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Kerr, Rhonda, and Delia V. Hendrie. "Is capital investment in Australian hospitals effectively funding patient access to efficient public hospital care?" Australian Health Review 42, no. 5 (2018): 501. http://dx.doi.org/10.1071/ah17231.
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Objective This study asks ‘Is capital investment in Australian public hospitals effectively funding patient access to efficient hospital care?’ Methods The study drew information from semistructured interviews with senior health infrastructure officials, literature reviews and World Health Organization (WHO) reports. To identify which systems most effectively fund patient access to efficient hospitals, capital allocation systems for 17 Organisation for Economic Cooperation and Development (OECD) countries were assessed. Results Australian government objectives (equitable access to clinically appropriate, efficient, sustainable, innovative, patient-based) for acute health services are not directly addressed within Australian capital allocation systems for hospitals. Instead, Australia retains a prioritised hospital investment system for institutionally based asset replacement and capital planning, aligned with budgetary and political priorities. Australian systems of capital allocation for public hospitals were found not to match health system objectives for allocative, productive and dynamic efficiency. Australia scored below average in funding patient access to efficient hospitals. The OECD countries most effectively funding patient access to efficient hospital care have transitioned to diagnosis-related group (DRG) aligned capital funding. Measures of effective capital allocation for hospitals, patient access and efficiency found mixed government–private–public partnerships performed poorly with inferior access to capital than DRG-aligned systems, with the worst performing systems based on private finance. Conclusion Australian capital allocation systems for hospitals do not meet Australian government standards for the health system. Transition to a diagnosis-based system of capital allocation would align capital allocation with government standards and has been found to improve patient access to efficient hospital care. What is known about the topic? Very little is known about the effectiveness of Australian capital allocation for public hospitals. In Australia, capital is rarely discussed in the context of efficiency, although poor built capital and inappropriate technologies are acknowledged as limitations to improving efficiency. Capital allocated for public hospitals by state and territory is no longer reported by Australian Institute of Health and Welfare due to problems with data reliability. International comparative reviews of capital funding for hospitals have not included Australia. Most comparative efficiency reviews for health avoid considering capital allocation. The national review of hospitals found capital allocation information makes it difficult to determine ’if we have it right’ in terms of investment for health services. Problems with capital allocation systems for public hospitals have been identified within state-based reviews of health service delivery. The Productivity Commission was unable to identify the cost of capital used in treating patients in Australian public hospitals. Instead, building and equipment depreciation plus the user cost of capital (or the cost of using the money invested in the asset) are used to estimate the cost of capital required for patient care, despite concerns about accuracy and comparability. What does this paper add? This is the first study to review capital allocation systems for Australian public hospitals, to evaluate those systems against the contemporary objectives of the health systems and to assess whether prevailing Australian allocation systems deliver funds to facilitate patient access to efficient hospital care. This is the first study to evaluate Australian hospital capital allocation and efficiency. It compares the objectives of the Australian public hospitals system (for universal access to patient-centred, efficient and effective health care) against a range of capital funding mechanisms used in comparable health systems. It is also the first comparative review of international capital funding systems to include Australia. What are the implications for practitioners? Clinical quality and operational efficiency in hospitals require access for all patients to technologically appropriate hospitals. Funding for appropriate public hospital facilities, medical equipment and information and communications technology is not connected to activity-based funding in Australia. This study examines how capital can most effectively be allocated to provide patient access to efficient hospital care for Australian public hospitals. Capital investment for hospitals that is patient based, rather than institutionally focused, aligns with higher efficiency.
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Unnithan, Chandana. "RFID Implementation in Australian Hospitals." International Journal of Enterprise Information Systems 10, no. 2 (April 2014): 40–61. http://dx.doi.org/10.4018/ijeis.2014040103.
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Radio Frequency Identification (RFID) is a mobile technology that was explored in hospitals in the last decade for improving process efficiencies. However, in the Australian context, this technology is still regarded as an innovation that health ICT practitioners and hospitals are reluctant to trial. This technology, although non-intrusive, is perceived as disruptive by hospitals. Information Systems professionals in the ICT sector and Health Informatics practitioners in Australia are exploring best practices for implementation. In this research paper, I report on findings from empirical research that was conducted in Australia, based in two large hospitals1, to better understand the factors involved in the successful implementation of RFID in Australian hospitals. Findings from this study are presented and endorsed by health ICT practitioners and informatics professionals as current implications for the field.
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Dwyer, Judith, and Sandra G. Leggat. "Innovation in Australian hospitals." Australian Health Review 25, no. 5 (2002): 19. http://dx.doi.org/10.1071/ah020019b.
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This paper examines the challenge of innovation,and reports on innovation in the Australian hospital sector. Through review of both published and 'grey' literature,the analysis of the innovative record of Australian hospitals is focused on two key questions: How has the hospital sector made use of opportunities for renewal and improved effectiveness in its ongoing response to the challenges it faces? And are the conditions for effective innovation in place? To be truly innovative,the Australian hospital sector requires greater supporting mechanisms including:a consistent policy and funding framework,greater ability to harness the power of information,and development of innovation skills.The government has an important role to play in stimulating the creative capacities of hospitals and their staff.
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Cheah, Ron, Arjun Rajkhowa, Rodney James, Kym Wangeman, Sonia Koning, Karin Thursky, and Kirsty Buising. "Case for antimicrobial stewardship pharmacy technicians in Australian hospitals." Australian Health Review 44, no. 6 (2020): 941. http://dx.doi.org/10.1071/ah19236.
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The pharmacist’s role in hospital antimicrobial stewardship (AMS) programs is known to improve patient safety and the quality of care. Despite this, many Australian hospitals struggle to provide adequate pharmacy AMS program resourcing and need to explore newer models of care. The Pharmacy Board of Australia’s Guidelines for Dispensing Medicines permit suitably qualified, competent and experienced pharmacy technicians to assist pharmacists in ‘tasks in a pharmacy department’. The pharmacy technician workforce is expanding, and there is growing interest in career advancement and expansion of the pharmacy technician role. We propose that the pharmacy technician, a well-integrated member of many Australian hospital pharmacy departments, can play an important role in hospital AMS programs. To bolster AMS initiatives in Australian hospitals, this paper explores the existing evidence for pharmacy technicians in AMS programs and describes how this role may be better supported in Australia.
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Thompson, Walter R., Garry D. Phillips, and Michael J. Cousins. "Anaesthesia underpins acute patient care in hospitals." Australian Health Review 31, no. 5 (2007): 116. http://dx.doi.org/10.1071/ah07s116.
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The Australian and New Zealand College of Anaesthetists (ANZCA) carried out a review of the roles of anaesthetists in providing acute care services in both public and private hospitals in Europe, North America and South-East Asia. As a result, ANZCA revised its education and training program and its processes relating to overseastrained specialists. The new training program, introduced in 2004, formed the basis for submissions to the Australian Medical Council, and the Australian Competition and Consumer Commission/ Australian Health Workforce Officials? Committee review of medical colleges. A revised continuing professional development program will be in place in 2007. Anaesthetists in Australia and New Zealand play a pivotal role in providing services in both public and private hospitals, as well as supporting intensive care medicine, pain medicine and hyperbaric medicine. Anaesthesia allows surgery, obstetrics, procedural medicine and interventional medical imaging to function optimally, by ensuring that the patient journey is safe and has high quality care. Specialist anaesthetists in Australia now exceed Australian Medical Workforce Advisory Committee recommendations
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Lightfoot, Diane. "The history of Public Health Diagnostic Microbiology in Australia: early days until 1990." Microbiology Australia 38, no. 4 (2017): 156. http://dx.doi.org/10.1071/ma17056.
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The arrival of the First Fleet in Port Jackson in 1788, and the subsequent establishment of the colony of NSW began the history of the Australian public health system. Prior to Federation each state dealt with their own public health issues and much of the microbiological analysis was performed in the early hospitals and medical school departments of universities. Today, as there is no central Laboratory for the Commonwealth of Australia, each Australian state is responsible for the microbiological testing relevant to public health. However, because of various Commonwealth of Australia Department of Health initiatives, the Australian Government Department of Health is responsible for the overall public health of Australians.
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Duckett, S. J. "Australian hospital services: An overview." Australian Health Review 25, no. 1 (2002): 2. http://dx.doi.org/10.1071/ah020002a.
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Hospital services in Australia are provided by public hospitals (about 75% of hospitals, two-thirds of separations) and private hospitals (the balance). Australians use about one bed day per person per year, with an admission rate of about300 admissions per thousand population per annum. Provision rates for public hospitals have declined significantly (by 40%) over the last 20 years but separation rates have increased. Average length of stay for overnight patients has been stable but, because the proportion of same day patients has increased dramatically, overall length of stay has declined from around seven days in the mid 1980s to around four days in the late 1990s. Overall, the Commonwealth and state governments each meet about half the costs of public hospital care, private health insurance meets about two-thirds of the costs of private hospitals.
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L Gilbert, G. "A resistant culture - ?superbugs? in Australian hospitals." Microbiology Australia 28, no. 4 (2007): 184. http://dx.doi.org/10.1071/ma07182.
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Antimicrobial resistance is not new in Australian hospitals. In 1946, shortly after penicillin became available for treatment of civilians, a penicillin resistant Staphylococcus aureus strain caused ~50% of staphylococcal surgical wound infections at the Royal Prince Alfred Hospital (RPAH), in Sydney. During the 1950s, another virulent penicillin resistant S. aureus strain (phage type 80/81) emerged in neonatal units in Sydney and spread to other hospitals in Australia and overseas, to the families of affected infants and to the general community, causing serious soft tissue infections, osteomyelitis, pneumonia and septicaemia.
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Norman, Daniel A., Margie Danchin, Christopher C. Blyth, Pamela Palasanthiran, David Tran, Kristine K. Macartney, Ushma Wadia, Hannah C. Moore, and Holly Seale. "Australian hospital paediatricians and nurses’ perspectives and practices for influenza vaccine delivery in children with medical comorbidities." PLOS ONE 17, no. 12 (December 12, 2022): e0277874. http://dx.doi.org/10.1371/journal.pone.0277874.
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Introduction Influenza vaccination of children with medical comorbidities is critical due their increased risks for severe influenza disease. In Australia, hospitals are an avenue for influenza vaccine delivery to children with comorbidities but are not always effectively utilised. Qualitative enquiry sought to ascertainment the barriers and enablers for influenza vaccination recommendation, delivery, and recording of these children at Australian hospitals. Methods Semi-structured interviews and discussion group sessions were conducted with paediatricians and nurses at four tertiary paediatric specialist hospitals and two general community hospitals in three Australian states. Transcripts from interviews and group sessions were inductively analysed for themes. The Capability, Opportunity, Motivation, and Behaviour (COM-B) model was used to explore the elements of each theme and identify potential interventions to increase influenza vaccination recommendation and delivery behaviours by providers. Results Fifteen discussion sessions with 28 paediatricians and 26 nurses, and nine in-depth interviews (five paediatricians and four nurses) were conducted. Two central thematic domains were identified: 1. The interaction between hospital staff and parents/patients for influenza vaccine recommendation, and 2. Vaccination delivery and recording in the hospital environment. Six themes across these domains emerged detailing the importance of dedicated immunisation services, hospital leadership, paediatricians’ vaccine recommendation role, the impact of comorbidities, vaccination recording, and cocooning vaccinations. Supportive hospital leadership, engaged providers, and dedicated immunisation services were identified as essential for influenza vaccination of children with comorbidities in Australian hospital. Conclusion Recommendation of influenza vaccination for Australian children with comorbidities is impacted by the beliefs of paediatricians and the perceived impact of influenza disease on children’s comorbidities. Dedicated immunisation services and supportive hospital leadership were drivers for influenza vaccine delivery at hospitals. Future interventions targeting hospital-based influenza vaccine delivery for children with comorbidities should take a rounded approach targeting providers’ attitudes, the hospital environment and leadership support.
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Adams, Nicole, and David Tudehope. "Australia’s persistently high rate of early-term prelabour Caesarean delivery." Australian Health Review 45, no. 4 (2021): 463. http://dx.doi.org/10.1071/ah20176.
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ObjectiveTo compare the incidence of prelabour Caesarean delivery (PCD) at early term (37 weeks and 0 days (370) to 38 weeks and 6 days (386) of gestation) between Australian states and hospital sectors over time and to compare these rates with those of England and the United States of America (USA). MethodA population-based descriptive study of 556040 singleton PCDs at term (370−406 weeks) in all public and private hospitals in Australian states, 2005–16, was performed. The primary outcome was the early-term PCD rate, defined as early-term PCDs as a percentage of all term PCDs. ResultsAcross Australian states, the early-term PCD rate fell from 56.4% in 2005 to 52.0% in 2016. Over a similar period, England’s rate fell from 48.2% in 2006–07 to 35.2% in 2016–17, while the USA’s rate fell from 47.4% in 2006 to 34.2% in 2016. Australian public hospitals reduced their rate from 54.2% in 2005 to 44.7% in 2016, but the rate increased in private hospitals from 59.1% in 2005 to 62.5% in 2016. There was considerable variation between states and hospital sectors. ConclusionsThe early-term PCD rate increased in Australian private hospitals from 2005 to 2016. The public hospital rate fell by nearly 10% over the period but remained ~10% above the English and USA national rates. What is known about the topic?Babies born at early term (370−386 weeks) are at greater risk of morbidity than babies born at full term (390−406 weeks). Australia has a persistently high rate of early-term prelabour Caesarean delivery (PCD). What does this paper add?This paper reveals concerning differences in the early-term PCD rate between Australian states and hospital sectors. Further, the paper highlights that both Australian hospital sectors (public and private) have not reduced their rates to levels achieved in England and the USA. What are the implications for practitioners?These results should inform efforts to reduce Australia’s early-term PCD rate to prevent harm to babies.
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Balanda, Kevin P., John B. Lowe, Warren Stanton, Amaya Gillespie, and Vincent Conway. "Cancer Control Activities in Australian Public Hospitals." International Quarterly of Community Health Education 15, no. 3 (October 1994): 229–40. http://dx.doi.org/10.2190/gxjq-gp33-pmx9-7nlh.
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Cancer is a major cause of death in Australia and there is considerable interest in the role health education in hospital settings has in reducing this burden. Based on a survey of medical superintendents and other hospital staff, this article describes the cancer control activities routinely conducted in Australian public hospitals. The survey considered cigarette smoking, alcohol, diet and nutrition, exercise, and the early detection of skin cancer, cervical cancer, and breast cancer. Overall 112 medical superintendents (93%) participated and a further 163 hospital staff members provided additional details. Not unexpectedly, the survey confirmed the very low level of activity and identified a number of specific issues that need to be addressed in order to enhance cancer control activities in public hospitals. Given the relatively higher level of activity, and the prominence of cigarette smoking and alcohol consumption as health issues, one approach might be to initially concentrate on these areas when they are related to the patient's condition.
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Swerissen, Hal. "Editorial: Strengthening clinical governance in primary health and community care." Australian Journal of Primary Health 11, no. 1 (2005): 2. http://dx.doi.org/10.1071/py05001.
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Large numbers of people die each year in hospitals as a result of preventable errors. High profile cases like the Royal Bristol Infirmary in the UK or the King Edward Memorial Hospital in Western Australia highlight the problem in the popular media, putting pressure on governments, providers and the professions to improve safety and quality in hospitals. In Australia, the Quality in Australian Health Care study reviewed the medical records of 14,179 admissions to 28 hospitals and found that an adverse event occurred in 16.6% of cases, with 51% considered to have been preventable (Wilson et al., 1995).
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Lambert, Robyn, Naomi Burgess, Nadine Hillock, Joy Gailer, Pravin Hissaria, Tracy Merlin, Chris Pearson, Benjamin Reddi, Michael Ward, and Catherine Hill. "South Australian Medicines Evaluation Panel in review: providing evidence-based guidance on the use of high-cost medicines in the South Australian public health system." Australian Health Review 45, no. 2 (2021): 207. http://dx.doi.org/10.1071/ah20018.
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ObjectiveThe South Australian Medicines Evaluation Panel (SAMEP) was established in 2011 to make evidence-based recommendations on the funding of high-cost medicines in South Australian public hospitals via a high-cost medicines formulary. SAMEP represents one component of South Australia’s process for state-based health technology assessment (HTA). The aim of this study was to describe the experience of SAMEP in the context of Australia’s complex governance model for hospital-based care. MethodsA retrospective review was conducted of the SAMEP process and outcomes of medicine evaluations. Decision summaries and meeting minutes were reviewed and reflected upon by the authors to explore the views of the SAMEP membership regarding the function of the committee and state-based HTA more broadly. ResultsSAMEP has reviewed 29 applications, with 14 (48%) listed on the high-cost medicines formulary. Three applications have been the subject of outcome review and confirm expectations of patient benefit. ConclusionRetrospective review of the committee experience suggests that state-based HTA as operationalised by SAMEP is feasible, provides greater equity of access to high-cost medicines in the South Australian public hospital system and allows for access with evidence development. What is known about the topic?State-based hospital funders often need to make decisions on the provision of high-cost medicines for which there is no national guidance or subsidy. Little published information exists about state-based approaches to medicines evaluation and reimbursement within public hospitals in Australia. What does this paper add?The South Australian experience demonstrates a method for states and territories to tackle the challenges of providing evidence-based access to high-cost medicines in Australian public hospitals. What are the implications for practitioners?This paper provides information for other jurisdictions considering state-based approaches to medicines evaluation and contributes to the broader literature about state-based HTA in Australia.
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Moss, John. "Funding of South Australian public hospitals." Australian Health Review 25, no. 1 (2002): 156. http://dx.doi.org/10.1071/ah020156.
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Since the 1994-95 financial year, inpatient episodes of care in South Australian public hospitals have been funded according to their casemix. This paper describes the current funding system, sets it in some context and examines what can be established about hospital performance.
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Agarwal, Renu, Roy Green, Neeru Agarwal, and Krithika Randhawa. "Benchmarking management practices in Australian public healthcare." Journal of Health Organization and Management 30, no. 1 (March 21, 2016): 31–56. http://dx.doi.org/10.1108/jhom-07-2013-0143.
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Purpose – The purpose of this paper is to investigate the quality of management practices of public hospitals in the Australian healthcare system, specifically those in the state-managed health systems of Queensland and New South Wales (NSW). Further, the authors assess the management practices of Queensland and NSW public hospitals jointly and globally benchmark against those in the health systems of seven other countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. Design/methodology/approach – In this study, the authors adapt the unique and globally deployed Bloom et al. (2009) survey instrument that uses a “double blind, double scored” methodology and an interview-based scoring grid to measure and internationally benchmark the management practices in Queensland and NSW public hospitals based on 21 management dimensions across four broad areas of management – operations, performance monitoring, targets and people management. Findings – The findings reveal the areas of strength and potential areas of improvement in the Queensland and NSW Health hospital management practices when compared with public hospitals in seven countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. Together, Queensland and NSW Health hospitals perform best in operations management followed by performance monitoring. While target management presents scope for improvement, people management is the sphere where these Australian hospitals lag the most. Practical implications – This paper is of interest to both hospital administrators and health care policy-makers aiming to lift management quality at the hospital level as well as at the institutional level, as a vehicle to consistently deliver sustainable high-quality health services. Originality/value – This study provides the first internationally comparable robust measure of management capability in Australian public hospitals, where hospitals are run independently by the state-run healthcare systems. Additionally, this research study contributes to the empirical evidence base on the quality of management practices in the Australian public healthcare systems of Queensland and NSW.
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Inglis, B., I. Heding, M. Merrylees, and P. R. Stewart. "Bacteriophage 604: a marker phage for multi-resistantStaphylococcus aureusin Australia." Epidemiology and Infection 104, no. 2 (April 1990): 211–18. http://dx.doi.org/10.1017/s0950268800059379.
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SUMMARYOf 28 multi-resistant isolates ofStaphylococcus aureuscollected during 1986 from hospitals in major cities around Australia, 27 were found to contain the same prophage (denoted phage 604). Hospital isolates carrying three or fewer resistance markers, and community isolates carrying one or no resistance markers, did not carry this prophage. Phage 604 does not confer antibiotic resistance on its lysogens, nor does it increase virulence in chick embryo assays. Phage 604 appears to be a correlate of antibiotic multi-resistance inS. aureusin Australia, and may provide a molecular marker for incipiently epidemic strains of this bacterium in Australian hospitals.
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Looi, Jeffrey CL, Tarun Bastiampillai, William Pring, Stephen R. Kisely, and Stephen Allison. "Private psychiatric hospital care in Australia: a descriptive analysis of casemix and outcomes." Australasian Psychiatry 30, no. 2 (November 27, 2021): 174–78. http://dx.doi.org/10.1177/10398562211051252.
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Objective: To provide a rapid clinical update on casemix, average length of stay, and the effectiveness of Australian private psychiatric hospitals. Methods: We conducted a descriptive analysis of the publicly available patient data from the Australian Private Hospitals Association Private Psychiatric Hospitals Data Reporting and Analysis Service website, from 2015–2016 to 2019–2020. This was compared with corresponding reporting on public and private hospitals from the Australian Institute of Health and Welfare, and Australian Mental Health Outcomes and Classification Network. Results: In 2019–2020, there were 72 private psychiatric hospitals in Australia with 3582 acute beds. There were 42,942 inpatients with 1,286,470 days of care, and a mean length of stay 19.6 days (SD 13.9) for the financial year 2019–2020. The main diagnoses were major affective and other mood disorders (49%), and alcohol and other substance abuse disorders (21%). Clinician-rated outcome measures, that is, the HoNOS, showed an improvement effect size of 1.64, while the patient-rated MHQ-14 showed an improvement effect size of 1.18. Results are similar for previous years. Conclusions: Private psychiatric hospitals provide substantial, effective psychiatric care.
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Travers, C., G. J. Byrne, N. A. Pachana, K. Klein, and L. Gray. "Delirium in Australian Hospitals: A Prospective Study." Current Gerontology and Geriatrics Research 2013 (2013): 1–8. http://dx.doi.org/10.1155/2013/284780.
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Objectives. Australian data regarding delirium in older hospitalized patients are limited. Hence, this study aimed to determine the prevalence and incidence of delirium among older patients admitted to Australian hospitals and assess associated outcomes.Method. A prospective observational study (n=493) of patients aged ≥70 years admitted to four Australian hospitals was undertaken. Trained research nurses completed comprehensive geriatric assessments using standardized instruments including the Confusion Assessment Method to assess for delirium. Nurses also visited the wards daily to assess for incident delirium and other adverse outcomes. Diagnoses of dementia and delirium were established through case reviews by independent physicians.Results. Overall, 9.7% of patients had delirium at admission and a further 7.6% developed delirium during the hospital stay. Dementia was the most important predictor of delirium at (OR=3.18, 95% CI: 1.65–6.14) and during the admission (OR=4.82; 95% CI: 2.19–10.62). Delirium at and during the admission predicted increased in-hospital mortality (OR=5.19, 95% CI: 1.27–21.24;OR=31.07, 95% CI: 9.30–103.78).Conclusion.These Australian data confirm that delirium is a common and serious condition among older hospital patients. Hospital clinicians should maintain a high index of suspicion for delirium in older patients.
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O'Rourke, Michael F., and C. Siân Davies. "Cardiac arrest in Australian hospitals." Medical Journal of Australia 179, no. 9 (November 2003): 461–62. http://dx.doi.org/10.5694/j.1326-5377.2003.tb05647.x.
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McGain, Forbes, Grant A. Blashki, Kevin P. Moon, and Fiona M. Armstrong. "Mandating sustainability in Australian hospitals." Medical Journal of Australia 190, no. 12 (June 2009): 719–20. http://dx.doi.org/10.5694/j.1326-5377.2009.tb02659.x.
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Jelinek, George A., and G. Michael Calvin. "Observation wards in Australian hospitals." Medical Journal of Australia 151, no. 2 (July 1989): 80–83. http://dx.doi.org/10.5694/j.1326-5377.1989.tb101166.x.
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McManus, Peter. "Cardiovascular drugs in Australian hospitals." Medical Journal of Australia 157, no. 10 (November 1992): 717. http://dx.doi.org/10.5694/j.1326-5377.1992.tb137447o.x.
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McNeill, Paul M., Julie D. Walters, and Ian W. Webster. "Ethical issues in Australian hospitals." Medical Journal of Australia 160, no. 2 (January 1994): 63–65. http://dx.doi.org/10.5694/j.1326-5377.1994.tb126515.x.
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McNeil, John J., and Stephen R. Leeder. "How safe are Australian hospitals?" Medical Journal of Australia 163, no. 9 (November 1995): 472–75. http://dx.doi.org/10.5694/j.1326-5377.1995.tb124692.x.
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McGain, Forbes. "Sustainable hospitals? An Australian perspective." Perspectives in Public Health 130, no. 1 (January 2010): 19–20. http://dx.doi.org/10.1177/1757913909354147.
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Pugliese, Gina, and Martin S. Favero. "Surveillance Methods in Australian Hospitals." Infection Control & Hospital Epidemiology 21, no. 3 (March 2000): 238. http://dx.doi.org/10.1017/s0195941700052255.
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Sharma, Yogesh, Chris Horwood, Paul Hakendorf, John Au, and Campbell Thompson. "Characteristics and clinical outcomes of index versus non-index hospital readmissions in Australian hospitals: a cohort study." Australian Health Review 44, no. 1 (2020): 153. http://dx.doi.org/10.1071/ah18040.
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Objective Risk factors and clinical outcomes of non-index hospital readmissions (readmissions to a hospital different from the previous admission) have not been studied in Australia. The present study compared characteristics and clinical outcomes between index and non-index hospital readmissions in the Australian healthcare setting. Methods This retrospective cohort study included medical admissions from 2012 to 2016 across all major public hospitals in South Australia. Readmissions within 30 day to all public hospitals were captured using electronic health information system. In-hospital mortality and readmission length of hospital stay (LOS) were compared, along with 30-day mortality and subsequent readmissions among patients readmitted to index or non-index hospitals. Results Of 114105 index admissions, there were 20539 (18.0%) readmissions. Of these, 17519 (85.3%) were index readmissions and 3020 (14.7%) were non-index readmissions. Compared with index readmissions, patients in the non-index readmissions group had a lower Charlson comorbidity index, shorter LOS and fewer complications during the index admission and were more likely to be readmitted with a different diagnosis to the index admission. No difference in in-hospital mortality was observed, but readmission LOS was shorter and 30-day mortality was higher among patients with non-index readmissions. Conclusion A substantial proportion of patients experienced non-index hospital readmissions. Non-index hospital readmitted patients had no immediate adverse outcomes, but experienced worse 30-day outcomes. What is known about the topic? A significant proportion of unplanned hospital readmissions occur to non-index hospitals. North American studies suggest that non-index hospital readmissions are associated with worse outcomes for patients due to discontinuity of care, medical reconciliation and delayed treatment. Limited studies have determined factors associated with non-index hospital readmissions in Australia, but whether such readmissions lead to adverse clinical outcomes is unknown. What does this paper add? In the Australian healthcare setting, 14.7% of patients were readmitted to non-index hospitals. Compared with index hospital readmissions, patients admitted to non-index hospitals had a lower Charlson comorbidity index, a shorter index LOS and fewer complications during the index admission. At the time of readmission there was no differences in discharge summary completion rates between the two groups. Unlike other studies, the present study found no immediate adverse outcomes for patients readmitted to non-index hospitals, but 30-day outcomes were worse than for patients who had an index hospital readmission. What are the implications for practitioners? Non-index hospital readmissions may not be totally preventable due to factors such as ambulance diversions stemming from emergency department overcrowding and prolonged emergency department waiting times. Patients should be advised to re-present to hospital in case they experience recurrence or relapse of a medical condition, and preferably should be readmitted to the same hospital to prevent discontinuity of care.
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Ma, Yunlong, Sherif Zedan, Aaron Liu, and Wendy Miller. "Impact of a Warming Climate on Hospital Energy Use and Decarbonization: An Australian Building Simulation Study." Buildings 12, no. 8 (August 19, 2022): 1275. http://dx.doi.org/10.3390/buildings12081275.
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The high energy use of hospitals and healthcare facilities globally contributes to greenhouse gas emissions. At the same time, a large percentage of this energy use is attributed to space heating, cooling and ventilation, and is hence correlated to the climate. While the energy performance of Australian hospitals at the design stage is evaluated using historical weather data, the impact of the warming climate on Australian hospitals into the future remains unknown. The research question addressed is: What is the impact of future climates on the energy use of Australian hospitals built with the current design conditions? Two archetype hospital models were developed (a small single-story healthcare facility and a large multi-story hospital). DesignBuilder was used to simulate the performance of these models in 10 locations, ranging from the tropics to cool temperate regions in Australia. Current (1990–2015) and future climate files (2030, 2050, 2070 and 2090) were used. The results show that with the warming climate, the heating demand decreased, while the cooling demand increased for both hospital models for all sites. Cooling dominated climates, such as Darwin and Brisbane, were significantly impacted by the changing climates due to a substantial increase in cooling energy use. Heating based climates, such as Hobart and Canberra, resulted in an overall small reduction in total building energy use. In addition, the single-story facility was more impacted by the change in climate (in terms of energy use intensity) than the multi-story facility. The study highlights the importance of future climate files in building simulation and decarbonization planning.
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Roff, Michael. "A Private Hospitals Perspective." Australian Health Review 26, no. 1 (2003): 5. http://dx.doi.org/10.1071/ah030005.
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Renwick, Manoa. "Quality Assurance in Australian Hospitals: How Far Does it Go?" Australian Medical Record Journal 18, no. 3 (September 1988): 97–101. http://dx.doi.org/10.1177/183335838801800304.
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The Australian Institute of Health (AIH) surveyed all acute hospitals in Australia to discover the extent of quality assurance (QA) activities, the types of programs being run and the processes being used. This paper explains the Institute's research strategy and puts the survey into the context of QA in Australia today. It describes the research method, identifies sources of bias, and presents some of the results. These show that medical record administrators (MRAs) play an active role in QA by coordinating hospital programs, by implementing individual reviews of their own departments, and by servicing other departmental reviews. The results pertaining to the extent and nature of QA are discussed and it is concluded that there seems to be some review of the quality of care for the majority of hospital patients. The effectiveness of that review, and whether or not it is quality assurance, still has to be investigated. (AMRJ 1988, 18(3), 97–101).
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Keys, Cathy. "Designing hospitals for Australian conditions: The Australian Inland Mission's cottage hospital, Adelaide House, 1926." Journal of Architecture 21, no. 1 (January 2, 2016): 68–89. http://dx.doi.org/10.1080/13602365.2016.1141790.
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Assareh, Hassan, Helen M. Achat, and Jean-Frederic Levesque. "Accuracy of inter-hospital transfer information in Australian hospital administrative databases." Health Informatics Journal 25, no. 3 (December 18, 2017): 960–72. http://dx.doi.org/10.1177/1460458217730866.
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Inter-hospital transfers improve care delivery for which sending and receiving hospitals both accountable for patient outcomes. We aim to measure accuracy in recorded patient transfer information (indication of transfer and hospital identifier) over 2 years across 121 acute hospitals in New South Wales, Australia. Accuracy rate for 127,406 transfer-out separations was 87 per cent, with a low variability across hospitals (10% differences); it was 65 per cent for 151,978 transfer-in admissions with a greater inter-hospital variation (36% differences). Accuracy rate varied by departure and arrival pathways; at receiving hospitals, it was lower for transfer-in admission via emergency department (incidence rate ratio = 0.52, 95% confidence interval: 0.51–0.53) versus direct admission. Transfer-out data were more accurate for transfers to smaller hospitals (incidence rate ratio = 1.06, 95% confidence interval: 1.03–1.08) or re-transfers (incidence rate ratio > 1.08). Incorporation of transfer data from sending and receiving hospitals at patient level in administrative datasets and standardisation of documentation across hospitals would enhance accuracy and support improved attribution of hospital performance measures.
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Assareh, Hassan, Jack Chen, Lixin Ou, Stephanie J. Hollis, Kenneth Hillman, and Arthas Flabouris. "Rate of venous thromboembolism among surgical patients in Australian hospitals: a multicentre retrospective cohort study." BMJ Open 4, no. 10 (October 2014): e005502. http://dx.doi.org/10.1136/bmjopen-2014-005502.
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ObjectivesDespite the burden of venous thromboembolism (VTE) among surgical patients on health systems in Australia, data on VTE incidence and its variation within Australia are lacking. We aim to explore VTE and subsequent mortality rates, trends and variations across Australian acute public hospitals.SettingA large retrospective cohort study using all elective surgical patients in 82 acute public hospitals during 2002–2009 in New South Wales, Australia.ParticipantsPatients underwent elective surgery within 2 days of admission, aged between 18 and 90 years, and who were not transferred to another acute care facility; 4 362 624 patients were included.Outcome measuresVTE incidents were identified by secondary diagnostic codes. Poisson mixed models were used to derive adjusted incidence rates and rate ratios (IRR).Results2/1000 patients developed postoperative VTE. VTE increased by 30% (IRR=1.30, CI 1.19 to 1.42) over the study period. Differences in the VTE rates, trends between hospital peer groups and between hospitals with the highest and those with the lowest rates were significant (between-hospital variation). Smaller hospitals, accommodated in two peer groups, had the lowest overall VTE rates (IRR=0.56:0.33 to 0.95; IRR=0.37:0.23 to 0.61) and exhibited a greater increase (64% and 237% vs 19%) overtime and greater between-hospital variations compared to larger hospitals (IRR=8.64:6.23 to 11.98; IRR=8.92:5.49 to 14.49 vs IRR=3.70:3.32 to 4.12). Mortality among patients with postoperative VTE was 8% and remained stable overtime. No differences in post-VTE death rates and trends were seen between hospital groups; however, larger hospitals exhibited less between-hospital variations (IRR=1.78:1.30 to 2.44) compared to small hospitals (IRR>23). Hospitals performed differently in prevention versus treatment of postoperative VTE.ConclusionsVTE incidence is increasing and there is large variation between-hospital and within-hospital peer groups suggesting a varied compliance with VTE preventative strategies and the potential for targeted interventions and quality improvement opportunities.
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Cotta, Menino O., Megan S. Robertson, Caroline Marshall, Karin A. Thursky, Danny Liew, and Kirsty L. Buising. "Implementing antimicrobial stewardship in the Australian private hospital system: a qualitative study." Australian Health Review 39, no. 3 (2015): 315. http://dx.doi.org/10.1071/ah14111.
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Objective To explore organisational factors and barriers contributing to limited uptake of antimicrobial stewardship (AMS) in Australian private hospitals and to determine solutions for AMS implementation. Methods A qualitative study using a series of focus group discussions was conducted in a large private hospital making use of a semistructured interview guide to facilitate discussion among clinical and non-clinical stakeholders. A thematic analysis using five sequential components that mapped and interpreted emergent themes surrounding AMS implementation was undertaken by a multidisciplinary team of researchers. Results Analysis revealed that autonomy of consultant specialists was perceived as being of greater significance in private hospitals compared with public hospitals. Use of an expert team providing antimicrobial prescribing advice and education without intruding on existing patient–specialist relationships was proposed by participants as an acceptable method of introducing AMS in private hospitals. There was more opportunity for nursing and pharmacist involvement, as well as empowering patients. Opportunities were identified for the hospital executive to market an AMS service as a feature that promoted excellence in patient care. Conclusions Provision of advice from experts, championing by clinical leaders, marketing by hospital executives and involving nurses, pharmacists and patients should be considered during implementation of AMS in private hospitals. What is known about the topic? Hospital-wide AMS programs have been shown to be an effective means to address the problem of accelerating antimicrobial resistance. However, current literature predominantly focuses on evaluation of AMS activities rather than on improving implementation success. In addition, most research on hospital AMS programs is from the public hospital sector. AMS is now part of new National Safety and Quality Health Service accreditation standards mandatory for all Australian hospitals; however, uptake of AMS in private hospitals lags behind public hospitals. Australian private hospitals are fundamentally different to public hospitals and there is more information needed to determine how AMS can best be introduced in these hospitals. What does this paper add? Further investigation on how AMS can be implemented into private hospitals is urgently required. The qualitative work detailed in the present study provides a means of tailoring AMS strategies on the basis of organisational factors that may be considered unique to Australian private hospitals. What are the implications for practitioners? Clinical and hospital executive stakeholders in the private hospital sector will be able to use solutions presented herein as a blueprint for designing sustainable AMS programs within their private healthcare facilities.
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Hay, Patricia, Kathy Wilton, Jennifer Barker, Julie Mortley, and Megan Cumerlato. "The importance of clinical documentation improvement for Australian hospitals." Health Information Management Journal 49, no. 1 (July 14, 2019): 69–73. http://dx.doi.org/10.1177/1833358319854185.
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Clinical documentation improvement (CDI) is a recent initiative gaining increased momentum in Australia. The benefits surrounding its success internationally include improved quality and patient safety outcomes and increased reimbursement. The premise of CDI is simple: engage clinicians to improve the clinical documentation in the medical record in “real time” so that it is fit for reporting, analysis and reimbursement. Every country has differing healthcare systems and this article has focused on validating the relevancy of CDI for the Australian healthcare environment.
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Broom, Alex, Jennifer Broom, Emma Kirby, and Jon Adams. "The social dynamics of antibiotic use in an Australian hospital." Journal of Sociology 52, no. 4 (July 10, 2016): 824–39. http://dx.doi.org/10.1177/1440783315594486.
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Misuse of antibiotics in hospitals in Australia and internationally is common. The combination of multi-resistant organisms and continued misuse of antibiotics is contributing to a predicted ‘antimicrobial perfect storm’ in the coming decades. Attempts to influence doctors’ use of antibiotics have seen limited success internationally, yet few studies have explored the potential social factors driving current practices within hospitals and the interpersonal processes that underpin persistent ‘suboptimal’ antibiotic use. In this qualitative study of hospital-based Australian doctors we explore some of these dynamics including: the role of clinical uncertainty and ambivalence; experiences of immediate risk; interpersonal and intra-professional pressure; and the role of localised norms and ‘craft groups’ in driving antibiotic practices. We argue that the development of a sociological understanding of antibiotic misuse in the hospital sector (and beyond) is vital for progress to be made in protecting antibiotics for future generations.
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Ferguson, Chantal, Robert Fletcher, Portia Ho, and Elizabeth MacLeod. "Should Australian states and territories have designated COVID hospitals in low community transmission? Case study for Western Australia." Australian Health Review 44, no. 5 (2020): 728. http://dx.doi.org/10.1071/ah20199.
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This case study describes the process of selecting the most appropriate state-wide hospital system to manage COVID-19 cases in a setting of low community transmission of COVID-19 infection. A rapid review of the literature was conducted of the advantages and disadvantages of having designated COVID hospitals. This led to three different options being presented for discussion. Following consultation, the option chosen was for all hospital facilities to remain prepared to care for COVID-19 patients where they present rather than having specified designated hospitals because this was considered the most practical option currently.
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Dowling, John. "The strategy of casemix." Australian Health Review 18, no. 4 (1995): 105. http://dx.doi.org/10.1071/ah950105.
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While the political debate rages over whether casemix brings economic benefitsfor Australian health care, managers are observing a pragmatic change to theirbusiness and some are using casemix to understand and manage their businessbetter. Casemix is a useful tool in this environment of increasing managementaccountability and process re-engineering.This article reviews casemix from a process innovation perspective; commentson its real use for strategic health care management; and suggests a simple matrixused by St John of God hospitals throughout Australia to implement and measureprogress towards quality casemix-managed hospitals. The management motivationfor this matrix was to promote hospital resourcing decisions supplemented bycasemix information.
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Cadilhac, Dominique A., Nadine E. Andrew, Monique F. Kilkenny, Kelvin Hill, Brenda Grabsch, Natasha A. Lannin, Amanda G. Thrift, et al. "Improving quality and outcomes of stroke care in hospitals: Protocol and statistical analysis plan for the Stroke123 implementation study." International Journal of Stroke 13, no. 1 (September 15, 2017): 96–106. http://dx.doi.org/10.1177/1747493017730741.
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Rationale The effectiveness of clinician-focused interventions to improve stroke care is uncertain. Aims To determine whether an organizational intervention can improve the quality of stroke care over usual care. Sample size estimates To detect an absolute 10% difference in overall performance (composite outcome), a minimum of 21 hospitals and 843 patients per group was determined. Methods and design Before and after controlled design in hospitals in Queensland, Australia. Intervention Externally facilitated program (StrokeLink) using outreach workshops incorporating clinical performance feedback, patient outcomes (survival, quality of life at 90–180 days), local barrier assessments to best practice care, action planning, and ongoing support. Descriptive and multivariable analyses adjusted for patient correlations by hospital (intention-to-treat method). Context Concurrent implementation of financial incentives to increase stroke unit access and use of the Australian Stroke Clinical Registry for performance monitoring. Study outcome(s) Primary outcome: net change in composite score (i.e. total number of process indicators achieved divided by the sum of eligible indicators for each cohort). Secondary outcomes: change in individual indicators, change in composite score comparing hospitals that did or did not develop action plans (per-protocol analysis), impact on 90–180-day health outcomes. Sensitivity analyses: hospital self-rated status, alternate cross-sectional audit data (Stroke Foundation). To account for temporal effects, comparison of Queensland hospital performance relative to other Australian hospitals will also be undertaken. Discussion Twenty-one hospitals were recruited; however, one was unable to participate within the study time frame. Workshops were held between 11 March 2014 and 7 November 2014. Data are ready for analysis.
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Atkins, Emily R., Elizabeth A. Geelhoed, Lee Nedkoff, and Tom G. Briffa. "Disparities in equity and access for hospitalised atherothrombotic disease." Australian Health Review 37, no. 4 (2013): 488. http://dx.doi.org/10.1071/ah13083.
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Objective. This study of equity and access characterises admissions for coronary, cerebrovascular and peripheral arterial disease by hospital type (rural, tertiary and non-tertiary metropolitan) in a representative Australian population. Methods. We conducted a descriptive analysis using data linkage of all residents aged 35–84 years hospitalised in Western Australia with a primary diagnosis for an atherothrombotic event in 2007. We compared sociodemographic and clinical features by atherothrombotic territory and hospital type. Results. There were 11670 index admissions for atherothrombotic disease in 2007 of which 46% were in tertiary hospitals, 41% were in non-tertiary metropolitan hospitals and 13% were in rural hospitals. Coronary heart disease comprised 72% of admissions, followed by cerebrovascular disease (19%) and peripheral arterial disease (9%). Comparisons of socioeconomic disadvantage reveal that for those admitted to rural hospitals, more than one-third were in the most disadvantaged quintile, compared with one-fifth to any metropolitan hospital. Conclusions. Significant differences in demographic characteristics were evident between Western Australian tertiary and non-tertiary hospitals for patients hospitalised for atherothrombotic disease. Notably, the differences among tertiary, non-tertiary metropolitan and rural hospitals were related to socioeconomic disadvantage. This has implications for atherothrombotic healthcare provision and the generalisation of research findings from studies conducted exclusively in the tertiary metropolitan hospitals. What is known about the topic? Equity and access to hospital care for atherothrombotic disease in a geographically diverse population is poorly characterised. National data show that both fatal and non-fatal coronary heart disease and non-fatal stroke hospitalisations increase with remoteness. Fatal in-hospital stroke is greatest in major cities, whereas peripheral arterial disease hospitalisations are greatest in the inner and outer regional areas. What does this paper add? This study demonstrates that around 13% of atherothrombotic events were treated in rural hospitals with in-hospital case fatality higher than in tertiary and non-tertiary metropolitan hospitals. A greater proportion of atherothrombotic disease cases treated in rural hospitals were in the most disadvantaged Socioeconomic Indices For Area group. What are the implications for practitioners? It is important to consider differences in disadvantage when generalising results of studies generated from tertiary hospital data to non-tertiary metropolitan and rural patients.
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Bruxner, George, Peter Burvill, Sam Fazio, and Sam Febbo. "Aspects of Psychiatric Admissions of Migrants to Hospitals in Perth, Western Australia." Australian & New Zealand Journal of Psychiatry 31, no. 4 (August 1997): 532–42. http://dx.doi.org/10.3109/00048679709065075.
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Objective: Recent Australian Government initiatives have emphasised problems with service provision to the ethnic mentally ill. This study aims to address the paucity of contemporary data describing the disposition of the ethnic mentally ill in hospital settings. Method: Patterns of admissions for psychiatric disorders to all hospitals in Perth, Western Australia, for the 3 years from 1990 to 1992, of migrants and the Australian born were compared using data from the Western Australian Mental Health Information System. Results: The overall rates for European migrants showed a ‘normalisation’ towards those of the Australian-born. There were high rates for the schizophrenic spectrum disorders in Polish and Yugoslavian (old terminology) migrants. There were low admission rates for South-East Asian migrants, predominantly those from Vietnam and Malaysia. Rates for alcoholism were low in Italian and all Asian migrants. There were high rates of organic psychosis, especially in those older than 75 years, among the Italian and Dutch migrants. The relative risk of a first admission in the 3 years being an involuntary admission to a mental hospital was almost twice that of the Australian-born for migrants from Poland, Yugoslavia, Malaysia and Vietnam. Conclusions: The results imply the possibility of significant untreated and/or undiagnosed psychiatric morbidity in the South-East Asian-born. They also indicate a need for further exploration of the unexpectedly high levels of psychiatric morbidity among some ethnic elderly groups, specifically the Dutch- and Italian-born. The findings demonstrate the persistence of high rates of presentation for psychotic disorders among Eastern European-born populations, many years post migration.
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Bloom, Abby L. "The funding of private hospitals in Australia." Australian Health Review 25, no. 1 (2002): 19. http://dx.doi.org/10.1071/ah020019.
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Private hospitals are an essential component of Australia's complex mix of public and private health funding and provision. Private hospitals account for 34.3 per cent of all hospital separations, and over half (56.2%) of all same-dayseparations. The revenue (funding) of the sector approached $4 billion by 1998/99, and as a result of its recent rapid growth capital expenditure in the sector was nearly $550 million in the same year. Private casemix of privatehospitals is distinctive, and characterised by a high proportion of surgical procedures in general (48.1per cent), andmore than a majority of all services in such areas as rehabilitation, orthopaedics (shoulder, knee, spinal fusion, and hand surgery), alcohol disorders, same day colonoscopy and sleep disorders. This chapter synthesises data from amultitude of sources to produce a comprehensive picture of Australia's private hospital sector and its funding. It examines the funding (revenue) sources of private hospitals, and considers how and why private hospitals approach theissue of funding from a different perspective than their public sector colleagues. To illustrate how Australian privatehospitals approach revenue (funding) strategically, a series of indicative types of hospitals is explored.
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Farrell, Lindsay, Paula Schulz, and Monica Nebauer. "Art Research in Australian Catholic Hospitals." International Journal of Social, Political and Community Agendas in the Arts 11, no. 4 (2016): 11–26. http://dx.doi.org/10.18848/2326-9960/cgp/v11i04/11-26.
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McNeill, Paul M., Julie D. Walters, and Ian W. Webster. "Ethics decision‐making in Australian hospitals." Medical Journal of Australia 161, no. 8 (October 1994): 487–88. http://dx.doi.org/10.5694/j.1326-5377.1994.tb127562.x.
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Schapper, P. R. "PRICE INDICES FOR AUSTRALIAN PUBLIC HOSPITALS." Community Health Studies 5, no. 3 (February 12, 2010): 250–62. http://dx.doi.org/10.1111/j.1753-6405.1981.tb00332.x.
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Zinn, C. "14000 preventable deaths in Australian hospitals." BMJ 310, no. 6993 (June 10, 1995): 1487. http://dx.doi.org/10.1136/bmj.310.6993.1487.
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Jeganathan, V. Swetha, Stuart R. Walker, and Chris Lawrence. "RESUSCITATING THE AUTOPSY IN AUSTRALIAN HOSPITALS." ANZ Journal of Surgery 76, no. 4 (April 2006): 205–7. http://dx.doi.org/10.1111/j.1445-2197.2006.03703.x.
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BUCHAN, HEATHER, and CHRISTOPHER BROOK. "Quality in Australian Hospitals—Who Cares?" International Journal for Quality in Health Care 9, no. 4 (1997): 243–44. http://dx.doi.org/10.1093/intqhc/9.4.243.
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Lane, Karen, and Kerreen Reiger. "Regime change in Australian maternity hospitals." Social Theory & Health 11, no. 4 (May 8, 2013): 407–27. http://dx.doi.org/10.1057/sth.2013.7.
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Dussel, Veronica, Kira Bona, John A. Heath, Joanne M. Hilden, Jane C. Weeks, and Joanne Wolfe. "Unmeasured Costs of a Child's Death: Perceived Financial Burden, Work Disruptions, and Economic Coping Strategies Used by American and Australian Families Who Lost Children to Cancer." Journal of Clinical Oncology 29, no. 8 (March 10, 2011): 1007–13. http://dx.doi.org/10.1200/jco.2009.27.8960.
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Purpose Financial concerns represent a major stressor for families of children with cancer but remain poorly understood among those with terminally ill children. We describe the financial hardship, work disruptions, income loss, and coping strategies of families who lost children to cancer. Methods Retrospective cross-sectional survey of 141 American and 89 Australian bereaved parents whose children died between 1990 and 1999 and 1996 to 2004, respectively, at three tertiary-care pediatric hospitals (two American, one Australian). Response rate: 63%. Results Thirty-four (24%) of 141 families from US centers and 34 (39%) of 88 families from the Australian center reported a great deal of financial hardship resulting from their children's illness. Work disruptions were substantial (84% in the United States, 88% in Australia). Australian families were more likely to report quitting a job (49% in Australia v 35% in the United States; P = .037). Sixty percent of families lost more than 10% of their annual income as a result of work disruptions. Australians were more likely to lose more than 40% of their income (34% in Australia v 19% in the United States; P = .035). Poor families experienced the greatest income loss. After accounting for income loss, 16% of American and 22% of Australian families dropped below the poverty line. Financial hardship was associated with poverty and income loss in all centers. Fundraising was the most common financial coping strategy (52% in the United States v 33% in Australia), followed by reduced spending. Conclusion In these US and Australian centers, significant household-level financial effects of a child's death as a result of cancer were observed, especially for poor families. Interventions aimed at reducing the effects of income loss may ease financial distress.