment and extract recurring themes and concerns. RESULTS: Student interest in pursuing multiple specialties decreased significantly after exposure to their current selection criteria, particularly in ophthalmology, intensive care, neurology, and obstetrics and gynaecology. Automated textual analysis revealed a clear negative sentiment across most surgical specialties. Respondents' main concerns of selection criteria related to research requirements, competitiveness, time commitment, requirement of academic achievement despite a lack of awards in medical school, burnout, and affect on family planning. CONCLUSIONS: Understanding the perspectives of medical students on specialty training selection processes may help inform strategies to improve equity and address workforce imbalances. Student suggestions to improve specialty training selection processes included earlier education on specialty pathways, clearer guidance to build a competitive curriculum vitae, and more equitable access to research, mentorship, and professional development opportunities. Future research may consider investigating the perspectives of prevocational medical graduates and medical students across multiple Australian institutions.
Ward RL, Nutbeam D, Mijnhardt W
… +6 more, Nelson P, Todd AL, Richards J, Jackson K, Khan NN, Chung S
Aust Health Rev
· 2025 Dec · PMID 41082917
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Traditional academic impact frameworks and metrics have been criticised, because they fail to assess the 'real-world' value of research. The Research Impact Assessment Framework was developed to complement and extend exi...Traditional academic impact frameworks and metrics have been criticised, because they fail to assess the 'real-world' value of research. The Research Impact Assessment Framework was developed to complement and extend existing impact assessment frameworks by focusing on health system needs and priorities. This paper reports on piloting of the Research Impact Assessment Framework for feasibility and utility with researchers working in health and research organisations in Sydney, Australia. The Framework's Research Environment domain was assessed through a bespoke employee survey, and the Alignment and Influence of Research domain through independent review of case studies. Using synthetic data, the outputs from the two domains were combined to compare institutions. The tools tested in this pilot are feasible to use in assessing an organisation's capacity to produce impactful research that is aligned with identified health, social and economic priorities. The case study reviews illustrated the challenge of determining potential versus realised impact. This study identified that implementation of the Research Impact Assessment Framework will be enabled by use of existing routinely collected data, such as annual employee surveys, and the use of artificial intelligence tools to reduce administrative burden and ensure consistency of outputs.
Kinner SA, Borschmann R, Shuttleworth R
… +3 more, Pellicano S, Kouyoumdjian F, Williams B
Aust Health Rev
· 2025 Dec · PMID 41077633
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OBJECTIVE: The aim of this study was to quantify and describe National Health and Medical Research Council (NHMRC) funding for research on the health of justice-involved people (i.e. people who are incarcerated or otherw...OBJECTIVE: The aim of this study was to quantify and describe National Health and Medical Research Council (NHMRC) funding for research on the health of justice-involved people (i.e. people who are incarcerated or otherwise under criminal justice supervision). METHODS: We searched the NHMRC funding database for the period 2000-2022 using keywords and names of prominent researchers. Potentially relevant grants were independently reviewed by two authors for inclusion. Information about included grants was independently extracted by the same two authors. RESULTS: Of A$16.4 billion in NHMRC funding over the period 2000-2022, A$38.7 million (0.22%) was for justice health research. Most grants were for research in Australia's most populous eastern states and focused on mental health, substance use and/or infectious disease. Only A$4.5 million (0.03% of the total NHMRC allocation) was for research on the health of justice-involved children and adolescents. CONCLUSIONS: NHMRC funding for justice health research in Australia is out of step with the substantial health and economic burden associated with Australian criminal justice systems. Greater investment in independent, high-quality research in the justice health field has the potential to improve public health, reduce costs and reduce health inequities. More funding for research on non-communicable disease, disability, and the health of justice-involved children and adolescents is required.
Aust Health Rev
· 2025 Oct · PMID 41022638
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OBJECTIVE: The aim of this study was to estimate avoidance of hospital bed-days and the resulting cost savings from a wholistic quality improvement program that was implemented to systematically reduce hospital-acquired...OBJECTIVE: The aim of this study was to estimate avoidance of hospital bed-days and the resulting cost savings from a wholistic quality improvement program that was implemented to systematically reduce hospital-acquired complications (HACs) in an Australian local health service between 2018 and 2023. METHODS: This was an uncontrolled retrospective observational analysis of prospectively collected data. An association between HAC and length of stay (LOS) was explored through a zero truncated negative binomial regression model for two LOS cohorts, using 21 days as the threshold for long-stay share of bed-days. Bed-day cost avoidance was estimated by applying the adjusted marginal effect of HAC on LOS, multiplied by the estimated number of HAC episodes averted, average weighted average units per bed-day, and the national efficiency price in respective years. RESULTS: HACs were found to increase hospital bed-days by an average of 5.5 days (95% CI: 5.19-5.86) for episodes with LOS of 1-21 days, and by 7.1 days (95% CI: 6.78-7.48) for episodes with LOS exceeding 21 days. The program resulted in an estimated avoidance of HACs in 2991 episodes of care over a 5-year period, averaging 598 episodes per year. This equated to avoidance of a total of 16,751 hospital bed-days, or 3350 annually. Annual cost voidance from bed-days ranged from A$6.4 to A$11.5 million between 2019 and 2023. The budget for program management was A$514,500 per year, resulting in average net benefits of A$7.1 to A$8.2 million, a 14-16-fold return on investment for the health service. CONCLUSION: Findings suggest that financially viable opportunities are available for hospitals to achieve sustained reduction in HACs, which have the potential for wider adoption to tackle the challenges associated with adverse events in hospitals.
Aust Health Rev
· 2025 Oct · PMID 41022376
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What is known about the topic? This article explores the integration of artificial intelligence (AI) in aged care, emphasising that technology cannot substitute for systemic reform. While AI is already deployed to detect...What is known about the topic? This article explores the integration of artificial intelligence (AI) in aged care, emphasising that technology cannot substitute for systemic reform. While AI is already deployed to detect pain, predict falls, and reduce administrative burdens, its risks include bias, depersonalisation, and inequity when adopted without ethical guardrails. What does this paper add? The article proposes three guiding questions: who designs the AI and who is missing, what outcomes it optimises for, and whether it reduces or reinforces inequities. What are the implications for practitioners? The article concludes that AI should augment-not replace-care, ensuring dignity, equity, and human rights remain at the centre of aged care systems.
Aust Health Rev
· 2025 Oct · PMID 41022369
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The Royal Commission into Aged Care Quality and Safety identified two key building blocks to aged care reform: independence from Government and a secure source of funding. It is telling that both the current and the prev...The Royal Commission into Aged Care Quality and Safety identified two key building blocks to aged care reform: independence from Government and a secure source of funding. It is telling that both the current and the previous Australian Governments rejected each of these in their response to the Royal Commission. A philosophical shift is required that places the people receiving care at the centre of quality and safety regulation. An independent Aged Care Commission with guaranteed funding though a hypothecated Aged Care Levy would, in my view, create the substrate upon which this change in philosophy can flourish.
Aust Health Rev
· 2025 Oct · PMID 41022368
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This policy reflection asks why there is so much attention paid to persons receiving aged and home care at the expense of those in the unpaid economy? Why do some calls for a new initiative for older Australians fall on...This policy reflection asks why there is so much attention paid to persons receiving aged and home care at the expense of those in the unpaid economy? Why do some calls for a new initiative for older Australians fall on deaf ears. It answers these questions by presenting an example of failed efforts by a range of key lobby groups for a Senior Dental Benefits Scheme and discusses the differences between a preventive social model of health versus a reactive medical model of health for older Australians.
Aust Health Rev
· 2025 Sep · PMID 40964750
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Objective This research presents a benchmarking study of staffing levels and reporting structures in libraries that support evidence-based health care, and deliver education and research support services within the Austr...Objective This research presents a benchmarking study of staffing levels and reporting structures in libraries that support evidence-based health care, and deliver education and research support services within the Australian health system. Methods Benchmarking data were collected through a two-phase approach. First, a set of questions was distributed via email to health libraries across Australia, using a national health libraries e-list and professional networks. Second, an international literature review was conducted to examine workforce composition and organisational structures in health libraries over the past 10years. Results This study reveals that Australian health libraries operate with staffing levels approximately 34% below the country's national guidelines. The recommended ratio of 1 health library staff member per 1250 institutional full-time equivalent is proposed to guide workforce planning. Reporting structures vary widely, with libraries most commonly reporting to corporate divisions. However, reporting to clinical, education or research-aligned portfolios was associated with stronger advocacy and strategic alignment. Conclusions Australian health libraries play a critical role in supporting clinical decision-making, research and education. Despite their importance, health libraries are increasingly under-resourced, threatening equitable access to evidence and information services. Strategic investment and targeted funding are needed to address the workforce shortfall. Reporting structures should be aligned with clinical or research functions to enhance visibility and support.
Crossman M, Kovoor J, Hains L
… +12 more, Gim H, Ovenden C, Stretton B, Gupta A, Seth I, Gao C, Goh R, El-Masri S, Chan WO, Jeffree L, Abou-Hamden A, Bacchi S
Aust Health Rev
· 2025 Sep · PMID 40953597
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Objective Outpatient attendance at metropolitan neurosurgical clinics imposes significant logistical and psychosocial burdens on patients, particularly those with central nervous system tumours residing in geographically...Objective Outpatient attendance at metropolitan neurosurgical clinics imposes significant logistical and psychosocial burdens on patients, particularly those with central nervous system tumours residing in geographically dispersed regions. In Australia, where vast distances separate many regional populations from tertiary care centres, these burdens may also translate into substantial environmental costs. This study sought to quantify the environmental and economic impact associated with patient travel to public neurosurgery outpatient services in South Australia. Methods A retrospective analysis was conducted using administrative data from all in-person public neurosurgery outpatient appointments across South Australia's two public neurosurgical centres between July 2022 and June 2024. Patient postcode data were used to calculate geodesic one-way travel distances to clinic sites. Estimated fuel consumption, carbon dioxide (CO2 ) emissions, and petrol costs were derived using published national averages for vehicle efficiency and emissions. Analyses were stratified by Modified Monash Model (MMM) classification to assess regional variation. Results The cohort comprised 9840 patients, accounting for 19,148 outpatient appointments. The median one-way travel distance was 17.7km (IQR: 9.4-52.1km), with 16.9% of patients travelling over 100km. The cumulative distance travelled was 1.75millionkm over 2years, equating to an estimated petrol consumption of 185,531L and CO2 emissions of 435.6tonnes. The associated direct fuel cost exceeded AUD 357,000. Although individual environmental impact increased with MMM classification, the highest aggregate emissions were attributable to patients in MMM category 5, reflecting both travel distance and patient volume. Conclusions The environmental and financial burdens associated with outpatient neurosurgical care are considerable, particularly for patients in rural and remote areas. These findings underscore the need to explore sustainable models of care, including the expanded use of telehealth and regional outreach services, as strategies to reduce carbon emissions and improve healthcare accessibility.
Aust Health Rev
· 2025 Sep · PMID 40915640
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Despite a doubling of the number of medical graduates almost 25years ago, shortages and persistent distribution problems remain. Policies to direct graduates to areas and specialties of greatest population need have been...Despite a doubling of the number of medical graduates almost 25years ago, shortages and persistent distribution problems remain. Policies to direct graduates to areas and specialties of greatest population need have been too little too late. Rural regions and areas with high need continue to be underserved, while the gulf between general practitioner and specialist numbers widens. Recommended reforms have been slow and fragmented, with limited success in addressing fundamental distribution challenges across geography, specialties and professional types. Current reforms need to move much more quickly and require significant additional investment to ensure that patients do not have to experience the harms of shortages and surpluses for the next 25years.
Aust Health Rev
· 2025 Sep · PMID 40915638
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This perspective serves as a primer and overview of the underlying causes of the current stress on the healthcare system, indicating no expected relief in the medium term. Demographic trends - such as ageing and growth o...This perspective serves as a primer and overview of the underlying causes of the current stress on the healthcare system, indicating no expected relief in the medium term. Demographic trends - such as ageing and growth of the population, declining birth rates, rising healthcare expenditure, and increasing workforce shortages - are presented as the context for the urgent need for greater efficiency and transformative change within the health system. Potential solutions are discussed in response to the impending crisis.
Beard C, Tjokrowijoto P, Cartwright J
… +3 more, Moylan N, Cations M, Loi SM
Aust Health Rev
· 2025 Sep · PMID 40903033
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Young-onset dementia presents unique care challenges that require comprehensive range of allied health interventions. While Australia's National Disability Insurance Scheme serves as the primary post-diagnostic care path...Young-onset dementia presents unique care challenges that require comprehensive range of allied health interventions. While Australia's National Disability Insurance Scheme serves as the primary post-diagnostic care pathway for accessing these essential services, recent national survey findings reveal significant systemic barriers preventing people with young-onset dementia from obtaining adequate allied health care under this scheme. This perspective article outlines the critical but underrecognised role of allied health professionals in young-onset dementia care management and identifies key access barriers within the NDIS framework, including gaps in public awareness and provider education on young-onset dementia needs, and systemic issues affecting service coordination. Drawing on recent survey data, we briefly discuss current issues and concerns, and present key reform areas with direct implications for policymakers, National Disability Insurance Scheme planners, allied health professionals, and service providers. Our discussion highlights the urgent need for targeted reforms to enhance access to essential allied health professionals and improve outcomes for this growing, vulnerable population.
Webb M, Holyday M, Milosavljevic M
… +2 more, Elphick TL, Dunn P
Aust Health Rev
· 2025 Sep · PMID 40889947
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The primary objective of this study was to engage early career allied health professionals (ECAH) in a career development framework targeted specifically to their needs. The secondary objectives were to: identify if the...The primary objective of this study was to engage early career allied health professionals (ECAH) in a career development framework targeted specifically to their needs. The secondary objectives were to: identify if the framework increased clinician participants' career achievements and altered manager participants' practices in offering development opportunities to ECAH. This was a 12-month observational (non-experimental) trial of a pragmatic program implementation. Data collected included: initial uptake of staff into the program; retention rate after 12months; number of participants' career achievements; and program evaluation by both participants and managers. At 12months, 35 of the 123 enrolled ECAH remained engaged in the career development program; that is, 28.5% retention, and these participants had an increased number of achievements. The program was effective in broadening managers' practices, 77% offered increased opportunities to ECAH across the development domains of supervision, service planning and quality. This study was partially successful in meeting its objectives. It was unsuccessful in retaining ECAH in a career development program for 12months, although it was successful in increasing the number of achievements for those ECAH that remained engaged. It also broadened managers' practice in the opportunities they offered. The program's success was heavily reliant on the intrinsic motivation of both managers and clinicians. Increasing career development opportunities for AH is important to pursue as a means of increasing satisfaction, retention, and fostering a culture of quality and safety.
Aust Health Rev
· 2025 Aug · PMID 40854733
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Objective This study aimed to investigate the relationship between emergency department (ED) patient volume at time of presentation and risk of departing before commencing treatment in the ED (did not wait; DNW). Methods...Objective This study aimed to investigate the relationship between emergency department (ED) patient volume at time of presentation and risk of departing before commencing treatment in the ED (did not wait; DNW). Methods A retrospective analysis of linked data was conducted using the New South Wales Emergency Department Data Collection for level 5 and level 6 hospitals, between April 2022 and March 2023. ED patient volume was measured at the time of each patient's presentation and categorised into quintiles by hospital level. Patients who DNW were compared to those who waited, using multivariable logistic regression to identify independent predictors of DNW, such as rising ED patient volumes, age, triage category, and time of presentation. Results Out of 1,673,247 ED presentations, 155,425 (9.29%) patients were recorded as DNW. ED patient volume was a significant predictor of increased likelihood of DNW, with those presenting when the ED was at the highest patient volume quintile being 3.5 times more likely not to wait compared to the lowest quintile of patient volume after adjusting for relevant characteristics such as age, triage category, and time of presentation. Conclusion ED patient volume was a significant predictor of DNW with a direct dose-response relationship observed further emphasising the effect of ED overcrowding on the quality of care in EDs.
Lathlean T, Chilcott A, Shobbrook Am M
… +6 more, Papadopoulos C, Divakar R, Barclay L, Hibberd K, Saar E, Tan J
Aust Health Rev
· 2025 Aug · PMID 40789278
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Objective This study aims to understand workforce retention and attrition of chiropractors in Australia. Methods An online survey of chiropractors in 2024 and a retrospective analysis of 10years of Australian Health Prac...Objective This study aims to understand workforce retention and attrition of chiropractors in Australia. Methods An online survey of chiropractors in 2024 and a retrospective analysis of 10years of Australian Health Practitioner Regulation Agency (Ahpra) registration data were undertaken. Results Of 1513 surveyed chiropractors, 80.0% intended to continue in the profession, 6.6% intended to leave (excluding retirement), 6.7% were unsure, and the remainder were retired. Seventy percent of those intending to leave planned to do so within 1year. Top reasons included unsatisfactory remuneration (35.4%), lack of recognition/feeling undervalued (31.3%), work no longer professionally satisfying (31.3%), work no longer fulfilling/meaningful (29.2%), and retirement (29.2%). Those with limited registration status, working outside 20 to 49h per week, and on casual or temporary contracts are also more likely to not renew or be unsure. Australian Health Practitioner Regulation Agency (Ahpra) data (2014-2023) showed a 12.2% increase in registered chiropractors per 100,000 of the Australian population and a 15.8% rise in replacement rate (with fluctuations). Conclusions The overall number of chiropractors has increased from 2014 to 2023, and the replacement rate increased from 2015 to 2023. This highlights growth in the profession despite some issues in workforce stability, particularly among those with limited registration, non-standard work hours per week, and casual/temporary contract status. Addressing intrinsic and workplace factors such as remuneration, workplace recognition, and job satisfaction may improve retention.
Polong Brown JA, East K, Zhang P
… +9 more, Byrnes J, Duncan J, Jones L, Brown NJ, Rosengren D, Furyk J, Green D, Rothwell S, Crilly J
Aust Health Rev
· 2025 Aug · PMID 40785066
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Objective Globally, the social and economic costs of alcohol-related disorders are considerable. The aim of this study was to determine the characteristics, clinical care requirements and outcomes of alcohol-related pres...Objective Globally, the social and economic costs of alcohol-related disorders are considerable. The aim of this study was to determine the characteristics, clinical care requirements and outcomes of alcohol-related presentations (ARPs) to emergency departments (EDs). Methods A multi-site observational study was undertaken in Queensland, Australia. We selected a random sample of 2720 presentations to four public hospital EDs between April 2016 and August 2017, in which the treating clinician perceived that alcohol contributed to the presentation. Routinely collected demographic, clinical, outcomes and costings data were analysed. Additional data about clinical care delivery in the ED (bedside tests, radiology, pathology and referrals) were extracted by manual medical record review. Results The ARPs predominantly involved young men: 62% arrived by ambulance and 61% arrived between 6pm and 6am. Most (>83%) ARPs had at least one vital observation (i.e. heart rate, blood pressure, respiratory rate) recorded, 46% had pathology, and 41% had radiology. Some form of medication (e.g. paracetamol, diazepam, thiamine) was ordered in 65% of ARPs and 20% involved intravenous fluid treatment. Referrals to a specialist team (e.g. mental health, alcohol and other drug services) were documented for 42% of patients. The median ED length of stay was 194min (IQR: 122-292 min); the admission rate was 38%; and the median cost of ED episodes of care (in Australian dollars) was A$651 (IQR: A$422-961). Conclusions The ED resource utilisation and costs due to the use of alcohol are considerable. Public health measures that reduce alcohol-related harm have the potential to reduce ED occupancy, workloads and costs.
Aust Health Rev
· 2025 Aug · PMID 40784678
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Objective This study aims to outline the bureaucratic process of obtaining ethical and governance approval to undertake a research project on severe acute maternal morbidity (SAMM), highlighting the effect this had on pe...Objective This study aims to outline the bureaucratic process of obtaining ethical and governance approval to undertake a research project on severe acute maternal morbidity (SAMM), highlighting the effect this had on performing research in a timely way. Methods A retrospective, descriptive case study evaluation, from the researcher's perspective, of the research ethics and governance process required, during 2022-2023, to conduct a retrospective audit of 20years of one SAMM event (peripartum hysterectomy) in five public maternity care facilities (two Hospital and Health Services (HHSs)) within a single state of Australia. Outcome measures included: the number of documents/forms completed, emails sent, phone calls/meetings held, number of people involved in approval, the number of submissions/re-submissions required and the time to obtain ethics/governance approval (working days). Results Ten data custodian approvals from within the same organisation were required to obtain peripartum hysterectomy data from five statewide databases and from local records in two HHSs. Overall, it took 268 working days from submission of the first ethics application to obtaining approval for the final governance application. Conclusions Cumbersome research approval processes consume a lot of research time. Our study exemplifies the continuing overregulation of low- and negligible-risk research that continues to limit investigation and prevention of serious obstetric conditions.