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Hindle, Don. "Health care funding in the Australian Capital Territory: From hospital to community." Australian Health Review 25, no. 1 (2002): 121. http://dx.doi.org/10.1071/ah020121.
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This paper presents an outline of the socio-demographic features of the Australian Capital Territory (the ACT) and of its health care system. I describe how health care resources are allocated in the government sector, present a moredetailed description of the way that hospital services are purchased, and summarise the government's policy directions for health. I argue that the main directions are sensible, and particularly those that support more integrated care that is largely based in the community. There appear to be no major weaknesses in the budget-share output-based funding model used in the purchase of hospital services, although the rationale for some of the components might be clarified.In total, the ACT government appears to be on the right track. However, I argue that more rapid progress might bepossible if there were greater collaboration between the Territory health authority and the relatively powerful private medical profession.
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Townsend, Michelle. "Educational outcomes of children on guardianship or custody orders: A pilot study: Australian Institute of Health and Welfare." Children Australia 32, no. 3 (2007): 4–5. http://dx.doi.org/10.1017/s1035077200011603.
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The Australian Institute of Health and Welfare (AIHW) has recently released a report on the educational outcomes for children and young people on guardianship or custody orders. This report, four years in the making, represents one of the first comprehensive Australian assessments based on educational performance data from multiple jurisdictions for children on guardianship or custody orders. Developed for the National Child Protection and Support Services data group, the study was funded by the Community and Disability Services Ministers’ Advisory Council (AIHW 2007).This pilot study examines how children on guardianship/custody orders are performing compared with all Australian children in education department-based testing for reading and numeracy in years 3, 5 and 7. Mean test scores were examined in addition to the achievement of national benchmarks for reading and numeracy. These nationally agreed benchmarks are designed to assess whether children have achieved the minimum standards for years 3, 5 and 7 (AIHW 2007). Data on 895 children on guardianship or custody orders were collected from five jurisdictions - Queensland, Victoria, South Australia, Tasmania and the Australian Capital Territory - for August 2003 (AIHW 2007). The data were linked through collaborative efforts by state and territory education and community services departments.
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D'Cunha, Nathan, Jane Kellett, Stephen Isbel, Elizabeth Low, Stephanie Mulhall, Brittany Harriden, Felix Liu, et al. "Nutrition and Healthy Ageing Trajectories in Retirement Living in the Australian Capital Territory: Study Protocol." Current Developments in Nutrition 5, Supplement_2 (June 2021): 1271. http://dx.doi.org/10.1093/cdn/nzab057_001.
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Abstract Objectives There are a growing number of people aged over 55 years living in retirement communities in Australia. These communities typically consist of accommodation, services and community facilities which cater to older people and the desire to maintain independence. The Nutrition and Healthy Ageing Trajectories in Retirement Living (NutriHAT-RL) study aims to investigate the nutrition and lifestyle-based behaviours which contribute to healthy ageing and the maintenance of social and physical functioning among older people living in retirement communities. Methods This study will recruit a total of 2,770 people aged 55 years or over living in retirement communities in the Australian Capital Territory and southern New South Wales regions of Australia for a four-year prospective longitudinal study commencing in March 2021. A range of measures, including nutritional intake, health and lifestyle behaviours, cognitive and psychological function, and physical health, will be completed on three occasions over a total of four years. Participants will complete a face-to-face comprehensive, validated food frequency questionnaire at each time point. Risk of malnutrition and nutritional behaviour (emotional appetite and intuitive eating) will also be evaluated. Multiple mental, social, and physical health domains will be assessed at each time point. This will include cognitive and mental health (depression, anxiety, and loneliness) screening, social and occupational functioning questionnaires, self-reported and observed physical function assessments, and sleep quality. Bitter taste endophenotype, salivary C-reactive protein, telomere length, and blood biomarkers associated with healthy ageing will also be evaluated. Results Ethics approval has been obtained through the University of Canberra Human Ethics Research Committee (UCHREC-2306). To reduce risk of COVID-19 transmissions, a risk mitigation plan has been developed. Conclusions The NutriHAT-RL study will be the first Australian longitudinal study with a focus on nutrition and healthy ageing in people living in retirement communities. Findings from this study will contribute to understanding of nutrition and healthy ageing in this growing population and will inform policy and practice related to nutrition and ageing in place. Funding Sources N/A.
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Borotkanics, Robert, Cassandra Rowe, Andrew Georgiou, Heather Douglas, Meredith Makeham, and Johanna Westbrook. "Changes in the profile of Australians in 77 residential aged care facilities across New South Wales and the Australian Capital Territory." Australian Health Review 41, no. 6 (2017): 613. http://dx.doi.org/10.1071/ah16125.
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Objective Government expenditure on and the number of aged care facilities in Australia have increased consistently since 1995. As a result, a range of aged care policy changes have been implemented. Data on demographics and utilisation are important in determining the effects of policy on residential aged care services. Yet, there are surprisingly few statistical summaries in the peer-reviewed literature on the profile of Australian aged care residents or trends in service utilisation. Therefore, the aim of the present study was to characterise the demographic profile and utilisation of a large cohort of residential aged care residents, including trends over a 3-year period. Methods We collected 3 years of data (2011–14) from 77 residential aged care facilities and assessed trends and differences across five demographic and three service utilisation variables. Results The median age at admission over the 3-year period remained constant at 86 years. There were statistically significant decreases in separations to home (z = 2.62, P = 0.009) and a 1.35% increase in low care admissions. Widowed females made up the majority (44.75%) of permanent residents, were the oldest and had the longest lengths of stay. One-third of permanent residents had resided in aged care for 3 years or longer. Approximately 30% of residents were not born in Australia. Aboriginal residents made up less than 1% of the studied population, were younger and had shorter stays than non-Aboriginal residents. Conclusion The analyses revealed a clear demographic profile and consistent pattern of utilisation of aged care facilities. There have been several changes in aged care policy over the decades. The analyses outlined herein illustrate how community, health services and public health data can be used to inform policy, monitor progress and assess whether intended policy has had the desired effects on aged care services. What is known about the topic? Characterisation of permanent residents and their utilisation of residential aged care facilities is poorly described in the peer-reviewed literature. Further, publicly available government reports are incomplete or characterised using incomplete methods. What does this paper add? The analyses in the present study revealed a clear demographic profile and consistent pattern of utilisation of aged care facilities. The most significant finding of the study is that one-third of permanent residents had resided in an aged care facility for ≥3 years. These findings add to the overall picture of residential aged care utilisation in Australia. What are the implications for practitioners? The analyses outlined herein illustrate how community, health services and public health data can be utilised to inform policy, monitor progress and assess whether or not intended policy has had the desired effects on aged care services.
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Jakobs, Olivia M., Elizabeth M. O'Leary, Mark F. Cormack, and Guan C. Chong. "A working model for the extraordinary review of clinical privileges for doctors and dentists in the Australian Capital Territory." Australian Health Review 34, no. 2 (2010): 170. http://dx.doi.org/10.1071/ah08694.
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The extraordinary (unplanned) review of clinical privileges is the means by which an organisation can manage specific complaints about individual practitioners’ clinical competence that require immediate investigation. To date, the extraordinary review of clinical privileges for doctors and dentists has not been the subject of much research and there is a pressing need for the evaluation and review of how different legislated and non-legislated administrative processes work and what they achieve. Although it seems a fair proposition that comprehensive processes for the evaluation of the clinical competence of doctors and dentists may improve the overall delivery of an organisation’s clinical services, in fact, little is known about the relationship between the safety and quality of specific clinical services, procedures and interventions and the efficiency or effectiveness of established methodologies for the routine or the extraordinary review of clinical privileges. The authors present a model of a structured approach to the extraordinary review of clinical privileges within a clinical governance framework in the Australian Capital Territory. The assessment framework uses a primarily qualitative methodology, underpinned by a process of systematic review of clinical competence against the agreed standards of the CanMEDS Physician Competency Framework. The model is a practical, working framework that could be implemented on a hospital-, area health service- or state- and territory-wide basis in any other Australian jurisdiction. What is known about the topic?In Australia, there is a national standard for credentialing and defining the scope of clinical practice for doctors working in hospital settings. However, there are no published reports in the national arena on established processes for the extraordinary review of clinical privileges for doctors or dentists and, despite the major inquiries investigating health system failures in Australian hospitals, the effectiveness and adequacy of existing processes for the extraordinary review of clinical privileges has not yet been prioritised nationally as an area for improvement or reform. Internationally, health care organisations have also been slow to establish frameworks for the management of complaints about doctors or dentists. What does this paper add?This paper makes a significant contribution to the national and international safety and quality literature by presenting an exposition of a working model for the extraordinary review of clinical privileges of doctors and dentists. The authors describe a methodology in the public health sector that is territory-wide (not hospital-based), peer-reviewed, objective, fair and responsive. Because the model is a practical, working framework that could be implemented on a hospital-, area health service- or state- and territory-wide basis in any other Australian jurisdiction, this paper provides an opportunity for policy makers and legislators to drive innovative change. Although incursions into the provision of care by other health professionals have been avoided, the model could be readily adopted by clinical leaders from the nursing and allied health professions. What are the implications for practitioners?An organisation dedicated to investigating serious complaints with a real sense of urgency, objectivity and transparency is far less likely to fester a climate of disquiet or anger amongst staff, or to trigger concerns of a ‘cover-up’ or disregard for accountability than an organisation not adopting such an approach. Anecdotal experience suggests the model has the potential to minimise, if not prevent, the occurrence of the kinds of complaints that become much-publicised in the media. This is positive because these types of damaging high profile cases often have the effect of diminishing community confidence in the health care system, in particular, confidence in the medical profession’s ability to self-regulate. Often, they also lead to a misrepresentation of the medical profession in the media, which is unfair since the overwhelming majority of doctors do meet the standards of their profession.
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Reay, Rebecca, Scott Stuart, and Cathy Owen. "Implementation and Effectiveness of Interpersonal Psychotherapy in a Community Mental Health Service." Australasian Psychiatry 11, no. 3 (September 2003): 284–89. http://dx.doi.org/10.1046/j.1440-1665.2003.00574.x.
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Objective: Although the efficacy of a number of psychotherapeutic interventions has been well established in tightly controlled, randomized trials, there remains a paucity of literature examining the effectiveness of these interventions in community practice settings. In light of this, the Australian Capital Territory Mental Health Services (Canberra, ACT) set out to investigate the effectiveness of an empirically supported psychotherapeutic intervention, interpersonal psychotherapy (IPT). The present study describes a pilot evaluation of the training programme for health professionals and the IPT treatment programme. Methods: Forty community mental health professionals participated in intensive IPT training. Clinicians who completed a course of supervision were asked to apply the treatment with non-psychotic acutely depressed patients. Measures of patients’ health outcomes were taken before and after treatment using a standardized outcome measure. Results: A total of 17 out of 21 patients who were selected completed a course of 12–16 weeks of IPT. The majority of the patients had a depression originating in the post-partum period. A comparison of pre- and post-treatment scores of treatment completers revealed a significant decrease in mean depression scores. Clinicians who completed a course of training and supervision found that they were able to confidently apply IPT in a clinical setting. Conclusions: Although there were a number of barriers and obstacles to the introduction of an evidenced-based treatment, the results are promising and demonstrate that IPT can be readily taught to experienced mental health professionals. Further study is required to determine the feasibility of IPT in other non-academic settings using larger sample sizes and homogenous groups of patients.
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Jablensky, Assen, John McGrath, Helen Herrman, David Castle, Oye Gureje, Mandy Evans, Vaughan Carr, Vera Morgan, Ailsa Korten, and Carol Harvey. "Psychotic Disorders in Urban Areas: An Overview of the Study on Low Prevalence Disorders." Australian & New Zealand Journal of Psychiatry 34, no. 2 (April 2000): 221–36. http://dx.doi.org/10.1080/j.1440-1614.2000.00728.x.
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Objective: This paper reports on a study designed within the framework of the National Survey of Mental Health and Wellbeing to: estimate the prevalence of psychoses in urban areas of Australia; identify profiles of symptomatology, impairments and disabilities; collect information on services received and needed; and explore quality of life issues in a broadly representative sample of people with psychotic illnesses. Method: The study was conducted over four areas in the Australian Capital Territory, Queensland, Victoria and Western Australia, as a two-phase survey: (i) a census and screening for psychosis of all individuals who made contacts with mental health services during a period of 1 month in 1997; and (ii) interviews with a stratified random sample (n = 980) of the screen-positive individuals (n = 3800) using a standardised instrument. Results: The point prevalence (1 month) of psychotic disorders in the urban population aged 18–64 is in the range of 4–7 per 1000 with a weighted mean of 4.7 per 1000. People with psychotic disorders experience high rates of functional impairments and disability, decreased quality of life, persistent symptoms, substance-use comorbidity and frequent side effects of medication. Although the utilisation of hospital-based and community mental health services, as well as of public and non-governmental helping agencies, is high, the majority live in extreme social isolation and adverse socioeconomic circumstances. Among the many unmet needs, the limited availability of community-based rehabilitation, supported accommodation and employment opportunities is particularly prominent. Conclusions: The so-called ‘low-prevalence’ psychotic disorders represent a major and complex public health problem, associated with heavy personal and social costs. There is a need for a broad programmatic approach, involving various sectors of the community, to tackle the multiple dimensions of clinical disorder, personal functioning and socioeconomic environment that influence the course and outcome of psychosis and ultimately determine the effectiveness of service-based intervention.
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Parker, Rhian M., Allison Bell, Marian J. Currie, Louise S. Deeks, Gabrielle Cooper, Sarah J. Martin, Rendry Del Rosario, Jane S. Hocking, and Francis J. Bowden. "‘Catching chlamydia’: combining cash incentives and community pharmacy access for increased chlamydia screening, the view of young people." Australian Journal of Primary Health 21, no. 1 (2015): 79. http://dx.doi.org/10.1071/py12135.
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In Australia and elsewhere, chlamydia screening rates for those aged between 16 and 30 years continue to be low. Innovative, age-appropriate approaches are necessary to increase chlamydia screening among this target group to prevent short- and long-term consequences of the infection such as pelvic inflammatory disease, chronic pelvic pain, ectopic pregnancy and infertility. Studies have demonstrated that offering chlamydia screening in community pharmacies may be a useful adjunct to current screening services. Approximately 90% of Australians visit a pharmacy at least once a year. Chlamydia screening and education in community pharmacies with remuneration may provide another option for opportunistic testing as part of a national chlamydia screening scheme. Compensation is an accepted practice in the field of research and has been demonstrated to improve adherence to health promotion activities. In 2011, a cross-sectional study of community pharmacy-based chlamydia screening offered in conjunction with an A$10 cash incentive to participate was conducted in the Australian Capital Territory. As part of this study young people were asked about their experience of, and views about, pharmacy-based chlamydia screening. The views of consented participants were collected using the one-page questionnaire consisting of 10 closed questions and one open-ended question. Participants completed the questionnaire when they returned their urine sample and before being given the cash incentive. Overall participants were highly satisfied with the pharmacy-based chlamydia screening service. Over 60% of questionnaire respondents felt that the payment did affect their decision to have the chlamydia test, and 23% stated that it made no difference. Young people reported that pharmacy-based screening is acceptable and convenient. Accessibility and the small cash incentive played significant roles in increasing participation.
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Fisher, AA, MW Davis, SE Rubenach, DG Le Couteur, and AJ McLean. "The site-specific epidemiology of hip fracture in the Australian Capital Territory with projections for the first half of the 21st century: Implications for clinical management and health services planning." Australasian Journal on Ageing 26, no. 1 (March 2007): 45–51. http://dx.doi.org/10.1111/j.1741-6612.2007.00205.x.
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Essue, Beverley M., Tanisha Jowsey, Yun-Hee Jeon, Masoud Mirzaei, Carmen L. Pearce-Brown, Clive Aspin, and Tim P. Usherwood. "Informal care and the self-management partnership: implications for Australian health policy and practice." Australian Health Review 34, no. 4 (2010): 414. http://dx.doi.org/10.1071/ah09795.
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Objective. The Serious and Continuing Illness Policy and Practice Study (SCIPPS) aims to improve the care and support for patients with chronic illness and their family carers. Here we describe the carers’ contribution to the self-management partnership and discuss the policy and practice implications that are relevant to improving the support available for informal care in Australia. Design. A secondary analysis of SCIPPS data. Fourteen carers of patients between 45 and 85 years with chronic heart failure, chronic obstructive pulmonary disease and diabetes were conveniently sampled from western Sydney and the Australian Capital Territory. Semi-structured interviews were conducted. Data were analysed using qualitative content analysis. Results. Key roles that carers perform in the self-management partnership included: home helper; lifestyle coach; advocate; technical care manager; and health information interpreter. Two negative consequences of juggling these roles included: self-neglect and conflict. Conclusions. Rigid eligibility criteria limit carers’ access to essential support programs which underestimates and undervalues their contributions to the self-management partnership. Support services should focus on the development of practical skills to perform the caregiving roles. In addition, health professionals require support to work more effectively with carers to minimise the conflict that can overshadow the care and self-management partnership. What is known about the topic? There is a body of research developed both internationally and in Australia that describes the role of family carers in assisting family members with disabilities and other chronic illnesses to maintain independence in the home and community and that deals with the negative implications of caregiving. Much of the existing research is focussed on the roles and responsibilities that family carers perform in order to compensate for their care recipient’s physical and cognitive impairments due to illness. What does this paper add? This paper adds a qualitative exploration of the contribution that family carers make to the self-management partnership with care recipients and health professionals in the home, community and health care settings. It provides additional insights on the exact roles that family carers perform as part of the self-management partnership with care recipients who have chronic heart failure, chronic obstructive pulmonary disease and complicated diabetes. Furthermore, it offers a detailed discussion of the policy and practice implications of our findings and their relevance to improving the support available for informal care in Australia. What are the implications for practitioners? Carers have a vital role to play in the provision of care and this role is expected to increase in parallel with the rising rates of chronic illness. The paper discusses policy recommendations for improving access, demand and appropriateness of support services for carers providing support for care recipients not traditionally recognised as having a genuine need for care. It also identifies the need for health professionals to work more effectively with family carers by making explicit their expectations of this role in order to minimise conflict in the care partnership.
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Gilbert, Monica M., James A. Chamberlain, Carolynne R. White, Paul W. Mayers, Brendan Pawsey, Danny Liew, Matthew Musgrave, Kerry Crawford, and David J. Castle. "Controlled clinical trial of a self-management program for people with mental illness in an adult mental health service - the Optimal Health Program (OHP)." Australian Health Review 36, no. 1 (2012): 1. http://dx.doi.org/10.1071/ah11008.
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Objective. The objective of this study was to evaluate the effect and cost-effectiveness of a self-management intervention, delivered as part of routine care in an adult mental health service. Method. In a community mental health setting, routine care was compared with routine care plus a nine-session intervention (the Optimal Health Program) using a non-randomised controlled design. Adult (18–65 years) consumers of mental health services in the Australian Capital Territory were eligible for participation. Results. The Optimal Health Program was associated with significant improvements in health and social functioning as measured by the Health of the Nation Outcome Scale (average change relative to control: –3.17; 95% CI –4.49 to –1.84; P < 0.001). In addition, there was a reduction in hospital admissions in the treatment group (percentage of time in hospital reduced from 3.20 to 0.82; P = 0.07). This translated into a net cost saving of over AU$6000 per participant per year (uncertainty range AU$744 to AU$12 656). Conclusions. This study shows promising results for incorporating a self-management program into routine care to improve the health and social functioning of mental health consumers in a cost-effective manner. What is known about the topic? Current literature supports the efficacy of structured self-management programs for chronic conditions such as diabetes (type 1 and 2) and asthma, but there remains limited evidence that self-management programs improve outcomes for people with mental illness. What does this paper add? This study adds to the body of evidence supporting self-management as a cost-effective adjunct to routine care in mental health services. What are the implications for practitioners? Our study supports the feasibility of clinicians delivering cost-effective self-management programs as part of routine mental health service delivery.
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Holtzhausen, Nicol, Haider Mannan, Nasim Foroughi, and Phillipa Hay. "Effects associated with the use of healthcare for eating disorders by women in the community: a longitudinal cohort study." BMJ Open 10, no. 8 (August 2020): e033986. http://dx.doi.org/10.1136/bmjopen-2019-033986.
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ObjectivesThis study examined formal and informal healthcare use (HCU) in community women with disordered eating, and associations of HCU with mental health-related quality of life (MHRQoL), psychological distress, mental health literacy (MHL) and eating disorder (ED) symptoms over time.HypothesisWe hypothesised that HCU would lead to improvement in ED symptom severity, MHRQoL, MHL and psychological distress.Design, setting, participantsData were from years 2, 4 and 9 of a longitudinal cohort of 443 community women (mean age 30.6, SE 0.4 years) with a range of ED symptoms, randomly recruited from the Australian Capital Territory electoral role or via convenience sampling from tertiary education centres. Data were collected using posted/emailed self-report questionnaires; inclusion criteria were completion of the HCU questionnaire at time point of 2 years (baseline for this study). HCU was measured using a multiple-choice question on help seeking for an eating problem. To test the effect of HCU over time on MHRQoL (Short Form-12 score), psychological distress (Kessler Psychological Distress Scale score), ED symptom severity (Eating Disorder Examination Questionnaire score) and ED–MHL, linear or logistic mixed-effects regression analyses were used.Results20% of participants sought ED-specific help at baseline; more than half of participants sought help that was not evidence based. HCU at baseline was significantly associated with improved MHRQoL and ED symptom severity and decreased psychological distress over time (Cohen’s d all >0.3, ie, small). HCU was not significantly associated with MHL over time. The predictive ability of the fitted models ranged from 32.18% to 42.42% for psychological distress and MHL treatment, respectively.ConclusionsFormal and informal HCU were associated with small improvements in ED symptoms, MHRQoL and psychological distress but not with improved MHL. Informal services in ED management should be investigated further along with efforts to improve ED–MHL.
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William Best, David, Gerard Byrne, David Pullen, Jacqui Kelly, Karen Elliot, and Michael Savic. "Therapeutic communities and the local community: isolation or integration?" Therapeutic Communities: The International Journal of Therapeutic Communities 35, no. 4 (December 2, 2014): 150–58. http://dx.doi.org/10.1108/tc-07-2014-0024.
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Purpose – The purpose of this paper is to test the feasibility of utilising an Asset-Based Community Development (ABCD) model in the context of an Alcohol and Other Drug Therapeutic Community, and to use this as a way of assessing how TCs can contribute to the local communities in which they are sited. Design/methodology/approach – This is a qualitative action research project, based on an evolving model in which key stakeholders from participating sites were instrumental in shaping processes and activities, that is a partnership between a research centre, Turning Point in Melbourne, Australia and two Recovery Services operated by the Salvation Army Australia Eastern Territory (TSA). One of these is the Dooralong Transformation Centre on the Central Coast of New South Wales and the other, Fairhaven, is in the Gold Coast hinterland of Queensland, Australia. The project was designed to create “rehabilitation without walls” by building bridges between the treatment centres and the communities they are based in, and improving participation in local community life. This was done through a series of structured workshops that mapped community asset networks and planned further community engagement activities. Findings – Both of the TCs already had strong connections in their local areas including but not restricted to involvement with the mutual aid fellowships. Staff, residents and ex-residents still in contact with the service were strongly committed to community engagement and were able to identify a wide range of connections in the community and to build these around existing Salvation Army connections and networks. Research limitations/implications – This is a pilot study with limited research findings and no assessment of the generalisability of this method to other settings or TCs. Practical implications – Both TCs are able to act as “community resources” through which residents and ex-residents are able to give back to their local communities and develop the social and community capital that can prepare them for reintegration and can positively contribute to the experience of living in the local community. Social implications – This paper has significant ramifications for how TCs engage with their local communities both as a mechanism for supporting resident re-entry and also to challenge stigma and discrimination. Originality/value – The paper and project extend the idea of ABCD to a Reciprocal Community Development model in which TCs can act as active participants in their lived communities and by doing so can create a “therapeutic landscape for recovery”.
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Lovett, Ray, Phyll Dance, Jill Guthrie, Roxie Brown, and Julie Tongs. "Walan Girri: developing a culturally mediated case management model for problematic alcohol use among urban Indigenous people." Australian Health Review 38, no. 4 (2014): 440. http://dx.doi.org/10.1071/ah13148.
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Objective To describe the design and implementation of a culturally mediated case management model at Winnunga Nimmityjah Aboriginal Health Service (Winnunga) for Indigenous clients who consume alcohol at problematic levels. Methods Our research took place from March 2008 to March 2010 in the Australian Capital Territory and built on previous research partnerships between Winnunga and The Australian National University’s National Centre for Epidemiology and Population Health. We conducted a review of existing models to determine elements for consideration in the community controlled setting, and conducted staff surveys to assess current levels of skill and confidence around alcohol screening, brief intervention and care planning. Using the information from the review and staff surveys, we then undertook staff capacity building to build confidence and skills in conducting alcohol screening, brief intervention and care planning. This process was driven by Winnunga’s social health team. To meet Medicare benefits schedule requirements, and frame the study within the Aboriginal and Torres Strait Islander Chronic Disease Package framework, we included team care arrangements, care planning and health checks. Results Elements of case management were suggested by staff and incorporated into the final model. Forty staff in the health service participated in identifying training needs for the development of the case management model and undertook a range of training before the model was implemented. Staff working within the social health team decided that the focus of the case management was to build a stronger future for their clients, hence the name of the case management model ‘Walan Girri’ (Wiradjuri language for strong future). The model included a package of screening instruments and brief intervention, related polices and discussion of ‘mob’ and ‘country.’ Changes in Winnunga management and staff, the composition of the research team and the way Walan Girri evolved led to protracted development and implementation. Conclusions This project highlights considerations for implementing a case management model in a dynamic health service environment. Capacity building for Winnunga staff and for an Indigenous PhD scholar were part of the process and were integral in maintaining momentum in the project. What is known about the topic? Case management for chronic disease and other health conditions is currently recommended in assisting to resolve those issues. Case management aims to involve a range of healthcare practitioners (general practitioners, nurses and Aboriginal health workers) and providers in conjunction with the client to improve their health status. Currently, there is limited description of how case management models are used within the Aboriginal community controlled context. What does this paper add? This paper adds to the knowledge base in this field by describing the results of a method of case management driven by the community controlled health sector. It also introduces a simple approach that may be useful in a range of contexts in the health setting in building trust and rapport with clients, while engaging the healthcare practitioner in the Aboriginal and Torres Strait Islander cultural contexts of relationships to country and family (mob). What are the implications for practitioners? The implication may be that healthcare practitioners working in Aboriginal and/or Torres Strait Islander Health Services adopt Aboriginal and Torres Strait Islander cultural protocols, such as talking with clients about ‘mob’ and ‘country’, to build trust and rapport.
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Allen-kelly, Kandie, Morag McArthur, and Alice Roughley. "What I do I understand: Teaching community work in the Australian Capital Territory." Australian Social Work 54, no. 4 (December 2001): 39–49. http://dx.doi.org/10.1080/03124070108414344.
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Reay, Rebecca, Michael Robertson, and Cathy Owen. "Interpersonal psychotherapy for postnatal depression: a quality improvement approach." Australasian Psychiatry 10, no. 3 (September 2002): 211–13. http://dx.doi.org/10.1177/103985620201000302.
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Objective: To outline the processes involved in establishing an integrated perinatal mental health service in a public mental health setting. Conclusions: The Australian Capital Territory (ACT) Mental Health Services established a perinatal mental health service based on coordinated, evidence-based treatments. One of the treatment approaches introduced into the service was Interpersonal Psychotherapy, a time-limited, empirically validated therapy for postnatal depression.
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Drew, Leslie R. H., Donna M. Hodgson, and Kathleen M. Griffiths. "Clozapine in Community Practice: A 3-Year Follow-Up Study in the Australian Capital Territory." Australian & New Zealand Journal of Psychiatry 33, no. 5 (October 1999): 667–75. http://dx.doi.org/10.1080/j.1440-1614.1999.00631.x.
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Objective: This paper aims to present the first data on the long-term use of cloza-pine in an entire cohort of patients encountered in a community, the Australian Capital Territory. It examines the clinical and financial outcomes 3 years after the prescription of clozapine to a cohort of 37 patients. Method: Experience during the 2 years before clozapine was prescribed was compared with experience in the following 3 years on the basis of a retrospective review of official records. Data included hospital and hostel bed use and an estimate of treatment costs. In addition, changes in living circumstances and employment status were assessed and treating psychiatrists reported the presence of side effects and their impressions of clinical change since clozapine was prescribed. Results: Compared with the preclozapine period, there were significant reductions postclozapine in hospital admissions (year 3) and hospital bed-days (year 2) by the total cohort and in hospital bed-days and hospital expenditure for those patients (n = 25) who remained on clozapine (years 2 and 3). There was no significant increase or decrease postclozapine in the estimated combined cost of treatment attributable to bed use (hospital or hostel), clozapine tablets, blood monitoring, and the employment of a Clozapine Coordinator. Clinically, all patients who stayed on clozapine were reported to be moderately or markedly improved. Five of nine patients who were not taking clozapine at study's end were unimproved or deteriorated. Conclusions: The findings of significant clinical improvement without evidence of increased cost lend support for the selective use of clozapine in community practice.
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Dance, Phyll, Roslyn Brown, Gabriele Bammer, and Beverly Sibthorpe. "Aged care services for Indigenous people in the Australian Capital Territory and surrounds:analysing needs and implementing change." Australian and New Zealand Journal of Public Health 28, no. 6 (December 2004): 579–83. http://dx.doi.org/10.1111/j.1467-842x.2004.tb00051.x.
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Green, Janette, and Robert Gordon. "The development of Version 2áof the AN-SNAP casemix classification system." Australian Health Review 31, no. 5 (2007): 68. http://dx.doi.org/10.1071/ah070s68.
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This paper presents the results of a recent review of the Australian National Sub-acute and Nonacute Patient (AN-SNAP) classification system. The AN-SNAP system was developed by the Centre for Health Service Development, University of Wollongong in 1997. The review was conducted between August 2005 and September 2006. Four clinical sub-committees comprising more than 50 clinicians from sub-acute services across New South Wales as well as representatives from Queensland and the Australian Capital Territory were established to develop a set of proposals to be considered for incorporation into Version 2 of the classification. It is proposed that the final AN-SNAP Version 2 classification will be available for implementation from 1 July 2007.
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England, Danelle O., Marian J. Currie, and Francis J. Bowden. "An audit of contact tracing for cases of chlamydia in the Australian Capital Territory." Sexual Health 2, no. 4 (2005): 255. http://dx.doi.org/10.1071/sh05021.
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Background: Contact tracing is one of the central pillars of the management of sexually transmitted infections. The aims of this audit were to determine the yield of chlamydia infection from contact tracing the sexual partners of individuals diagnosed with chlamydia and to evaluate and compare the effectiveness of contact tracing undertaken at the Communicable Diseases Control Section (CDCS) of Australian Capital Territory (ACT) Health and the Canberra Sexual Health Centre (the clinic). Methods: A retrospective review of the notification records and contact-tracing documentation was undertaken at CDCS and the clinic from 1 September 2002 to 30 September 2003 (13 months). Results: The background rate of chlamydia in those tested in the ACT community is 3–5%. During the study period, 512 cases of chlamydia were notified to CDCS. Of these, 351 were referred for contact tracing, 293 by CDCS and 98 by the clinic. Of the 437 nominated sexual contacts (average of 1.12 per index case), 272 (62.2%) were contacted, 125 (28.6%) were tested and 51 (11.7%; 95% CI 8.8–15.1) tested positive for chlamydia (15.5%; 95% CI 11.5–20.6% in sexual contacts of CDCS index cases and 7.8%; 95% CI 4.8–12.5% in those of the clinic patients). Contact tracing through the CDCS reached significantly more nominated sexual contacts (78.4% v. 41.7%; P = 0.001) and significantly more of the nominated sexual contacts of index cases reported to CDCS were described as tested (34.7% v. 20.8%; P = 0.01). The average time taken to identify each chlamydia-positive sexual contact was 6.8 hours. Conclusions: Contact tracing more than doubled the case finding effectiveness of chlamydia screening, but was time consuming. These results suggest that provider-initiated contact tracing has clinical and public health value, but that the cost-effectiveness of this approach to chlamydia control should be further evaluated.
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Freeman, Toby, Fran Baum, Angela Lawless, Sara Javanparast, Gwyn Jolley, Ronald Labonté, Michael Bentley, John Boffa, and David Sanders. "Revisiting the ability of Australian primary healthcare services to respond to health inequity." Australian Journal of Primary Health 22, no. 4 (2016): 332. http://dx.doi.org/10.1071/py14180.
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Equity of access and reducing health inequities are key objectives of comprehensive primary health care. However, the supports required to target equity are fragile and vulnerable to changes in the fiscal and political environment. Six Australian primary healthcare services, five in South Australia and one in the Northern Territory, were followed over 5 years (2009–2013) of considerable change. Fifty-five interviews were conducted with service managers, staff, regional health executives and health department representatives in 2013 to examine how the changes had affected their practice regarding equity of access and responding to health inequity. At the four state government services, seven of 10 previously identified strategies for equity of access and services’ scope to facilitate access to other health services and to act on the social determinants of health inequity were now compromised or reduced in some way as a result of the changing policy environment. There was a mix of positive and negative changes at the non-government organisation. The community-controlled service increased their breadth of strategies used to address health equity. These different trajectories suggest the value of community governance, and highlight the need to monitor equity performance and advocate for the importance of health equity.
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McRae, Ian, and Mai Pham. "When is a GP home-visit program financially viable?" Australian Journal of Primary Health 22, no. 6 (2016): 554. http://dx.doi.org/10.1071/py15074.
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Despite a decline in GP home visits in Australia, these services remain an important aspect of healthcare access and delivery for the aged population. Home visits can both provide better care and decrease use of ambulance and emergency department (ED) services. The net costs of providing GP visits are complex, depending on the relative costs of home visits and ED attendances, the number of ED attendances saved by GP visits, and the number of services provided per day by a visiting GP. The Australian Capital Territory government created the General Practice Aged Day Service (GPADS) program in March 2011. Using data and information from this program as a basis, we examine the financial aspects of a daytime home-visit program in the Australian context. Whether or not a program is financially viable depends on a range of parameters; if all factors are aligned a program can generate net savings. While there is no information available on the net health benefits of home visits relative to ED attendance, these differences need not be large for the program to be cost-effective.
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Moore, Anthony M., Sandra Burgess, Hailey Shaw, Carolyn Banks, Irene Passaris, and Charles Guest. "Achieving high immunisation rates amongst children in the Australian Capital Territory: a collaborative effort." Australian Health Review 35, no. 1 (2011): 104. http://dx.doi.org/10.1071/ah10769.
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Background. In September 2008 the ACT achieved the highest childhood coverage rates in Australia with rates of 93.5% (12–15-month age cohort), 94.9% (24–27-month age cohort) and 90.58% (60–63-month age cohort). Purpose. To analyse the key contributing factors and policy initiatives that have likely to have led to high childhood immunisation rates in the ACT. Methods. Data used in this report were sourced from the Australian Childhood Immunisation Register (ACIR) held at Medicare Australia, General Practice Immunisation Incentives (GPII) ‘calculation’ data held at ACT Division of General Practice and internal immunisation databases held at Health Protection Service. Outcomes. Although the reasons for the high coverage rates seen in children are multi factorial (including national and consumer factors), key reasons locally in the ACT include: (a) the implementation of an ACT-wide immunisation strategy; (b) proactive follow up of children overdue for immunisation; (c) more sustainable provision of immunisation services across both public and private health providers; and (d) a centralised vaccine delivery service and ‘cold chain’ monitoring system. Conclusions. Although nationwide immunisation policy has been successful in increasing childhood coverage rates across all Australian jurisdictions, it is important to also acknowledge local factors that have likely to have contributed to the successful implementation of the Immunise Australia Program at the coal face. What is known about the topic? Childhood immunisation rates have risen significantly in Australia since the mid 1990s following a plethora of initiatives at both a national and state and territory level. This article examines in depth the various factors over the past decade that have likely to have contributed to the high childhood immunisation rates currently seen in the Australian Capital Territory What does this paper add? The ACT changed its strategic thinking towards immunisation provision in 2004 with an increased focus on immunisation delivery in general practice. Immunisation coverage rates improved in the ACT between 2005 and 2008 with general practice increasing their contribution to immunisation provision from 35 to 57% during this time period. This was despite of a drop in full-time equivalent general practices (GPs) in the ACT between 2003 and 2008. At face value the initial decision to increase immunisation provision through general practice in the face of a dwindling GP workforce appeared counter intuitive. What this article illustrates is the importance of having the right mix and proportion of providers delivering immunisation (public clinics v. general practice) as well as having well resourced support systems for vaccine delivery, provider education and data analysis. More importantly this paper illustrates that any disruption in any component of immunisation provision is likely to have a negative effect on coverage rates (examples provided in the article). What are the implications for practitioners? Achieving high immunisation in the ACT has been a collaborative effort by a range of immunisation stakeholders. These groups have formed strong partnerships to raise awareness of the value of immunisation and the importance of receiving vaccinations at the correct time. It is this collective effort across the health portfolio that is likely to have contributed to the ACT achieving high immunisation coverage rates amongst children. It is important for immunisation practitioners to retain strong professional networks with clear delineation of roles in order to maintain high immunisation rates. Such networks must also be adequately prepared for challenges on the horizon (i.e. change in government policy, loss of personnel, change in consumer attitudes towards immunisation, etc.) that may pose a threat towards high immunisation rates.
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Walker, Rae, and Hal Swerissen. "Editorial: Recording Excellence in Primary Care Practice." Australian Journal of Primary Health 9, no. 1 (2003): 7. http://dx.doi.org/10.1071/py03001.
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In this issue of the Australian Journal of Primary Health we publish papers that reflect the diverse approaches to knowledge characteristic of primary health care. There are articles on policy and management at the system level (for example, Primary health care research and evaluation development strategy in the Northern Territory), critical reviews of programs and community activities (for example, Motor racing in Australia: Health damaging or health promoting), and the community experiences of health and health services (for example, Communication and control in the co-construction of depression ...). The range of research valued in primary care is reflected in these articles.
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Deeks, Louise S., Sam Kosari, Mark Naunton, Gabrielle Cooper, Julie Porritt, Rachel Davey, Paresh Dawda, John Goss, and Gregory Kyle. "Stakeholder perspectives about general practice pharmacists in the Australian Capital Territory: a qualitative pilot study." Australian Journal of Primary Health 24, no. 3 (2018): 263. http://dx.doi.org/10.1071/py17086.
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Previous studies have found that integrating non-dispensing pharmacists in general practice may improve patient safety, improve patient outcomes, deliver health system efficiencies and generate savings. However, the employment of pharmacists in general practice is not common in Australia. A naturalistic study was conducted in the Australian Capital Territory with three general practices, each employing a part-time pharmacist for 12 months. This study reports on stakeholder perspectives of the benefits, barriers and enablers for integrating pharmacists into general practice. Patients, practice staff and community pharmacists that had interacted with a practice pharmacist were asked to complete a self-administered questionnaire. Patient questionnaire respondents (n=44) reported that a practice pharmacist was beneficial and wanted to see this continue. Practice pharmacists were also perceived beneficial by primary healthcare employees surveyed (n=42). Opinions were further explored by individual semi-structured interviews (n=20). The qualitative data explored five themes: perception of the practice pharmacist, collaboration with doctors, pharmacist roles, sustainability and community pharmacy aspects. Patients welcomed improved understanding about their medication, whereas general practice staff appreciated pharmaceutical advice about patients with chronic conditions. Participants discussed options to fund practice pharmacists longer term, which was identified as the main barrier to widespread roll out.
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Callander, Emily, Sarah Larkins, and Lisa Corscadden. "Variations in out-of-pocket costs for primary care services across Australia: a regional analysis." Australian Journal of Primary Health 23, no. 4 (2017): 379. http://dx.doi.org/10.1071/py16127.
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The aim of this study is to describe average out-of-pocket costs across different regions of Australia, as defined by Primary Health Network (PHN) boundaries, and assess the association between population characteristics and out-of-pocket costs for selected primary care services. A combination of descriptive and regression analysis was undertaken using administrative data from the Australian Department of Human Services reporting on the health services used across PHNs in Australia. Those in regional areas paid significantly more for Allied Health services than those in capital cities (A$5.68, P=0.006). The proportion of an area’s population aged 65 years and over was inversely related to out-of-pocket charges for Allied Mental Health (–A$79.12, P=0.029). Some areas had both high charges and disadvantaged populations: Country South Australia, Northern Queensland, Country Western Australia, Tasmania and Northern Territory, or populations with poor health: Northern Territory and Tasmania. Although there was a large amount of variation in out-of-pocket charges for primary care services between PHNs in Australia, there was little evidence of inequality based on health, age and socioeconomic characteristics of a population or the proportion of Aboriginal and Torres Strait Islander people.
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Davis, B. K., M. Schmidt, E. O'Keefe, M. J. Currie, A. M. Baynes, T. Bavinton, M. McNiven, and F. J. Bowden. "8. 'STAMP OUT CHLAMYDIA' PROJECT - BRINGING CHLAMYDIA SCREENING TO TERTIARY STUDENTS IN THE AUSTRALIAN CAPITAL TERRITORY." Sexual Health 4, no. 4 (2007): 287. http://dx.doi.org/10.1071/shv4n4ab8.
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Study's objective: Stamp Out Chlamydia (SOC) is a pilot research project funded by the Commonwealth Department of Health & Aging to devise and implement a cost effective program for education and chlamydia screening for ACT tertiary students aged 16-26 years at The Australian National University (ANU), University of Canberra and Canberra Institutes of Technology, that may be suitable for national implementation. Methodology: A collaborative clinical outreach project between Canberra Sexual Health Centre, Sexual Health and Family Planning ACT and ANU Medical School, whereby the SOC team attends student-initiated events on ACT tertiary campuses to educate and test young people, using self-obtained urine specimens. Summary of Results: The majority of these outreach events were attended by two Registered Nurses and the Health Promotion Officer. To date they have attended 19 events including Orientation Week activities, BBQ's, Easter Scavenger Hunt, Gay Pride Week events and sports events. Promoting the SOC project has been through word of mouth, SOC 'Champions', convenience and media advertising and a dedicated web site. By May 2007 the SOC project had: Interfaced with 1512 tertiary students and offered them the opportunity to participate in the research Screened 445 for chlamydia Found a chlamydia prevalence of 1.8% Treated eight cases and their contacts Of those screened: Male 240 Female 205 Target group 412 Conclusion: ACT tertiary students accept this outreach approach. Of students approached, over a quarter agreed to have screening. The high profile of the SOC project is leading to an increased awareness of chlamydia. Many students are unaware of the high incidence and/or the consequences of chlamydia, if left untreated and report that they would not have attended mainstream services for screening. Ongoing data analysis will determine if this project is cost effective and feasible.
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Furst, Mary Anne, Jose A. Salinas-Perez, and Luis Salvador-Carulla. "Organisational impact of the National Disability Insurance Scheme transition on mental health care providers: the experience in the Australian Capital Territory." Australasian Psychiatry 26, no. 6 (November 8, 2018): 590–94. http://dx.doi.org/10.1177/1039856218810151.
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Objectives: Concerns raised about the appropriateness of the National Disability Insurance Scheme (NDIS) in Australia for people with mental illness have not been given full weight due to a perceived lack of available evidence. In the Australian Capital Territory (ACT), one of the pilot sites of the Scheme, mental health care providers across all relevant sectors who were interviewed for a local Atlas of Mental Health Care described the impact of the scheme on their service provision. Methods: All mental health care providers from every sector in the ACT were contacted. The participation rate was 92%. We used the Description and Evaluation of Services and Directories for Long Term Care to assess all service provision at the local level. Results: Around one-third of services interviewed lacked funding stability for longer than 12 months. Nine of the 12 services who commented on the impact of the NDIS expressed deep concern over problems in planning and other issues. Conclusions: The transition to NDIS has had a major impact on ACT service providers. The ACT was a best-case scenario as it was one of the NDIS pilot sites.
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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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Almado, Haidar, Estie Kruger, and Marc Tennant. "Application of spatial analysis technology to the planning of access to oral health care for at-risk populations in Australian capital cities." Australian Journal of Primary Health 21, no. 2 (2015): 221. http://dx.doi.org/10.1071/py13141.
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Australians are one of the healthiest populations in the world but there is strong evidence that health inequalities exist. Australia has 23.1 million people spread very unevenly over ~20 million square kilometres. This study aimed to apply spatial analysis tools to measure the spatial distribution of fixed adult public dental clinics in the eight metropolitan capital cities of Australia. All population data for metropolitan areas of the eight capital cities were integrated with socioeconomic data and health-service locations, using Geographic Information Systems, and then analysed. The adult population was divided into three subgroups according to age, consisting of 15-year-olds and over (n = 7.2 million), retirees 65 years and over (n = 1.2 million), and the elderly, who were 85 years and over (n = 0.15 million). It was evident that the States fell into two groups; Tasmania, Northern Territory, Australian Capital Territory and Western Australia in one cluster, and Victoria, New South Wales, Queensland and South Australia in the other. In the first group, the average proportion of the population of low socioeconomic status living in metropolitan areas within 2.5 km of a government dental clinic is 13%, while for the other cluster, it is 42%. The clustering remains true at 5 km from the clinics. The first cluster finds that almost half (46%) of the poorest 30% of the population live within 5 km of a government dental clinic. The other cluster of States finds nearly double that proportion (86%). The results from this study indicated that access distances to government dental services differ substantially in metropolitan areas of the major Australian capital cities.
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O'Keefe, Elissa J., Anne Gardner, Marian J. Currie, Suzanne Garland, Sepehr Tabrizi, and Francis J. Bowden. "Prevalence of genital human papillomavirus DNA in a sample of senior school-aged women in the Australian Capital Territory." Sexual Health 3, no. 2 (2006): 91. http://dx.doi.org/10.1071/sh05047.
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Background: A strong association between persistent infection with oncogenic types of human papillomavirus (HPV) and cervical cancer is well established. Small numbers of international studies examining adolescent HPV infection and the risk factors associated are published, but there is currently no evidence on the prevalence and risk factors for HPV in an Australian, sexually active female adolescent population. Methods: To provide prevalence and risk factors for HPV in a female sexually active, senior high school population in the Australian Capital Territory (ACT), a convenience sample of 161, 16–19-year-old females attending a senior high school was evaluated. The sample formed part of a larger sample recruited for a study of sexually transmitted infections and blood-borne viruses in senior high school students. A clinical record was used to collect information about sexual and other risk behaviours, while self-collected vaginal swabs were tested for HPV DNA detection and genotyping using polymerase chain reaction. Results: The prevalence of HPV DNA in this sample overall was 11.2%, with multiple genotypes in 38%. No statistically significant associations were found between HPV DNA and the number of male partners, age of coitarche, time since first sexually active, condom use, smoking or alcohol intake. Conclusions: This is the first Australian study that has examined the prevalence and risk factors for genital HPV in this demographic group. The prevalence of HPV infection is slightly lower than reported in similar age groups overseas and is lower than other Australian studies in older women and those attending sexual health centres. Of HPV-positive young women, high-risk genotypes were found in over half, with more than one-third of HPV existing as multiple genotypes. Large community-based prevalence studies are needed to guide the development of recommendations for the vaccination of young women against HPV and to support other health promotion initiatives.
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Crowe, B. L., and I. G. Mcdonald. "Telemedicine in Australia. Recent developments." Journal of Telemedicine and Telecare 3, no. 4 (December 1, 1997): 188–93. http://dx.doi.org/10.1258/1357633971931147.
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There have been a number of important developments in Australia in the area of telemedicine. At the national level, the House of Representatives' Standing Committee on Family and Community Affairs has been conducting the Inquiry into Health Information Management and Telemedicine. The Australian Health Ministers' Advisory Council has supported the establishment of a working party convened by the South Australian Health Commission to prepare a detailed report on issues relating to telemedicine. State governments have begun a number of telemedicine projects, including major initiatives in New South Wales and Victoria and the extensive development of telepsychiatry services in Queensland. Research activities in high-speed image transmission have been undertaken by the Australian Computing and Communications Institute and Telstra, and by the Australian Navy. The matter of the funding of both capital and recurrent costs of telemedicine services has not been resolved, and issues of security and privacy of medical information are subject to discussion. The use of the Internet as a universal communications medium may provide opportunities for the expansion of telemedicine services, particularly in the area of continuing medical education. A need has been recognized for the coordinated evaluation of telemedicine services as cost-benefit considerations are seen to be very important.
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Volker, Nerida, Lauren T. Williams, Rachel C. Davey, and Thomas Cochrane. "Community-based lifestyle modification workforce: an underutilised asset for cardiovascular disease prevention." Australian Journal of Primary Health 22, no. 4 (2016): 327. http://dx.doi.org/10.1071/py14178.
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This paper reports on a qualitative study exploring the capacity of the community sector to support a whole-of-system response to cardiovascular disease prevention in primary health care. As a component of the Model for Prevention (MoFoP) study, community-based lifestyle modification providers were recruited in the Australian Capital Territory to participate in focus group discussions; 34 providers participated across six focus groups: 20 Allied Health Professionals (four groups) and 14 Lifestyle Modification Program providers (two groups). Thematic analysis of focus group transcripts was undertaken using a mixed deductive and inductive approach. Participant responses highlight several barriers to their greater contribution to cardiovascular disease prevention. These included that prevention activities are not valued, limited sector linkages, inadequate funding models and the difficulty of behaviour change. Findings suggest that improvements in the value proposition of prevention for all stakeholders would be supported by improved funding mechanisms and increased opportunities to build relationships across health and community sectors.
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Hawkins, Russell M. F., Rosalie A. McDonald, Sandra Davison, and Steve R. Coy. "The prevention of child abuse, part one: Community resources." Children Australia 19, no. 3 (1994): 22–25. http://dx.doi.org/10.1017/s1035077200004065.
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The literature reveals greater emphasis on the causes and consequences of child abuse than on its prevention. A field study in an Australian capital city shows that while substantial amounts of information and services for people experiencing problems with parenting exist in the community, access to these sources is problematic. Improvements in efficiency or increases in funding will not, by themselves resolve the problem and strategies to change the more fundamental problem of public denial of the problem of child abuse will be required.
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Pearce, Claire, and Leanne Pagett. "Advanced allied health assistants: an emerging workforce." Australian Health Review 39, no. 3 (2015): 260. http://dx.doi.org/10.1071/ah14253.
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Objective Nationally and internationally there is work underway to continue to advance the scope of practice of allied health assistants (AHA). The advanced role requires additional training and competency development, as well as significant clinical experience. To build on the evidence relating to advanced scope AHAs, ACT Health undertook a project to explore the potential for the development of the local AHA workforce. This paper provides an overview of the project. Methods The potential for advanced AHAs in the Australian Capital Territory (ACT) was assessed using literature reviews, consultation with other services working with advanced AHAs and interviews with local allied health managers and assistants. Results A role for advanced AHAs within the ACT workforce was recommended, along with the need to further develop the AHA governance structure and AHA training packages and to undertake more research into the AHA workforce. Conclusion AHAs make a positive contribution to the delivery of effective, responsive, consumer-focused healthcare. The advanced AHA role provides further opportunities to enhance the flexibility of allied health services while also providing a career structure for this growing workforce.
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Rendalls, Shane, Allan D. Spigelman, Catherine Goodwin, and Nataliya Daniel. "Health service engagement with consumers and community in Australia for issue." International Journal of Health Governance 24, no. 4 (November 21, 2019): 274–83. http://dx.doi.org/10.1108/ijhg-05-2019-0039.
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Purpose The purpose of this paper is to provide an overview of consumer and community engagement in health service planning, quality improvement and programme evaluation in Australia, and key components and importance of a strong suite of tools for achieving effective outcomes. Design/methodology/approach This paper is a non-systematic review of Australian national, state and territory websites in relation to policy commitment to consumer engagement, best practice framework for consumer engagement and recent project example. Findings Consumer engagement is a recognised component of the Australian health system. It is reflected in the national and state health policy and is a mandatory requirement of hospital accreditation. The application of co-design principles is gaining increasing popularity in health service planning and programme evaluation. Co-design is an important enabler of patient/community-centred service planning and evaluation; however, on its own it may lead to poorer outcomes. Co-design must occur within a broader systemic framework. Practical implications The research identifies a conceptual framework, approaches and tools of value to health service management and planners. Originality/value Consumer and community engagements are critical to the development of consumer-centric services. However, this should complement and add value to, not divert attention away from established principles of service planning, continuous quality improvement and programme evaluation. To do so may result in poorer quality health and well-being outcomes, reduced efficiency and ultimately reduced consumer and community satisfaction with services. This paper examines consumer and community engagement within the broader planning and quality improvement framework and practical implications for keeping planning, research and evaluation on track.
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Winkworth, Gail, and Morag McArthur. "Back to schools: Human services workers increasing opportunities for early intervention and social inclusion from the school base." Children Australia 33, no. 4 (2008): 5–12. http://dx.doi.org/10.1017/s1035077200000389.
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This paper argues that Australia is lagging behind in recognising the important role social workers and other human services workers can play in schools to improve social and educational outcomes for students. It reports on a small, school-based, human services program, the Schools as Communities program, located in the Australian Capital Territory, and outlines key themes that emerged in interviews with principals and other school staff about the program's effectiveness. The program's outreach workers, who were mostly social workers, had a dual role working with individual families and facilitating community development initiatives of benefit to the school community. Case studies demonstrate how their presence contributed to earlier involvement and support of vulnerable families. They also illustrate that the school setting enabled social workers to work more effectively to build social inclusion in local communities. The paper argues the case for using a wider range of human services professionals from the school base and calls upon education and human services systems to create more effective governance arrangements to make this possible. An expansion of the traditional disciplinary base of education to incorporate social workers and other human services professionals who are skilled at working across multiple domains is essential if schools are to maximise the impact of early intervention and prevention in working towards a more socially inclusive society.
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Shield, Jennifer, Sabine Braat, Matthew Watts, Gemma Robertson, Miles Beaman, James McLeod, Robert W. Baird, et al. "Seropositivity and geographical distribution of Strongyloides stercoralis in Australia: A study of pathology laboratory data from 2012–2016." PLOS Neglected Tropical Diseases 15, no. 3 (March 9, 2021): e0009160. http://dx.doi.org/10.1371/journal.pntd.0009160.
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Background There are no national prevalence studies of Strongyloides stercoralis infection in Australia, although it is known to be endemic in northern Australia and is reported in high risk groups such as immigrants and returned travellers. We aimed to determine the seropositivity (number positive per 100,000 of population and percent positive of those tested) and geographical distribution of S. stercoralis by using data from pathology laboratories. Methodology We contacted all seven Australian laboratories that undertake Strongyloides serological (ELISA antibody) testing to request de-identified data from 2012–2016 inclusive. Six responded. One provided positive data only. The number of people positive, number negative and number tested per 100,000 of population (Australian Bureau of Statistics data) were calculated including for each state/territory, each Australian Bureau of Statistics Statistical Area Level 3 (region), and each suburb/town/community/locality. The data was summarized and expressed as maps of Australia and Greater Capital Cities. Principal findings We obtained data for 81,777 people who underwent serological testing for Strongyloides infection, 631 of whom were from a laboratory that provided positive data only. Overall, 32 (95% CI: 31, 33) people per 100,000 of population were seropositive, ranging between 23/100,000 (95% CI: 19, 29) (Tasmania) and 489/100,000 population (95%CI: 462, 517) (Northern Territory). Positive cases were detected across all states and territories, with the highest (260-996/100,000 and 17–40% of those tested) in regions across northern Australia, north-east New South Wales and north-west South Australia. Some regions in Greater Capital Cities also had a high seropositivity (112-188/100,000 and 17–20% of those tested). Relatively more males than females tested positive. Relatively more adults than children tested positive. Children were under-represented in the data. Conclusions/Significance The study confirms that substantial numbers of S. stercoralis infections occur in Australia and provides data to inform public health planning.
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Usher, Wayne, and Brittany A. McCormack. "Doctoral capital and well-being amongst Australian PhD students: exploring capital and habitus of doctoral students." Health Education 121, no. 3 (March 1, 2021): 322–36. http://dx.doi.org/10.1108/he-11-2020-0112.
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PurposeThe Higher Degree Research (HDR) journey is known for its difficulties, complexities and challenges (Lees-Deutsch, 2020), with many students experiencing multi-faceted issues and concerns (Skopek et al., 2020). Therefore, the purpose of this research is to investigate the relationships that exist between variables, vulnerability factors and doctorial capital of candidates (n = 532) studying at Australian universities (2019).Design/methodology/approachA quantitative cross-sectional correlational research design and Bronfenbrenner's socio – ecological framework (personal, home, university, community) was utilised to collect participants' (n = 532) descriptive statistics. Bourdieu's social reproduction theory was used as a lens to examine how experiences, across the PhD candidature, are influenced by several psychosocial factors and doctoral capital.FindingsFrom such a dual methodological approach, the findings from this study suggests that (1) age, (2) gender, (3) nationality, (4) financial/work status, (5) years of PhD and (6) attending postgraduate (PG) student events, go to significantly (p < 0.001) impact (positively and negatively) on students' experiences and correspondingly, impacts on their self-confidence, motivation and mental health and well-being status.Research limitations/implicationsResearch limitations are related to the recruitment of more doctoral students across more Australian universities. Further research is required from HDR supervisors, so as to “balance” the experiences of the PhD journey in higher education.Practical implicationsIn order to succeed in academia and HDR programs, students need to identify with and develop the “right kind of capital” to successfully navigate fields of social and scholarly play. Investigating how the participants perceive their social and scholarly habitus is seen as crucial in helping students to develop positive dispositions relevant to being a doctoral student.Social implicationsThe concept of doctoral capital and well-being, amongst Australian PhD students, is under researched and requires further investigation as a precursor to developing more specific policy designs aimed at providing heightened positive learning environments/HDR programs tailored to support doctoral students.Originality/valueWhilst reforms to improve PhD experiences are well established across the international literature (Geven et al., 2018; Skopek et al., 2020), evidence for Australia is largely missing. It is envisaged, that findings from this research will further assist in the development of quality policies that would go to provide effective services and support for doctoral students within Australian universities.
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Mond, Jonathan, Rodney Morice, and Cathy Owen. "Use of Antipsychotic Medications in Australian States and Territories Between July 1995 and December 2001." Australasian Psychiatry 11, no. 3 (September 2003): 267–72. http://dx.doi.org/10.1046/j.1440-1665.2003.00561.x.
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Objective: To examine trends in the use of oral conventional, depot and atypical antipsychotic medications in Australian States and Territories between 1995 and 2001. Methods: For each 6 month interval between July 1995 and December 2001, prescription data obtained were converted into a measure of drug utilization expressed as the number of defined daily doses per thousand population per day (DDDs/1000/day). Data concerning the major specialty of the prescriber were available for the period 1996–2000. Results: In each State and Territory, use of atypical antipsychotic medications increased markedly while use of oral conventional and depot medications declined. Between July 2001 and December 2001, the proportion of total prescriptions for antipsychotic medications accounted for by prescriptions for atypical medications varied from 63.1% in South Australia to 76.1% in the Australian Capital Territory (ACT). Relative use of atypical medications was higher in the ACT than in other regions, while relative use of depot medications was higher in the Northern Territory than in other regions. During the year 2000, the proportion of prescriptions for oral conventional and depot medications written by general practitioners (GPs) exceeded 75% in all regions other than the ACT. Between 1996 and 2000, the proportion of prescriptions for atypical medications written by GPs increased markedly in all regions but remained lower than for oral conventional and depot medications. Conclusions: Atypical antipsychotic medications have replaced conventional medications as the first-line pharmacological treatment for psychotic disorders in all regions of Australia. Continued expansion of programmes designed to foster collaboration between GPs and mental health services will be essential in achieving optimal prescribing of antipsychotic medications.
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Delfabbro, Paul, Julie Lahn, and Peter Grabosky. "Psychosocial Correlates of Problem Gambling in Australian Students." Australian & New Zealand Journal of Psychiatry 40, no. 6-7 (June 2006): 587–95. http://dx.doi.org/10.1080/j.1440-1614.2006.01843.x.
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Objective: This study examined the relationship between problem gambling and psychological and social adjustment in Australian adolescents. Method: A sample of 926 adolescents (mean age=14.46 years) in the Australian Capital Territory were administered a standardized series of measures relating to gambling and psychosocial adjustment. Young people were asked to indicate how often they gambled, to report any difficulties that they might have been experiencing with gambling, and to complete a variety of measures of psychosocial health, including: the GHQ-12, Rosenberg's self-esteem scale and other measures of social functioning. Results: The results were generally consistent with previous international studies. Those adolescents classified as problem gamblers were found to have poorer scores on all psychosocial measures. Although many in the problem gambling group reported being part of a socially active peer group, they also reported being more alienated and unpopular among their classmates. Conclusions: The results suggest that problem gambling appears to be a significant risk factor for poorer mental health among Australia adolescents. Given previous adult research indicating a link between early gambling and long-term gambling problems and poorer life outcomes (e.g. Abbott, McKenna and Giles, 2000 in New Zealand), these findings suggest a need to enhance existing educational initiatives and services specifically designed to assist adolescents with gambling problems.
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Mills, Jason, John P. Rosenberg, and Fran McInerney. "Building community capacity for end of life: an investigation of community capacity and its implications for health-promoting palliative care in the Australian Capital Territory." Critical Public Health 25, no. 2 (August 12, 2014): 218–30. http://dx.doi.org/10.1080/09581596.2014.945396.
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Barton, Elsa, Toby Freeman, Fran Baum, Sara Javanparast, and Angela Lawless. "The feasibility and potential use of case-tracked client journeys in primary healthcare: a pilot study." BMJ Open 9, no. 5 (May 2019): e024419. http://dx.doi.org/10.1136/bmjopen-2018-024419.
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ObjectivesTo determine the feasibility of case-tracking methods in documenting client journeys at primary healthcare (PHC) services in order to investigate the comprehensiveness of service responses and the experiences of clients.DesignProspective pilot study. Quantitative and qualitative case management data were collected from staff via questionnaire or interview.SettingFive Australian multidisciplinary PHC services were involved including four South Australian state-managed and one Northern Territory Aboriginal community-controlled PHC service.ParticipantsClients using services for depression (95) or diabetes (185) at the PHC services were case tracked over a 12-month period to allow construction of client journeys for these two conditions. Clients being tracked were invited to participate in two semi-structured interviews (21) and complete a health log.ResultsThough a number of challenges were encountered, the case-tracking methods were useful in documenting the complex nature of client journeys for those with depression or diabetes accessing PHC services and the need to respond to the social determinants of health. A flexible research design was crucial to respond to the needs of staff and changing organisational environments.ConclusionsThe client journeys provided important information about the services’ responses to depression and diabetes, and about aspects unique to comprehensive PHC such as advocacy and work that takes into account the social determinants of health.
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Islam, Md Irteja, Sharif Bagnulo, Yiwen Wang, Robyn Ramsden, Trent Wrightson, Amanda Masset, Richard Colbran, Mike Edwards, and Alexandra Martiniuk. "Job Satisfaction of Health Practitioners Providing Outreach Health Services during COVID-19 in Rural New South Wales (NSW) and the Australian Capital Territory (ACT), Australia." Healthcare 11, no. 1 (December 20, 2022): 3. http://dx.doi.org/10.3390/healthcare11010003.
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Outreach health practitioners play a key role in enhancing access to healthcare for remote, rural, regional, and Aboriginal and Torres Strait Islander communities in Australia. Outreach health practitioners are those providing ongoing and integrated health services in communities that would otherwise have limited access. In the context of the COVID-19 pandemic, it is important to understand the job satisfaction of health workers as it correlates with long-term retention of the workforce, as well as effectiveness in the role and clinical outcomes for patients. Method: The study analysed data from 258 outreach health practitioners who responded to two cross-sectional surveys conducted by the NSW Rural Doctors Network during the COVID-19 pandemic in 2020/21 and 2021/22 in NSW and the ACT, Australia. Both bivariate and multivariate analyses were employed to assess the associations between the outcome variable (outreach health practitioners’ job satisfaction) and independent variables (sociodemographic factors, motivation, self-confidence, communication, capability). Results: Overall, the study showed that 92.2% of health practitioners were satisfied in their role providing outreach health services during the COVID-19 pandemic. In the multivariable model, factors significantly associated with higher satisfaction included good communication with other local health practitioners, using telehealth along with in-person care, and having high self-rated capability compared to those health practitioners who said they had lower job satisfaction. Conclusions: Outreach health practitioners’ job satisfaction is important because poor satisfaction may lead to suboptimal healthcare delivery, poor clinical outcomes, and poor retention of staff in rural settings. These findings should be taken into consideration when developing future strategies to improve job satisfaction among rural outreach health practitioners and to enhance attraction, recruitment and retention and may be applicable to the broader health workforce.
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Fitts, Michelle S., John Humphreys, Terry Dunbar, Lisa Bourke, Edward Mulholland, Steven Guthridge, Yuejen Zhao, et al. "Understanding and responding to the cost and health impact of short-term health staffing in remote and rural Aboriginal and Torres Strait Islander community-controlled health services: a mixed methods study protocol." BMJ Open 11, no. 8 (August 2021): e043902. http://dx.doi.org/10.1136/bmjopen-2020-043902.
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IntroductionAccess to high-quality primary healthcare is limited for remote residents in Australia. Increasingly, remote health services are reliant on short-term or ‘fly-in, fly-out/drive-in, drive-out’ health workforce to deliver primary healthcare. A key strategy to achieving health service access equity, particularly evident in remote Australia, has been the development of Aboriginal Community Controlled Health Services (ACCHSs). This study aims to generate new knowledge about (1) the impact of short-term staffing in remote and rural ACCHSs on Aboriginal and Torres Strait Islander communities; (2) the potential mitigating effect of community control; and (3) effective, context-specific evidence-based retention strategies.Methods and analysisThis paper describes a 3-year, mixed methods study involving 12 ACCHSs across three states. The methods are situated within an evidence-based programme logic framework for rural and remote primary healthcare services. Quantitative data will be used to describe staffing stability and turnover, with multiple regression analyses to determine associations between independent variables (population size, geographical remoteness, resident staff turnover and socioeconomic status) and dependent variables related to patient care, service cost, quality and effectiveness. Qualitative assessment will include interviews and focus groups with clinical staff, clinic users, regionally-based retrieval staff and representatives of jurisdictional peak bodies for the ACCHS sector, to understand the impact of short-term staff on quality and continuity of patient care, as well as satisfaction and acceptability of services.Ethics and disseminationThe study has ethics approval from the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research (project number DR03171), Central Australian Human Research Ethics Committee (CA-19-3493), Western Australian Aboriginal Health Ethics Committee (WAAHEC-938) and Far North Queensland Human Research Ethics Committee (HREC/2019/QCH/56393). Results will be disseminated through peer-reviewed journals, the project steering committee and community/stakeholder engagement activities to be determined by each ACCHS.
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Lowe, Michael, and Pasqualina Coffey. "Effect of an ageing population on services for the elderly in the Northern Territory." Australian Health Review 43, no. 1 (2019): 71. http://dx.doi.org/10.1071/ah17068.
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Objective The aim of the present study was to describe the elderly population of the Northern Territory (NT), explore the challenges of delivering aged care services to this population and implications for the acute care sector. Methods Data gathered from a variety of sources were used to describe the demographic and health profile of elderly Territorians, the aged care structure and services in the NT, and admission trends of elderly patients in NT hospitals. Information regarding NT community and residential aged care services was sourced from government reports. NT public hospital admissions from 2001 to 2015 were adjusted by the estimated Aboriginal and non-Aboriginal populations. Results In 2015, elderly people constituted 9.2% of the NT population and this number is predicted to increase. Between 2001 and 2015, the number and rate of elderly admissions to NT public hospitals increased significantly. Compared with other jurisdictions, aged care in the NT is dominated by community services, which are of limited scope. Important geographical and economic factors affect the availability of residential aged care beds. This, in turn, affects the ability of elderly people to transition from hospital settings. Conclusions The NT has a relatively small but growing elderly population with increasing needs. This population is markedly different compared with its counterparts in other Australian states and territories, but receives aged care services based on national policies. Recent changes to community-based services and increases in residential beds should improve services and care, although remaining challenges and gaps need to be addressed. What is known about the topic? Increasing health and care needs of elderly people will place significant stress across the health and aged care system. In Australia, most aged care services are apportioned and funded under a national system. The NT has a markedly different population profile compared with the rest of Australia, which gives rise to unique considerations, but its aged care structure is based on nationally developed policies. What does this paper add? Elderly people in the NT are increasingly using acute care services. Aged care services in the NT have higher ratios of community-based services to residential aged care facilities (RACF) as a consequence of a ‘younger’ cohort of Aboriginal elderly people who live remotely. In addition, economic factors affect the low number of RACF places. As evidenced in past years, a small pool of beds can adversely affect the numbers and length of stay of elderly people waiting in hospitals. What are the implications for practitioners? The NT has a small but growing population of elderly people, which will place an increasing burden on acute care services that are ill equipped to manage their specific needs. Recent RACF and flexible care bed approvals may alleviate past difficulties to transition hospital patients awaiting RACF placement. Significant changes at the national level to community-based care services that increase flexibility for providers may bring about better outcomes for remote elderly recipients. However, high costs and issues with remote servicing will remain. Psychogeriatrics remains a major underserviced area in the NT with no prospective solution.
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J., Oguche, C., Dawam P. D., and Ebehikhalu O. .N. "Evaluation of Distance Cover to Access Services/Facilities in Informal Settlements in Federal Capital Territory, Abuja, Nigeria." Journal of Environmental Impact and Management Policy, no. 11 (August 27, 2021): 1–9. http://dx.doi.org/10.55529/jeimp11.1.9.
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The study examines distance cover to access services/facilities in informal settlements in Federal Capital Territory, Abuja, Nigeria. Specifically, the objective of the study was to: evaluate the distance cover to access services/facilities in informal settlements in the study area. Data were collected through primary and secondary data. The study makes use of multi-stage sampling techniques involving three stages (random sampling for selecting two communities from the six area councils at the first stage, a systematic random sampling technique was used in the administration of questionnaires to the twelve randomly selected informal housing and the questionnaires were administered to each community in relation to population size. A total of 800 questionnaires were distributed, out of which 792 were return successfully. And it was analyzed using simple statistics table. The finding reveals that 46.1% of the respondents’ access schools services/facilities at the distance of 4km and above. The paper also suggested that steps be taken to improve quality of housing scheme targeting the urban poor through public housing delivery by Government and the road network in the study area is un-tarred and dilapidated, therefore the government should construct a road to reduce the long distances cover for services and facilities like, health care, schools, market, police station, bank and water and also the suffering of the people living in these informal settlements may be reduce.
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Lystad, Reidar P., Benjamin T. Brown, Michael S. Swain, and Roger M. Engel. "Impact of the COVID-19 Pandemic on Manual Therapy Service Utilization within the Australian Private Healthcare Setting." Healthcare 8, no. 4 (December 13, 2020): 558. http://dx.doi.org/10.3390/healthcare8040558.
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The COVID-19 pandemic has impacted a wide range of health services. This study aimed to quantify the impact of the COVID-19 pandemic on manual therapy service utilization within the Australian private healthcare setting during the first half of 2020. Quarterly data regarding the number and total cost of services provided were extracted for each manual therapy profession (i.e., chiropractic, osteopathy, and physiotherapy) for the period January 2015 to June 2020 from the Australian Prudential Regulation Authority. Time series forecasting methods were used to estimate absolute and relative differences between the forecasted and observed values of service utilization. An estimated 1.3 million (13.2%) fewer manual therapy services, with a total cost of AUD 84 million, were provided within the Australian private healthcare setting during the first half of 2020. Reduction in service utilization was considerably larger in the second quarter (21.7%) than in the first quarter (5.7%), and was larger in physiotherapy (20.6%) and osteopathy (12.7%) than in chiropractic (5.2%). The impact varied across states and territories, with the largest reductions in service utilization observed in New South Wales (17.5%), Australian Capital Territory (16.3%), and Victoria (16.2%). The COVID-19 pandemic has had a profound impact on manual therapy service utilization in Australia. The magnitude of the decline in service utilization varied considerably across professions and locations. The long-term consequences of this decline in manual therapy utilization remain to be determined.
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Freeman, Toby, Fran Baum, Ronald Labonté, Sara Javanparast, and Angela Lawless. "Primary health care reform, dilemmatic space and risk of burnout among health workers." Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 22, no. 3 (February 17, 2017): 277–97. http://dx.doi.org/10.1177/1363459317693404.
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Health system changes may increase primary health care workers’ dilemmatic space, created when reforms contravene professional values. Dilemmatic space may be a risk factor for burnout. This study partnered with six Australian primary health care services (in South Australia: four state government–managed services including one Aboriginal health team and one non-government organisation and in Northern Territory: one Aboriginal community–controlled service) during a period of change and examined workers’ dilemmatic space and incidence of burnout. Dilemmatic space and burnout were assessed in a survey of 130 staff across the six services (58% response rate). Additionally, 63 interviews were conducted with practitioners, managers, regional executives and health department staff. Dilemmatic space occurred across all services and was associated with higher rates of self-reported burnout. Three conditions associated with dilemmatic space were (1) conditions inherent in comprehensive primary health care, (2) stemming from service provision for Aboriginal and Torres Strait Islander peoples and (3) changes wrought by reorientation to selective primary health care in South Australia. Responses to dilemmatic space included ignoring directives or doing work ‘under the radar’, undertaking alternative work congruent with primary health care values outside of hours, or leaving the organisation. The findings show that comprehensive primary health care was contested and political. Future health reform processes would benefit from considering alignment of changes with staff values to reduce negative effects of the reform and safeguard worker wellbeing.
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Anwar, Yasmeen, Fahad Abbasi, Abdullah Hafeez, Siham Sikander, and Assad Hafeez. "Resources for Preventing and Responding to Violence Against Children in Islamabad Capital Territory Pakistan." Pakistan Journal of Public Health 10, no. 2 (February 5, 2021): 125–32. http://dx.doi.org/10.32413/pjph.v10i2.493.
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Violence against children (VAC) is a serious problem with many millions of children being affected globally with serious health, social, and economic consequences. WHO has published an evidence-based framework (INSPIRE: Seven strategies to end Violence against Children), suggesting that prevention and effective response to VAC can be achieved through strategies directed at changing and modulating certain determinants. INSPIRE identifies 1) implementation of laws, 2) changing norms & values, 3) safe environments, 4) parent and caregiver support, 5) income and economic strengthening, 6) response and support services, and 7) education & life skills as areas where efforts can yield maximum impact. Our objective was to review the literature on available resources in the capital of Pakistan (Islamabad Capital City) to establish current state of affairs in terms of prevention and response to VAC. Resources for prevention and response to VAC according to the INSPIRE framework are discussed. We have found that laws are mostly ambiguous, implementation is rare; norms promote early and arranged marriages for girls, allow corporal punishment and child labor, shun all dialogue around sex and sexuality, and overtly prefer male offspring; many children live and work on the street; no large-scale programmes for parent and caregiver support to improve prevention and response to VAC were found; some income support programmes exist but they are unlikely to be organized or integrated with other services; some response and support services were found from both the public and private sectors, yet their effectiveness has not been established; life skill programmes are announced but even among the expensive private schools, only a few teach life skills. Although estimated to be high, there is no official data available on VAC, therefore the quantum of the problem cannot be ascertained. All relevant sectors will have to collaborate to bring about meaningful progress in child protection, prevention of VAC, and wellbeing of children. Preventive interventions and trauma-informed care by the health-sector are urgent needs. Formation of a central body for children’s affairs can ensure exclusive budget allocation to address child-specific issues, co-operation and collaboration from all concerned, and community and stakeholder participation. A comprehensive information system, effective large-scale interventions, and context-specific research are required to improve the state of available resources.