Australian Health Review[JOURNAL]
Sun
200 papers
Can I record this? A scoping review of Australian hospital policies governing consultation recording.
Prictor M, Milani N, Hyatt A
Aust Health Rev · 2024 Dec · PMID 39709640 · Publisher ↗
Objective Recording consultations can benefit patients and healthcare providers, but advantageous recording practices are dogged by legal concerns. In Australia, relevant laws are poorly understood. We postulate that loc...
Objective Recording consultations can benefit patients and healthcare providers, but advantageous recording practices are dogged by legal concerns. In Australia, relevant laws are poorly understood. We postulate that local policies are more important than law in guiding consultation recording. This study aimed to describe the availability and content of consultation recording policy in Australian hospitals. Methods We conducted a scoping review utilising JBI methods and our previously published protocol. We collected policies from Australian hospitals (April-October 2023) about the audio/video recording of patients, providers or others within the hospital. We reported findings descriptively and analysed policies' alignment with the law. Results Of the 43 hospitals examined, 17/43 (40%) had relevant policies, 17/43 (40%) had a partial policy and 9/43 (21%) had no policy. Policies were usually difficult to find and were stricter than relevant law. Conclusions When patients want to record their appointments, it can be hard to identify relevant hospital policy. Policies generally weigh against consultation recording and are more restrictive than Australian law allows. These results indicate that healthcare services should develop clear, readily available policies on recording, balancing patients' and providers' interests.
What's in a name? Why the proposed title change for podiatric surgeons is a step backward.
Gilheany MF
Aust Health Rev · 2024 Dec · PMID 39681075 · Publisher ↗
The Australian Podiatry Board's proposal to change the title 'podiatric surgeon' to 'surgical podiatrist' lacks evidence and is contrary to broader healthcare reform agendas. The current title 'podiatric surgeon' reflect...
The Australian Podiatry Board's proposal to change the title 'podiatric surgeon' to 'surgical podiatrist' lacks evidence and is contrary to broader healthcare reform agendas. The current title 'podiatric surgeon' reflects scope of practice. Instead of a title change, regulators should focus on removing barriers to effective collaborative care.
Medication incidents at supported disability accommodation (group homes) in Victoria, Australia: a retrospective audit of calls to a poisons information centre.
Hormiz R, Stanley B, Elliott RA
Aust Health Rev · 2024 Dec · PMID 39675358 · Publisher ↗
Background Many residents of shared supported disability homes (sometimes referred to as group homes) require assistance from staff to manage their medicines. Disability support workers in Australia often call a 24-h eme...
Background Many residents of shared supported disability homes (sometimes referred to as group homes) require assistance from staff to manage their medicines. Disability support workers in Australia often call a 24-h emergency poisons information service for advice following a medication incident. Objective To describe the number, type and timing of medication incident calls to the Victorian Poisons Information Centre from supported disability homes in Victoria, Australia. Methods This was a retrospective audit of poisons centre calls from supported disability homes over a 3-month period (October to December 2021). Incidents not related to therapeutic medication use, including deliberate self-poisoning, were excluded. Calls were categorised by incident-type, time-of-call and risk of an adverse event (low/moderate/high) based on the type of medicine involved. Results A total of 391 medication incident calls were included (mean 4.3 per day). The most common incidents were missed doses (n =145/391, 37%) and accidental overdoses (e.g. double-dose) (n =80/391, 20%). Most calls to the poisons centre (n =284/391, 73%) were received outside business hours (before 9am or after 5pm). For incidents where the medicine(s) were known (n =326), a moderate-risk medicine (most commonly an anticonvulsant or antipsychotic) or high-risk medicine (most commonly an anticoagulant or opioid) was involved in two-thirds of cases (n =217, 66.6%). Conclusions Calls to an emergency poisons information service about medication incidents were common, and were mostly outside business hours. Nearly half of the calls were about incidents unrelated to poisoning or toxicology, including missed doses. The study highlights a gap in medication management support for residents and disability support workers, especially after-hours, that needs to be addressed.
A population-based model of indicators of allied health workforce needs: proof-of-concept in podiatry.
Horsley J, Nancarrow S
Aust Health Rev · 2024 Dec · PMID 39648145 · Publisher ↗
Objective Allied health workforce planning faces challenges because of insufficient metrics that accurately reflect population need for services. This paper presents a method and proof-of-concept in the podiatry professi...
Objective Allied health workforce planning faces challenges because of insufficient metrics that accurately reflect population need for services. This paper presents a method and proof-of-concept in the podiatry profession for developing population-based need indicators and indices suitable for allied health workforce planning and comparative benchmarking. Methods Population-based indicators of podiatry need were selected and combined into an index of need by Statistical Area Level 3 (SA3) in Australia. Medicare patient age and sex distributions for relevant item numbers were used to determine the inclusion of specific population age groups and sex as indicators. Other indicators included diabetes, socioeconomic status, and Aboriginal and Torres Strait Islander status. The need index was calculated based by aggregating these indicators at the SA3 level. The resulting need index was compared with podiatry supply (per capita clinician counts) using a population-weighted correlation coefficient (pwCorr). Results Analysis of Medicare usage data led to the inclusion of indicators: population aged 65 and over, and female gender. The need index had a small but significant negative correlation with supply at the SA3-level (pwCorr =-0.12, P =0.03) and positively, but not significantly, correlated at the state/territory-level (pwCorr=0.42, P =0.30). Conclusions Developing profession-specific population-based need indices provides a valuable tool for allied health workforce planners to benchmark need and supply within professions. Combining single need indicators with supply metrics offers a concise framework for effective workforce planning and advocacy.
Evaluating the research capacity and culture of an urban Mental Health and Wellbeing Program.
Innes S, Taylor D, Hope J
Aust Health Rev · 2024 Dec · PMID 39648144 · Publisher ↗
Objective Research capacity in health care involves the ability to conduct, access, evaluate, and apply research evidence and results in elevated quality of care. Despite its significance, mental health organisations fac...
Objective Research capacity in health care involves the ability to conduct, access, evaluate, and apply research evidence and results in elevated quality of care. Despite its significance, mental health organisations face challenges in assessing and enhancing their research capacity. This study aimed to evaluate the research capacity and culture within a large metropolitan health service's Mental Health and Wellbeing Program (MHWP). Methods A cross-sectional, observational study using the Research Capacity and Culture (RCC) tool was conducted among approximately 1081 MHWP employees. An online survey recorded staff views on research readiness, interest, motivators, and barriers. Results Of 220 survey entries, 100 were completed. The majority were female (n =68), under 40years old (n =51), and employed full-time (n =54). The highest RCC domain score was for organisational culture. Half of the respondents thought research was not part of their role, yet 70% wanted more involvement. Motivators included skill development, while barriers included a lack of time and funds. Conclusions The findings emphasise the need for targeted strategies to enhance research culture at the individual level. However, opportunities also exist at the team and organisational levels. The study provided insights that can guide future interventions and capacity-building initiatives.
Reporting Indigenous status, ethnicity, language and country of birth to build equity in international paediatric clinical trials with Australian sites: a scoping review.
Cunninghame J, Takashima M, Holland L … +6 more , Nguyen L, Diaz A, Guo S, Dufficy M, Munns CF, Ullman A
Aust Health Rev · 2024 Dec · PMID 39622494 · Publisher ↗
Objective Ensuring equitable access to clinical trials for children from Indigenous and ethnically and linguistically diverse backgrounds should be central to clinical trial design. This review aims to expansively review...
Objective Ensuring equitable access to clinical trials for children from Indigenous and ethnically and linguistically diverse backgrounds should be central to clinical trial design. This review aims to expansively review the reporting of Indigenous status (Aboriginal and/or Torres Strait Islander origin), ethnicity, culture, location, language and country of birth in paediatric clinical trials with Australian sites. Methods This scoping review systematically searched PubMed, CINAHL and Embase for international clinical trials with Australian sites conducted between 2018 and 2022 involving children (aged <18years) to determine the reporting of Indigenous status, race, ethnicity, language and country of birth. Results Of the 262 studies included, 154 (58.8%) clinical trials did not report any of the variables of interest. When reported, terms used by authors were heterogeneous. 'Indigenous status' was most reported (n =40, 15.3%) and self-identification was the most common method to determine this (n =14, 35.9%). International clinical trials had higher rates of reporting for ethnicity, cultural background and race. Overall, more than 60 terms were used to categorise study participants in relation to 'Indigenous status', 'ethnicity and cultural background', 'race', 'race and ethnicity' or 'natural skin colour'. Conclusions This review demonstrated low rates of reporting of demographic variables in paediatric clinical trials. Clear reporting standards, partnering with consumers to co-design trials and self-identification during collection are required. Ensuring adequate access to clinical trials for Indigenous children and children from ethnically, linguistically and geographically diverse backgrounds is essential in building health equity and ensuring patient safety.
Placement poverty has major implications for the future health and education workforce: a cross-sectional survey.
Lambert K, Austin K, Charlton K … +9 more , Heins R, Kennedy M, Kent K, Lutze J, Nicholls N, O'Flynn G, Probst Y, Walton K, McMahon A
Aust Health Rev · 2024 Dec · PMID 39622489 · Publisher ↗
Objective 'Placement poverty' refers to the financial burdens imposed upon students by the completion of mandatory professional placement. We aimed to identify the financial implications of mandatory professional placeme...
Objective 'Placement poverty' refers to the financial burdens imposed upon students by the completion of mandatory professional placement. We aimed to identify the financial implications of mandatory professional placements on student wellbeing. Methods A cross-sectional online survey (August 2023 to January 2024) completed during students' most recent professional placement in the final year of their degree. Eligible participants were health or teaching students studying at Australian and New Zealand universities in degrees requiring mandatory professional placement. Questions included total and accommodation costs, financial support, impact of finances on placement preferences, presence of food insecurity, and implications for student wellbeing. Results Participants (n =530) were mostly health professional (65%) students (median, 25; interquartile range (IQR), 22-30 years, 95.3% domestic, 88.3% full time, 2.0% New Zealand). Health students had higher total costs (in Australian dollars) for the recent placement ($1500; IQR, 600-3453) compared to teaching students ($1200; IQR, 600-2757) (P =0.02), likely due to longer placement duration (6weeks for health students). A higher proportion of health students required financial support (P =0.0001). Placement preferences were always or sometimes (63.8%) determined by cost rather than learning opportunity. Food insecurity was experienced by most students (70.2%) (10.4% marginal, 32.1% moderate, 27.7% severe), with no difference by degree type. Thematic analysis identified themes of burnout, emotional distress, inability to focus on learning, postponing care of oneself, urgent need for financial support, unanticipated family and other circumstances, and worsened societal inequity. Conclusions Our study identified widespread financial difficulty in students undertaking placement that adversely impacted personal wellbeing. Strategies are needed to support wellbeing and ameliorate the financial burden.
What factors affect the recruitment and retention of allied health professionals working in hospitals? A systematic literature review.
Baumgartner L, Wright O, Barne K … +5 more , Bartrim K, Kirkegaard A, Sullivan V, Burch E, Ball L
Aust Health Rev · 2024 Dec · PMID 39617398 · Publisher ↗
Objective Workforce shortages in hospitals have necessitated a focus on recruitment and retention of health professionals. The aim of this systematic review was to synthesise literature relating to factors that affect re...
Objective Workforce shortages in hospitals have necessitated a focus on recruitment and retention of health professionals. The aim of this systematic review was to synthesise literature relating to factors that affect recruitment and retention of allied health professionals working in hospital settings. Method PubMed, CINAHL (via EbscoHost), Embase (via Elsevier), and Scopus Advanced Search databases were used to retrieve 1665 studies, of which 16 were included. Herzberg's two-factor theory was used to synthesise study findings and develop key themes. Results Job advancement, company policies, supervision (leadership), working conditions, salary, recognition, and growth opportunities were factors identified as affecting recruitment and retention. Conclusion Identified factors are largely amenable to change and could contribute to a more sustainable allied health workforce in hospitals and enhance the quality of care. This research could significantly impact and enhance the evidence supporting interventions and strategies that are critical for retaining the allied health workforce in hospitals.
Allied health and the frail patient in hospital - a prospective cohort study.
Bui JH, Ngian VJJ, Tran F … +3 more , Scott K, Ngai KC, Ong BS
Aust Health Rev · 2024 Nov · PMID 39581601 · Publisher ↗
Objectives Frailty is associated with significant mortality and morbidity in hospitalised patients. We describe physiotherapy and occupational therapy practices in hospitalised frail patients and examine the role of earl...
Objectives Frailty is associated with significant mortality and morbidity in hospitalised patients. We describe physiotherapy and occupational therapy practices in hospitalised frail patients and examine the role of early intervention. Methods We performed a prospective, observational cohort study in a medical assessment unit in a tertiary care hospital. Patients with COVID-19 infection were excluded. Frailty was measured by the Clinical Frailty Scale (CFS). Early allied health intervention was defined as involvement within 48h of admission. Demographic data, clinical diagnoses, time spent with physiotherapy and occupational therapy, CFS, hospital length of stay and outcomes were recorded and analysed. Results A total of 356 patients were categorised into non-frail (CFS score <5) and frail (CFS score ≥5) groups. The prevalence of frailty was 68% (n =241). Physiotherapy (77.2%) and occupational therapy (75.5%) reviews were more frequent in frail patients than in non-frail patients. Frail patients who had allied health involvement within 48h of admission had a significant reduction in their hospital length of stay (mean reduction of 7.3days, 95% CI: 0.53, 14, P =0.035) and a 2.44% reduction in the relative risk of developing pressure injuries (95% CI: 1.31, 4.53). There was no statistically significant differences in outcomes with allied health intervention for non-frail patients and patients who require residential aged care facility level care. Conclusions Allied health have a key role in the management of frailty. Early allied health intervention was associated with a reduced hospital length of stay as well as a reduced incidence of pressure injury in frail patients.
Hospital visiting hours - do they need to be revised?
Forero R, Mohsin M, Singh F … +9 more , Hunt L, Frost S, McDonnell S, Piya M, Verick D, Kohler F, Chow JSF, Widloecher S, Hillman K
Aust Health Rev · 2024 Nov · PMID 39557012 · Publisher ↗
Objective This study aimed to determine the number of visitors to an acute hospital, the time of visit, destination, and details of parking over the same period. Methods A prospective observational pilot study in a large...
Objective This study aimed to determine the number of visitors to an acute hospital, the time of visit, destination, and details of parking over the same period. Methods A prospective observational pilot study in a large metropolitan public hospital in Australia was performed. The research team observed all visitors over a 14-day period between 17 and 30 October 2022 counting the people visiting relatives or friends of admitted hospital patients as well as those visiting outpatient clinics during the observation period. Other outcome measures included time of the visit, destination, and estimated costs of parking. Results During the 14 days of observation there were 18,066 visitors, averaging 1290 per day. The majority were visitors to inpatients (62.2%, 11,232, averaging 802 per day). Those attending outpatients were less (37.8%, 6834, averaging 668 per weekday). The estimated average parking cost was A$18.10 per day normally and A$11.85 for concessions. Conclusions This was the first known study on hospital-wide visiting in Australia or globally. These findings would be important for addressing issues such as hospital planning, and for future research including the impact of visiting on patient outcomes, the patient and community experience, and the expectations and experience of hospital visitors.
A digitally enabled health workforce for Australia.
Janssen A, Baysari M, Igasto C … +4 more , Quirke K, Milnes P, Shaw T, Dunn A
Aust Health Rev · 2024 Dec · PMID 39551622 · Publisher ↗
Australia has world-class education for healthcare professionals and is recognised for its strength in digital health research but is yet to fill some important gaps in training healthcare professionals in the safe imple...
Australia has world-class education for healthcare professionals and is recognised for its strength in digital health research but is yet to fill some important gaps in training healthcare professionals in the safe implementation and use of digital technologies. In this case study, we bring together the perspectives of clinicians, health system leaders, and academics to guide efforts in establishing a digitally enabled workforce in Australia. Building on published evidence, our recommendations include leveraging on recent momentum, building strong partnerships with healthcare organisations, academia, and the digital health industry, and ultimately an expansion of a digitally enabled clinical informatics and digital health workforce.
Addressing unnecessary and avoidable transfers from residential aged care to emergency departments and hospitals.
Peters MD, Clarke J, Marnie C
Aust Health Rev · 2024 Nov · PMID 39551074 · Publisher ↗
Purpose The purpose of this article is to examine and discuss the literature regarding emergency department (ED) transfers from residential aged care with a focus on reducing potentially avoidable transfers to enhance ca...
Purpose The purpose of this article is to examine and discuss the literature regarding emergency department (ED) transfers from residential aged care with a focus on reducing potentially avoidable transfers to enhance care experiences, safety, and outcomes. Design Researchers experienced in evidence synthesis and policy research in the aged care space reviewed the literature about residential aged care transfers to EDs, including factors underlying transfers and interventions to reduce transfers. Findings Transfers to EDs from aged care are common. They can be harmful, distressing, costly, and have a variety of negative impacts on residents, staff, and the aged care and health system. High rates of potentially avoidable or unwarranted transfers suggests the presence of systemic issues, including the lack of sufficient staffing levels and skills mix with the requisite knowledge, training, resources, and support. Reforms are required to improve staffing levels and skills mix, enhance access to on-site and in-reach clinical expertise, provide access to quality improvement initiatives, and engage consumers to ensure shared decision-making. Further research is also required to help determine the best approach to reducing unnecessary hospital transfers from aged care considering the specific scopes of practice of aged care workers. Conclusion While some transfers from residential aged care to EDs are necessary, many do not represent safe, dignified care for older people. Unwarranted transfers are burdensome and risky and should be minimised through the provision of a range of reforms including sufficient staffing, resources, and support, that allow for the delivery of care in place where appropriate.
Implementation of an Ambassador program to reduce occupational violence in hospital inpatient settings: a pilot study.
Jeffries L, Xu HG, Doubrovsky A … +3 more , Woollett K, Griffiths J, Duff J
Aust Health Rev · 2024 Nov · PMID 39551073 · Publisher ↗
Background Occupational violence (OV) is a significant workplace issue that affects 62% of healthcare workers globally. An Ambassador is a new role that focuses on preventing OV in healthcare settings. They proactively e...
Background Occupational violence (OV) is a significant workplace issue that affects 62% of healthcare workers globally. An Ambassador is a new role that focuses on preventing OV in healthcare settings. They proactively engage with patients and visitors, using behavioural strategies to redirect or de-escalate people who may be of concern. This pilot study evaluated the introduction of an Ambassador in an acute inpatient hospital setting. Methods A cross-sectional multiple-method evaluation was conducted in three surgical wards in a major metropolitan hospital in Australia from December 2020 to February 2021. Data from security records, incident reports and staff surveys were collected before and during the pilot. The survey included multiple-choice and open-ended questions. Quantitative data were analysed in SPSS, and qualitative data were analysed using thematic analysis. Results After the 3 month pilot, a significant decrease was seen in security calls (from 111 to 44, a decrease of 60%, χ 2 =28.96, P <0.001) and incident reports (from 20 to 6, a decrease of 70%, χ 2 =7.54, P =0.006). Staff surveys showed an increased awareness of OV as a workplace issue (from 60% to 82%, χ 2 =7.65, P =0.005). The qualitative analysis identified three main themes: professional roles and functions, key personnel characteristics, and suggestions for future implementation. Conclusions An improvement was seen in the staff perception of safety and a reduction in organisational metrics related to OV. Future research is required to evaluate program effectiveness across different wards and settings. Application to practice The success of the Ambassador program relies on selecting the right candidates, providing clear role descriptions, offering appropriate training and ensuring adequate support resources.
Examining the experience of healthcare workers who led staff wellness rounding during the COVID-19 pandemic.
Wilson N, Smith L, Taylor R … +1 more , Kohler F
Aust Health Rev · 2024 Nov · PMID 39505358 · Publisher ↗
Objective Staff wellness rounding (SWR) is a process in which healthcare leaders have real-time conversations with healthcare workers (HCW) to identify safety and wellness issues. This study examined the experience of mu...
Objective Staff wellness rounding (SWR) is a process in which healthcare leaders have real-time conversations with healthcare workers (HCW) to identify safety and wellness issues. This study examined the experience of multidisciplinary healthcare leaders, who were not trained in psychology, who delivered SWR during the surge phase of the COVID-19 pandemic. Methods A mixed methods approach was used. Phase 1 included a survey of HCW who participated in SWR during July-October 2021. Phase 2 included semi-structured interviews of leaders who delivered SWR. Results There were 403 respondents to the survey, with 169 participants (41.9%) being eligible for the study. More than 67% of eligible respondents would recommend SWR to other colleagues, and 77.5% reported that SWR provided an opportunity to escalate issues or concerns about COVID-19. Eleven SWR leaders were interviewed about their experience of leading SWR. Four key themes were identified: SWR (1) offered a defined process for communication between executive leaders and HCW; (2) enabled escalation and actioning of issues to and from executive teams in the organisation; (3) required flexible scheduling to meet varied work schedules of HCW; and (4) required the leaders to have a core set of skills and competencies. Conclusion This study examined the contribution that an SWR intervention can make to support HCW wellbeing during crisis-type events. The model facilitated interactions between executive leaders, managers and frontline staff. It fostered collegiality with peers, managers and leaders, supported recognition and acknowledgment of peers and used available resources effectively to support staff wellness during the surge phase of the COVID-19 pandemic.
The carbon footprint of total knee replacements.
McGain F, Wickramarachchi K, Aye L … +4 more , Chan BG, Sheridan N, Tran P, McAlister S
Aust Health Rev · 2024 Dec · PMID 39467327 · Publisher ↗
Objective Detailed quantifications of the environmental footprint of operations that include surgery, anaesthesia, and engineering are rare. We examined all such aspects to find the greenhouse gas emissions of an operati...
Objective Detailed quantifications of the environmental footprint of operations that include surgery, anaesthesia, and engineering are rare. We examined all such aspects to find the greenhouse gas emissions of an operation. Methods We undertook a life cycle assessment of 10 patients undergoing total knee replacements, collecting data for all surgical equipment, energy requirements for cleaning, and operating room energy use. Data for anaesthesia were sourced from our prior study. We used life cycle assessment software to convert inputs of energy and material use into outputs in kg CO2 e emissions, using Monte Carlo analyses with 95% confidence intervals. Results The average carbon footprint was 131.7kg CO2 e, (95% confidence interval: 117.7-148.5kg CO2 e); surgery was foremost (104/131.7kg CO2 e, 80%), with lesser contributions from anaesthesia (15.0/131.7kg CO2 e, 11%), and engineering (11.9/131.7kg CO2 e, 9%). The main surgical sources of greenhouse gas emissions were: energy used to disinfect and steam sterilise reusable equipment (43.4/131.7kg CO2 e, 33%), single-use equipment (34.2/131.7kg CO2 e, 26%), with polypropylene alone 13.7/131.7kg CO2 e (11%), and the knee prosthesis 19.6kg CO2 e (15%). For energy use, the main contributors were: gas heating (6.7kg CO2 e) and heating, cooling, and fans (4kg CO2 e). Conclusions The carbon footprint of a total knee replacement was equivalent to driving 914km in a standard 2022 Australian car, with surgery contributing 80%. Such data provide guidance in reducing an operation's carbon footprint through prudent equipment use, more efficient steam sterilisation with renewable electricity, and reduced single-use waste.
Standardising workforce cost estimates across Australian jurisdictions: genomic testing as a use case.
Mordaunt DA
Aust Health Rev · 2024 Dec · PMID 39462484 · Publisher ↗
Introduction Labour costs are a key driver of healthcare costs and a key component of economic evaluations in healthcare. We undertook the current study to collect information about workforce costs related to clinical ge...
Introduction Labour costs are a key driver of healthcare costs and a key component of economic evaluations in healthcare. We undertook the current study to collect information about workforce costs related to clinical genomic testing in Australia, identifying key components of pay scales and contracts, and incorporating these into a matrix to enable modelling of disaggregated costs. Methods We undertook a microcosting study of health workforce labour costs in Australia, from a health services perspective. We mapped the genomic testing processes, identifying the relevant workforce. Data was collected on the identified workforce from publicly available pay scales. Estimates were used to model the total cost from a public health services employer perspective, undertaking deterministic and probabilistic sensitivity analyses. Results We identified significant variability in the way in which pay scales and related conditions are both structured and the levels between jurisdictions. The total costs (2023-2024 Australian dollars) ranged from 160,794 (113,848-233,350) for administrative staff to 703,206 (548,011-923,661) for pathology staff (full-time equivalent). Deterministic sensitivity analysis identified that the base salary accounts for the greatest source of uncertainty, from 24.8% (20.0-32.9%) for laboratory technicians to 53.6% (52.8-54.4%) for medical scientists. Conclusion Variations in remuneration levels and conditions between Australian jurisdictions account for considerable variation in the estimated cost of labour and may contribute significantly to the uncertainty of economic assessments of genomic testing and other labour-intensive health technologies. We outline an approach to standardise the collection and estimation of uncertainty for Australian health workforce costs and provide current estimates for labour costs.
Comparison of a visiting subspecialist ophthalmology service to Royal Darwin Hospital with interstate transfers: costs and clinical outcomes of treatment.
Lam D, Moore M, Cunich M … +4 more , Lake S, Ho IV, McCluskey P, Mahendrarajah T
Aust Health Rev · 2024 Oct · PMID 39433301 · Publisher ↗
Objective This study aimed to compare the costs and clinical outcomes of treating patients with retinal diseases requiring surgery managed locally in Darwin through a visiting subspecialist ophthalmology service or trans...
Objective This study aimed to compare the costs and clinical outcomes of treating patients with retinal diseases requiring surgery managed locally in Darwin through a visiting subspecialist ophthalmology service or transferred to interstate tertiary eye centres. Methods A retrospective analysis of a case series of 70 consecutive patients presenting to the Royal Darwin Hospital for vitreo-retinal surgery during the calendar years 2018 and 2019 was performed. Results Twenty-two of the 29 patients in the transfer group had a retinal detachment and five vitreous haemorrhage. The 41 patients managed in Darwin had a range of diagnoses. Surgical success, complications and costs were similar. Conclusion There were excellent clinical outcomes and a minimal insignificant difference in costs.
Medicare-reimbursed psychiatric consultations before and after telehealth expansion in Australia: a time series study.
Woon LS, Maguire PA, Reay RE … +3 more , Mittinty M, Bastiampillai T, Looi JCL
Aust Health Rev · 2024 Dec · PMID 39433299 · Publisher ↗
Objective Telepsychiatry consultations grew rapidly with increased total consultations and reduced face-to-face consultations following the pandemic-triggered expansion of Medicare Benefits Schedule (MBS) telehealth item...
Objective Telepsychiatry consultations grew rapidly with increased total consultations and reduced face-to-face consultations following the pandemic-triggered expansion of Medicare Benefits Schedule (MBS) telehealth items. It was unclear how much telehealth expansion independently impacted overall and face-to-face consultation trends after accounting for lockdown severity. Methods We extracted monthly MBS Item Reports for psychiatric consultations (January 2012-December 2023). The monthly average Stringency Index (SI) for Australia represented lockdown severity from January 2020 to December 2022. A dichotomous variable denoted telehealth expansion (March 2020 onward). We constructed consecutive multiple linear regression models for combined consultations and face-to-face consultations to include seasonality, trend, SI, and telehealth expansion. We compared model performance using information criteria. Results Median monthly total consultations increased from 148,413 (Interquartile range, IQR: 138,219-153,709) pre-expansion (January 2012-February 2020) to 173,016 (IQR: 158,292-182,463) post-expansion (March 2020-December 2023). Contrarily, median monthly face-to-face consultations decreased from 143,726 (IQR: 135,812-150,153) to 99,272 (IQR: 87,513-107,778). Seasonality and trend were present in both time series. The time series regression model with expansion but excluding SI best explained all consultations, while both telehealth expansion and SI were significant in the best-fit model for face-to-face consultations. Conclusion MBS telehealth expansion was associated with total and face-to-face consultations independent of lockdown severity changes. Policy changes allowing wider access to new telehealth services have possibly led to increased uptake of psychiatric care and addressed previously unmet needs.
Pattern of hospital admissions and costs associated with acute rheumatic fever and rheumatic heart disease in Australia, 2012-2017.
Stacey I, Katzenellenbogen J, Hung J … +6 more , Seth R, Francia C, MacDonald B, Marangou J, Murray K, Cannon J
Aust Health Rev · 2024 Oct · PMID 39433298 · Publisher ↗
Objective This study aims to describe the pattern and trends in acute rheumatic fever (ARF)/rheumatic heart disease (RHD)-related hospitalisations and costs for Australians aged <65 years. Methods This retrospective link...
Objective This study aims to describe the pattern and trends in acute rheumatic fever (ARF)/rheumatic heart disease (RHD)-related hospitalisations and costs for Australians aged <65 years. Methods This retrospective linked data study measured trends in hospitalisations and costs for ARF, RHD and complications of ARF/RHD in Northern Territory, South Australia, Western Australia, Queensland and New South Wales between 1 July 2012 and 30 June 2017. Persons with ARF/RHD were identified from RHD registers and/or hospital records. Results Over the 5-year study period, 791 children, aged <16years (86.3% Indigenous), and 2761 adults, aged 16-64years (44.8% Indigenous), were hospitalised for ARF, RHD or associated complications. On average there were 296 paediatric admissions per year, increasing 6.1% annually (95% CI: 2.4-9.6%, P =0.001) and 1442 adult admissions per year, increasing 1.7% annually (95% CI: 0.1-3.4%, P =0.03). Total 5-year costs were AU$130.6m (AU$17.6m paediatric, AU$113.0m adult). Paediatric costs were mostly for ARF-related admissions whereas adult costs mostly involved valvular surgery. Emergency admissions and air ambulance transfers were common, particularly for non-metropolitan residents. Conclusions Successful ARF/RHD prevention would deliver significant hospital cost savings. Investment in primary and specialist health care in regional areas may reduce emergency admissions and regional transfers, further reducing hospital burden.
Twice daily allied health rehabilitation is feasible in acutely hospitalised older people: an observational study.
Kay JE, D'Souza AN, Klaic M … +5 more , Jacob AN, Marston C, Goonan R, Crowley H, Granger CL
Aust Health Rev · 2024 Oct · PMID 39427720 · Publisher ↗
Objective To evaluate the feasibility of twice daily rehabilitation in older patients admitted to an acute care of the elderly (ACE) hospital ward. Method This was a prospective single-site, cohort study of twice daily i...
Objective To evaluate the feasibility of twice daily rehabilitation in older patients admitted to an acute care of the elderly (ACE) hospital ward. Method This was a prospective single-site, cohort study of twice daily interventions provided by ACE physiotherapists, occupational therapists and/or allied health assistants in an ACE hospital ward. The feasibility of twice daily therapy was evaluated using a range of outcomes including satisfaction, fidelity and limited efficacy. Results A total of 220 patients were included (median age 86 [IQR 81-91]years, 54% female, with a median length of hospital stay of 7 [IQR 5-10] days). Twice daily therapy was delivered on 71% (n =757) of patient admitted weekdays (fidelity). Moderate-to-large effect sizes were observed in patient functional and mobility measures during their hospital stay and most patients (74%) were able to be successfully discharged home (limited efficacy). Both staff and patients reported high levels of satisfaction with physiotherapy and occupational therapy while on the ACE ward. Conclusion Twice daily therapy with acutely hospitalised elderly patients is feasible, facilitated discharge home, and is associated with high patient and staff satisfaction.
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