Aust Health Rev
· 2025 Feb · PMID 39928920
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Objective This paper aims to identify and describe legislative and administrative barriers to hospital participation and national data linkage for the National Australian Congenital Heart Disease (CHD) Registry. Methods...Objective This paper aims to identify and describe legislative and administrative barriers to hospital participation and national data linkage for the National Australian Congenital Heart Disease (CHD) Registry. Methods A narrative review based on the National Australian CHD Registry experience of establishing participating hospital sites and national linkages associated with each jurisdiction. Results There were numerous identified barriers that could be overcome with additional resources/time, and barriers that could not be overcome, reported by jurisdiction. Conclusions There is a pressing need for greater harmonisation of state-based legislation governing research and harmonisation of administration to reduce duplication. Substantial state-based differences hinder the establishment of a truly national registry.
Leong CL, Cox I, Grundy R
… +4 more, Harkness N, Palmer AJ, de Graaff B, Ball E
Aust Health Rev
· 2025 Feb · PMID 39928915
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Objective In Australia, Tasmania has the second highest rate of incident lung cancer cases at 44.0 per 100,000 population, with an overall 5year relative survival rate of 20%. The aim of this retrospective study was to m...Objective In Australia, Tasmania has the second highest rate of incident lung cancer cases at 44.0 per 100,000 population, with an overall 5year relative survival rate of 20%. The aim of this retrospective study was to map and compare patient transit timelines from referral, diagnosis and treatment, to national care quality indicators (NCQI) and optimal care pathway (OCP) benchmarks. Methods Data were extracted from the weekly lung cancer multidisciplinary team meeting minutes, digital medical records and the ARIA Oncology-Information System for newly diagnosed small cell and non-small cell lung cancer cases between 2019 and 2022, at a regional, university-affiliated tertiary hospital in Tasmania. Sociodemographic data and key dates were extracted, including first general practitioner (GP) referral, specialist appointments (respiratory, medical oncology, radiation oncology and cardiothoracic), investigations, diagnosis, staging and treatment of any intent. Timelines were benchmarked against NCQI and the OCP. Results A total of 165 cases were included; mean patient age was 72years, and 57% were male. A total of 153 patients (93%) were diagnosed with non-small cell cancer and 12 (7%) with small cell lung cancer. Results for all years showed that 93% of patients were seen by the respiratory service within 14days of their GP referral and 71% diagnosed within 28days of their referral, in accordance with current standards. The time taken between GP referrals and diagnosis to any treatment was greater than the required standards, with on average 7% of patients meeting the quality standards (range, 0-16%) for all treatment intents. Conclusion Current national benchmarks have proven challenging to achieve, with prolonged time to treatment of any intent. Challenges both at a patient and systemic level will need to be assessed to improve clinical indicator outcomes.
Jacob A, Ince P, Ross C
… +4 more, Hua S, Swannie B, Demetrios L, Falconer D
Aust Health Rev
· 2025 Feb · PMID 39923752
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Objective Statutory checking requirements for nursing students vary across Australian states and territories. In Australia, predictions of a shortfall of 123,000 full-time equivalent nurses will occur by 2030, emphasisin...Objective Statutory checking requirements for nursing students vary across Australian states and territories. In Australia, predictions of a shortfall of 123,000 full-time equivalent nurses will occur by 2030, emphasising the necessity for standardised policies that enhance processes and address inconsistencies to ensure a qualified and accessible nursing workforce. The objective of this study was to understand the requirements for nursing students' statutory checking across Australian jurisdictions. Methods The study investigated compliance requirements through in-depth pragmatic case study analysis utilising publicly available data from official government sources. Results The study found that nursing students in Australia are mandated by the federal government to undergo statutory checks that are regulated by state and territory laws. All have similarities while varying in cost, processes, and timeframes. Costs varied widely between A$19.90 and A$254 over the course of a 3-year degree. Conclusion This study highlights the inconsistencies regarding nursing students' statutory checking requirements in different jurisdictions in Australia. Various financial and logistical challenges negatively impact nursing students as they prepare for clinical placements. Further examination and potential reforms in healthcare policy to facilitate a smoother transition for nurses entering health care are required.
Tan J, Divakar R, Barclay L
… +3 more, Bayyavarapu Bapuji S, Anderson S, Saar E
Aust Health Rev
· 2025 Feb · PMID 39923309
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Objective To identify factors associated with the retention and attrition of regulated health practitioners in Australia across nine health professions. Methods An online survey of practitioners and an analysis of 10year...Objective To identify factors associated with the retention and attrition of regulated health practitioners in Australia across nine health professions. Methods An online survey of practitioners and an analysis of 10years of Australian Health Practitioner Regulation Agency (Ahpra) registration data were carried out. Results Among surveyed health practitioners, 20,449 (79.4%) intended to stay, 1368 (5.3%) intended to leave, and 1759 (6.8%) were unsure. Most intending to leave planned to do so immediately or within 1-year (72.8%). Top reasons for leaving included mental burnout (32.9%), retirement (30.5%), feeling undervalued/unrecognised (28.5%), lack of professional satisfaction (27.9%), and work no longer being fulfilling (25.1%). Men, older practitioners, those working fewer than 20h per week, and non-self-employed practitioners were more likely to consider not renewing or to be unsure. Analysis of Ahpra registration data from 2014 to 2023 showed that the number of registered practitioners per 100,000 population increased by 29.6%, but the replacement rate showed notable fluctuations over the observed period. Females consistently exhibited higher replacement rates compared to males, with exits from the workforce highest in those aged under 35 pre-2020 and highest in those aged 35-60 post-2020. Conclusions Although the overall number of health practitioners increased from 2014 to 2023, replacement rates have been fluctuating, highlighting concerns about workforce stability, particularly among males, older practitioners, those working fewer or greater than full-time hours, and non-self-employed practitioners. Addressing intrinsic and workplace factors such as mental burnout, lack of recognition, and job satisfaction may improve retention.
Aust Health Rev
· 2025 Feb · PMID 39923308
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Digitally delivered health care, such as telehealth, mobile apps and remote monitoring via apps or devices, can result in improved outcomes for chronic conditions. However, Australia is struggling to maximise the potenti...Digitally delivered health care, such as telehealth, mobile apps and remote monitoring via apps or devices, can result in improved outcomes for chronic conditions. However, Australia is struggling to maximise the potential of digital health for chronic conditions, due in part to funding arrangements that lack incentives for providers and end users. The aim of this article is to examine the current landscape of digital health funding for chronic conditions and considers potential funding arrangements for the future. Current funding arrangements for digital health in Australia lack sufficient incentives for both providers and end users, limiting the reach and effectiveness of digital health for managing chronic conditions. Alternative funding approaches, such as value-based models, are used internationally which include funding avenues for mobile apps and remote patient monitoring via apps or devices as well as for those operating digital health services. The development of sustainable value-based funding mechanisms that support stakeholder involvement and national adoption are recommended. For Australia to fully leverage the benefits of digital health in managing chronic conditions, funding reforms are one critical area to assist with the implementation of patient-centred and outcome-driven funding models. Effective and sustainable funding structures are essential to ensure long-term benefits of digital health for chronic disease management. Further research will be essential to identify effective funding avenues for digital health services, including mobile apps and remote patient monitoring.
Aust Health Rev
· 2025 Feb · PMID 39899984
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The importance of authentic consumer engagement to shape decisions in health care is now well recognised. Both the National Health and Medical Research Council and Cancer Council conceptualise consumer involvement as a p...The importance of authentic consumer engagement to shape decisions in health care is now well recognised. Both the National Health and Medical Research Council and Cancer Council conceptualise consumer involvement as a process that requires consumer capability and organisational capacity and emphasise that organisations should commit to acting on outcomes that have involved consumers. In this perspective piece, we share our experience of working with consumers to develop strategies that aimed to optimise referrals to an evidence-based and cost-effective intervention; a pulmonary rehabilitation program. Although we were successful at implementing some of the co-design strategies and were able to demonstrate an increase in referrals, we were surprised that many of the strategies, which were seemingly simple, could not be implemented due to bureaucratic barriers. Based on our experience, given their ability to navigate bureaucratic barriers within the system, future health researchers should consider actively recruiting senior hospital staff to be part of the co-design process from project inception.
Aust Health Rev
· 2025 Feb · PMID 39894016
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The Lived Experience Advisor Program (LEAP), introduced at Western Health in January 2023, is an innovative approach to consumer engagement in mainstream health care, integrating lived experience perspectives into organi...The Lived Experience Advisor Program (LEAP), introduced at Western Health in January 2023, is an innovative approach to consumer engagement in mainstream health care, integrating lived experience perspectives into organisational decision-making, research, and quality improvement. As health care has increasingly embraced consumer involvement at both direct care and governance levels, the LEAP was implemented to expand the role of health consumers beyond traditional volunteer positions, recognising lived experience as a valuable form of expertise. Through employment of Lived Experience Advisors (LEAs) across a range of clinical and operational projects, this program has enhanced service planning and health literacy for diverse communities. This case study details the development, implementation, and outcomes of the LEAP, focusing on how LEAs have contributed to areas such as youth health services, carer support, emergency care, and consumer engagement strategies. With support from a Community of Practice, LEAs receive ongoing mentorship and training, fostering skill development and promoting sustainable career pathways. The program has also driven shifts in staff perspectives, supporting a patient-centred culture where consumer voices are prioritised. Challenges in program funding, role clarity, and matching lived experience to project needs, underscore the need for thoughtful recruitment, executive sponsorship, and adaptable role design. The impact of the LEAP has extended beyond individual projects, influencing organisational culture, and enhancing staff capabilities in consumer partnership. The case study offers practical insights for other healthcare organisations aiming to integrate lived experience roles, emphasising the potential for consumer-led initiatives to drive transformative change in healthcare delivery and policy.
Baker DG, Kenny B, Prober SC
… +4 more, Sabo A, Hamilton MP, Gao CX, Cross S
Aust Health Rev
· 2025 Jan · PMID 39881448
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Objective This article provides researchers with an illustrative guide for a workshop model that facilitates evidence-informed policy. The Policy Lab model supports collaboration between experts and policymakers; in the...Objective This article provides researchers with an illustrative guide for a workshop model that facilitates evidence-informed policy. The Policy Lab model supports collaboration between experts and policymakers; in the example provided, participants considered digital technologies with near-term potential to improve youth mental health care. Method The Policy Lab model uses structured workshop activities to explore a policy question, before narrowing the focus on potential answers. The barriers, enablers, and implementation mechanisms of potential policies are then considered. From this data policy proposal(s) are drafted, reviewed, and reported. Results Through the Policy Lab activities, participants identified two priority technologies and generated data to inform the formulation of two policies. The policies were focused on (1) using artificial intelligence to improve the personalisation and precision of youth mental health care and (2) the expanded use of integrated data to improve youth mental health service quality. Conclusions Evidence-informed policy is a collaborative process. To potentially influence policy requires timely engagement with policymakers and an understanding of the policy context. Researchers considering using the model are encouraged to include a range of expertise.
Osiurak S, Taylor NF, Lawler K
… +3 more, Williams K, Albiston T, Snowdon DA
Aust Health Rev
· 2025 Jan · PMID 39870364
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Objective This study aimed to explore physiotherapist and manager perceptions of factors that influence physiotherapist participation in clinical supervision. Methods Individual semi-structured interviews were conducted...Objective This study aimed to explore physiotherapist and manager perceptions of factors that influence physiotherapist participation in clinical supervision. Methods Individual semi-structured interviews were conducted with physiotherapists (n = 15) and managers (n = 10) from a publicly funded health network. Interviews were audiotaped and transcribed verbatim. Qualitative analysis of transcripts was completed using inductive thematic analysis. Results Three themes explained the factors perceived by participants to influence participation in clinical supervision: the value of clinical supervision; operationalisation of the organisational clinical supervision framework; and the clinical supervision culture. Identified factors influenced participation by either facilitating or discouraging access to supervision and prioritisation of supervision relative to competing professional demands. Conclusions Physiotherapist participation in clinical supervision is crucial for their professional development and to deliver high-quality care. Participation might be enhanced by initiatives that address factors identified in this study. These may include introducing processes that ensure supervisees and supervisors are accountable for their participation in supervision; providing alternative supervisory arrangements during leave, vacancies, or redeployment; allocating on-site supervisors to accommodate preferred supervision formats; and promoting a safe learning environment where physiotherapists can address knowledge or skill gaps without fear of judgement.
Sweeny AL, Hall E, Padowitz A
… +7 more, Walters B, Zhang P, Alcorn K, Keijzers G, Marshall AP, Ranse J, Crilly J
Aust Health Rev
· 2025 Jan · PMID 39870363
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Objective COVID-19 affected health care globally. The aim of this study was to investigate the impact of COVID-19 on both public and private emergency departments (EDs). Methods This was a retrospective cohort study of E...Objective COVID-19 affected health care globally. The aim of this study was to investigate the impact of COVID-19 on both public and private emergency departments (EDs). Methods This was a retrospective cohort study of ED presentations made to three private and two public hospital EDs located in one region in Queensland. Presentation rates per 1000 population and incident rate ratios (IRR) for three time periods: T1: pre-pandemic (March-June 2018/2019), T2: initial restrictions (March-June 2020), and T3: restrictions easing (March-June 2021) were calculated. Linear trends were produced to describe pre- and post-pandemic changes. Additional outcomes reported for public EDs included ED length of stay (LoS) and cost. Results In T2, both public and private ED presentation rates decreased by 12% (overall IRR 0.88; 95% confidence interval (CI): 0.87-0.89). Private EDs experienced a quicker and greater return of patient volumes in T3, exceeding T1 levels. The median ED length of stay decreased and then increased above pre-pandemic levels (T1: 159 min, T2: 151 min, T3: 201 min). Total costs were higher during T2 but then decreased during T3, below that of T1 (T1: A$652, T2: A$791, T3: A$566). Between February 2020 and June 2021, 269 people tested positive for SARS-CoV-2, 19 of whom (7.1%) interfaced with the ED. Conclusions During initial COVID-19 restrictions, a shift towards fewer ED presentations was observed. Private ED presentations rebounded more quickly than public. Few COVID-19 patients interfaced with an ED. Systems and public-private agreements made during this time appeared to protect EDs and soften the impact of reduced volumes for the private sector.
Robertson C, Chapman JJ, Stewart V
… +8 more, Castles C, Palmer VJ, Lovelock H, Hawkins K, Banfield M, Research Translation Investigator Group TANCFMH, Policy And Practice Committee TANCI, Wheeler AJ
Aust Health Rev
· 2025 Jan · PMID 39805277
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Objectives The role of translational research in improving mental health care has been highlighted in federal policy; however, an examination of how and to what extent it has been articulated at this level has not been u...Objectives The role of translational research in improving mental health care has been highlighted in federal policy; however, an examination of how and to what extent it has been articulated at this level has not been undertaken. The aim of this scoping review was to characterise translational research concepts in federal mental health policy. Methods Australian Government websites were searched for federal policy documents that made recommendations for mental health services in primary care and/or community settings. Thirty eligible documents were identified, corresponding with 25 policies. Data extraction was informed by a conceptual model of translational research involving: (1) barriers and enablers and (2) recommendations and priorities codes; each had evidence generation and evidence translation subcodes. Coded text excerpts were further categorised into topics based on content. Results In total, 1951 references were coded, about three-quarters of which were 'recommendations and priorities'. More were related to evidence generation (total = 1163, 59.6%) than evidence translation (total = 788, 40.3%). Most were generic without specific recommendations for how translational research should be supported. Specific recommendations for evidence generation included the use of routine databases, lived experience involvement (e.g. co-design) and strategic responsibilities (e.g. funding, policy). Specific recommendations for evidence translation mostly referred to lived experience, quality improvement and strategic responsibilities. Conclusion While the value of translational research is broadly acknowledged, recommendations and priorities in federal policy should emphasise evidence translation with greater specificity about how translational research should be supported. This may further influence state policy and drive improvements in practice to improve mental health care.
Cherian M, Zhao Y, Ahumada-Canale A
… +4 more, Nihill P, VanBruggen M, Butler D, Burgess P
Aust Health Rev
· 2025 Jan · PMID 39800934
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Objective This study aimed to investigate associations between patient activation, healthcare use and clinical outcomes for Aboriginal peoples living with a chronic condition in remote Northern Territory (NT) communities...Objective This study aimed to investigate associations between patient activation, healthcare use and clinical outcomes for Aboriginal peoples living with a chronic condition in remote Northern Territory (NT) communities. Methods A retrospective cohort study was undertaken between 2 April 2020 and 1 April 2022 to measure activation and its associations with chronic conditions secondary prevention treatment targets and healthcare usage: hospitalisations, potentially preventable hospitalisations and patient travel. All Aboriginal peoples enrolled at NT Government health services, who had one or more preventable chronic conditions and were prescribed one or more oral chronic condition medications identified in the Primary Care Information System, were included in the study. Patient activation was defined as a 90-day medicine possession ratio ≥80%. An activated patient has the belief, knowledge, skills and behaviours to manage their chronic conditions. Results A total of 5356 patients met the inclusion criteria; 9% of these patients were activated. Activated patients were older and sicker but were significantly more likely to achieve treatment targets for glycosylated haemoglobin, blood pressure and total and low-density lipoprotein cholesterol. Activated patients used more primary healthcare and outpatient resources and had a non-significant trend for less acute care use. Conclusions The remote NT Government primary healthcare system is providing low-value chronic conditions care for patients. As identified by Aboriginal peoples, strengthening culturally appropriate self-management support could lead to more patients becoming activated, better health outcomes and decreased acute care demand.
Aust Health Rev
· 2025 Jan · PMID 39800485
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Australia's universal healthcare scheme, Medicare, has largely excluded oral healthcare resulting in inequitable access to affordable, essential oral healthcare. To achieve inclusion of oral health within Australia's uni...Australia's universal healthcare scheme, Medicare, has largely excluded oral healthcare resulting in inequitable access to affordable, essential oral healthcare. To achieve inclusion of oral health within Australia's universal healthcare scheme, it is necessary to identify and define the dental services that constitute essential oral healthcare. This perspective paper explores how essential oral healthcare should be considered for the Australian context and to align with the World Health Organization's approach to universal health coverage that includes oral health.
Do LHM, Dimitropoulos Y, Skinner J
… +1 more, Sohn W
Aust Health Rev
· 2025 Jan · PMID 39800440
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Objective The shortage of oral health professionals in rural and remote regions of Australia directly impacts the access to oral health services for people who live in these regions, including Aboriginal and Torres Strai...Objective The shortage of oral health professionals in rural and remote regions of Australia directly impacts the access to oral health services for people who live in these regions, including Aboriginal and Torres Strait Islander peoples. This scoping review aims to explore where and how these services are provided for Aboriginal and Torres Strait Islander peoples and the relevant workforce model used. Methods Electronic databases, including MEDLINE, EMBASE, Cochrane, and CINAHL, were searched. Grey literature searches included the Australian Indigenous HealthInfoNet webpage, Australian Institute of Health and Welfare, and Advanced Google search. Results Oral health services were classified into the following categories: (1) clinical oral health services, (2) oral health promotion to improve oral health awareness, knowledge, attitudes, behaviours, or skills at patient/community level, and (3) oral health promotion including the use of single clinical interventions (e.g. fluoride varnish). Services were delivered in a variety of settings including community health clinics and schools or using mobile dental equipment. Both the dental and non-dental workforce were utilised to provide these services. Limited data were found on the experiences and challenges faced by the workforce that provide these services. Conclusion Oral health services provided for Aboriginal and Torres Strait Islander peoples in rural and remote regions of Australia vary in service type, location, and workforce involved. Future research is required to explore the experiences and support of this workforce. This can enhance delivery of culturally and clinically safe oral health services for Aboriginal and Torres Strait Islander peoples, particularly in rural and remote regions.
Keuskamp D, Davies CE, Baker RA
… +7 more, Polkinghorne KR, Reid CM, Smith JA, Tran L, Williams-Spence J, Wolfe R, Mcdonald SP
Aust Health Rev
· 2025 Jan · PMID 39762149
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Objective Kidney failure increases people's risk of cardiovascular disease, sometimes requiring cardiac surgery. The aim of this study was to estimate the risk of cardiac surgery for adults with treated kidney failure in...Objective Kidney failure increases people's risk of cardiovascular disease, sometimes requiring cardiac surgery. The aim of this study was to estimate the risk of cardiac surgery for adults with treated kidney failure in comparison with the general population in Australia. Methods We performed a population-based retrospective cohort study by linking data between the Australia and New Zealand Dialysis and Transplant Registry and the Australian and New Zealand Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database, for 2010-2019. Age-sex-standardised surgery risk relative to the general population was estimated for adults receiving long-term dialysis and kidney transplant recipients, and subpopulations defined by procedure type, comorbidity, clinical status and dialysis-related factors. Results Among 1541 adults receiving treatment for kidney failure at the time of cardiac surgery in 2010-2019, the prevalence of comorbidity and risk factors was usually highest in those receiving dialysis, followed by transplant recipients and the general population (n =113,126). For all major cardiac surgical procedure types, the incidence of surgery for adults receiving dialysis and transplant recipients exceeded that for the general population (e.g. isolated coronary artery bypass grafting relative rates 15.3 [95% CI 13.7-17.0] and 2.0 [1.6-2.6] respectively). Relative incidence was especially high for the dialysis cohorts with insulin-treated diabetes and those with body mass index <25kg/m2 . Conclusions Adults with treated kidney failure had a higher risk of cardiac surgery than the general population in Australia in 2010-2019, especially when associated with diabetes. Data linkage between clinical quality registries enabled estimation of the extent of cardiac surgical burden.
Okuba T, Sa Z, Badgery-Parker T
… +8 more, Long JC, Braithwaite J, Makris A, Hutton A, Levesque JF, Watson DE, Westbrook JI, Mitchell R
Aust Health Rev
· 2024 Dec · PMID 39715629
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Objective This study aimed to examine group-based trajectories of hospital service use by people with chronic kidney disease (CKD) in the last 12months of life. Methods A retrospective cohort study was conducted using ho...Objective This study aimed to examine group-based trajectories of hospital service use by people with chronic kidney disease (CKD) in the last 12months of life. Methods A retrospective cohort study was conducted using hospital admission and mortality data in New South Wales, Australia. Individuals aged ≥18years who were hospitalised during 2014-2021 and who died during 2015-2021 were included. A group-based trajectory analysis was conducted including all-cause admissions and unplanned-only admissions. Multinomial logistic regression examined predictors of trajectory group membership. Results There were 10,653 adults who had at least one CKD hospital admission 12months prior to death. Four group-based trajectories of hospital service use were identified for all-cause admissions (i.e. Very-Low, Low, Moderate, High) and three group-based trajectories for unplanned-only admissions (i.e. Low, Moderate, High). The study identified associations between frequent hospitalisations and key patient characteristics and health conditions. Individuals in the High hospitalisation group were more likely to have cancer (OR 4.55; 95% CI: 2.54-8.16). Additionally, the High unplanned hospitalisation group showed increased likelihoods of being adults aged 18-64years (OR 1.94; 95% CI: 1.32-2.84) and having diagnosis of congestive heart failure (OR 1.80; 95% CI: 1.26-2.55), cancer (OR 2.25; 95% CI: 1.49-3.40), mental disorders (OR 1.88; 95% CI: 1.35-2.62) or smoking (OR 2.01; 95% CI: 1.49-2.70) compared with the Low hospitalisation group. Conclusions Group-based trajectory analysis revealed specific patterns in hospital service usage. Understanding these patterns helps in devising targeted strategies to decrease unplanned hospitalisations among these high-risk patients.
Aust Health Rev
· 2024 Dec · PMID 39715628
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Objectives This study aimed to evaluate the outcomes of Australia's first public hospital all-age Sport and Exercise Medicine Outpatient Clinic (SEMOC). Methods A retrospective cross-sectional study of patients referred...Objectives This study aimed to evaluate the outcomes of Australia's first public hospital all-age Sport and Exercise Medicine Outpatient Clinic (SEMOC). Methods A retrospective cross-sectional study of patients referred to and reviewed in the SEMOC, during a study period from March to October 2023, was performed. Outcomes were the number of appointments, number of patients reviewed, proportion reviewed within Queensland Health recommended timeframes, patient satisfaction, proportion of Aboriginal and Torres Strait Islander patients, and the rurality of the patients based on the Modified Monash Model of remoteness. Results There were 29 clinics, 472 allocated appointments, and 270 new patients referred to the SEMOC (1.7 appointments per patient). Almost a quarter (23.7%) of patients identified as Aboriginal and Torres Strait Islander peoples and a third (31.9%) were from rural or remote regions. Most (88.7%) patients referred during the study period were seen within the Queensland Health recommended timeframes, and almost all patients referred on for orthopaedic review were booked for surgery (93.6%). Over 90% of patients were satisfied with the quality of treatment they received and rated the overall service as good to excellent. Conclusion A SEMOC public hospital model has been shown to be feasible for providing care to patients with musculoskeletal conditions, reaching patients who face barriers to health care, reducing wait times, and improving referral for surgery. The model may assist in meeting Australia's growing demand for orthopaedic and musculoskeletal medicine and expand within Australia's public hospital system to become a nationally accepted practice.
Bryan I, Austen-Wishart A, Ranjan P
… +3 more, Plant L, Forcey D, Millar R
Aust Health Rev
· 2024 Dec · PMID 39709641
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Objective Patients who do not wait (DNW) to be seen are a problem for emergency department (ED) care. The aim of this study was to identify the rate and reasons of DNW patients during 1month of the COVID-19 pandemic. Met...Objective Patients who do not wait (DNW) to be seen are a problem for emergency department (ED) care. The aim of this study was to identify the rate and reasons of DNW patients during 1month of the COVID-19 pandemic. Methods An observational cohort study of DNW patients presenting to Austin Hospital ED was carried out in August 2021. Patients were identified using hospital coding data and surveyed by telephone. DNW patients' reasons were explored, and their demographics and clinical outcomes compared with those who received care. Results Of 7641 patients presenting to ED in the study period, 6% (n =452) were DNW patients. Compared with those who received care, DNW patients were younger (P <0.001), had lower triage categories (P =0.001) and were more likely to have self-presented (P =0.006). A total of 47% of DNW patients (n =213) participated in the survey. Reasons for leaving included waiting time (61%, n =129), symptom improvement (13%, n =28), reassurance from staff (7%, n =15) and ED crowding (6%, n =12). A total of 75% of DNW patients (n =159) sought alternative medical care; 14% (n =29) reported hospitalisation within 7days. 64% (n =137) did not feel that the experience affected their likelihood of seeking future ED care; 32% (n =69) felt less likely to seek future ED care. Conclusions During the month studied, the DNW rate was 6%. Reassuringly, most patients sought alternative medical care, although one-third were dissuaded from returning to the ED. Future research should focus on high-risk group delineation and qualitative description of the experiences and reasons of DNW patients.