Journal articles on the topic 'Health service provision (Australia)'
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Spinks, Jean, Stephen Birch, Amanda J. Wheeler, Lisa Nissen, Christopher Freeman, Thao Thai, and Joshua Byrnes. "Provision of home medicines reviews in Australia: linking population need with service provision and available pharmacist workforce." Australian Health Review 44, no. 6 (2020): 973. http://dx.doi.org/10.1071/ah19207.
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ObjectiveIdentifying and quantifying the health needs of a population are the basis of evidence-based health policy and workforce planning. The motivation for undertaking the present study was to evaluate whether the current level of medication review services corresponds to population need, as proxied by the rate of polypharmacy, and to undertake a preliminary analysis of the sufficiency of the current workforce. This paper: (1) estimates the age- and sex-standardised rates of polypharmacy as a proxy for population need for home medicines review; (2) compares the rate of polypharmacy with current service provision of home medicines reviews; and (3) links the estimated need for services with the current number and location of pharmacist providers. MethodsAge- and sex-adjusted polypharmacy rates, by state, were estimated from the National Health Survey of Australia (2017–18), service levels were estimated from national-level administrative claims data (2017–18) and the current workforce was estimated from the Australian Association of Consultant Pharmacists (2018). The current level of service provision was compared to the estimated population need for services, alongside the size of the pharmacy workforce required if need was met. ResultsThe adjusted rate of polypharmacy in Australia, using the strictest definition of ≥10 medications and ≥3 current chronic illnesses, was 1389 per 100000 population. The illustrative needs-based analysis suggests that there may be a disconnect between the current level of service provision and population health needs. ConclusionGiven that polypharmacy is a risk factor for medication-related problems, and that medication review is one of the few targeted strategies currently available to address medication-related problems in the population, service provision may be inadequate. Policy options to improve service provision could include interventions to increase workforce productivity and relaxing the current eligibility criteria for review, especially in rural and remote areas. What is known about the topic?Polypharmacy is a risk factor for medication-related problems, which can cause increased morbidity and mortality in the population. What does this paper add?This paper provides representative, population-based rates of polypharmacy in Australia and uses these rates in a needs-based analysis of service provision and workforce adequacy to provide home medicines review services. What are the implications for practitioners?Several policy options are available for consideration, including interventions to increase workforce productivity and relaxation of the current eligibility criteria for medicines review, especially in rural and remote areas.
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Walker, Christopher. "An overview of the role of government in the organisation and provision of health services in Japan." Australian Health Review 19, no. 2 (1996): 75. http://dx.doi.org/10.1071/ah960075.
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This article is illustrated with reference to health services in the Tokyo Prefecture.It seeks to describe the role of government in the organisation and provision of healthservices in Japan. It is based on experiences gained from a three-month placementat the Tokyo Metropolitan Government Bureau of Public Health in late 1994.Wherever possible the article identifies similarities and differences between theJapanese and Australian health care systems. Part of the analysis has been to identifyareas where opportunities exist for Australian health service providers to developfurther cooperation with particular sectors of the Japanese health system and alsowhere the potential for the export of health services may exist.The health systems of Australia and Japan have points of similarity anddifference. Essentially both systems operate within the context of a compulsoryuniversal health insurance system. However, unlike Australia, the bulk of serviceprovision in Japan is left to the private sector, while government retains the primaryrole of regulator. It is interesting to observe that while the Australian health caresystem is currently exploring options to expand the service range and level ofparticipation of private sector services in health care delivery (within the context ofuniversal health insurance), the Japanese health care system appears to be examiningoptions through which further government intervention can improve service accessand service efficiency. Japan presents opportunities to observe the benefits anddisadvantages of predominantly private sector provision within the context ofuniversal health insurance coverage.
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Glasheen, Kevin, and Marilyn Campbell. "The use of online counselling within an Australian secondary school setting: A practitioner’s viewpoint." Counselling Psychology Review 24, no. 2 (March 2009): 42–51. http://dx.doi.org/10.53841/bpscpr.2009.24.2.42.
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This paper proposes that the provision of online counselling services for young people accessed through their local school website has the potential to assist students with mental health issues as well as increasing their help seeking behaviours. It stems from the work of the authors who trialled an online counselling service within one Australian secondary school. In Australia, online counselling with the adult population is now an accepted part of the provision of mental health services. Online provision of mental health information for young people is also well accepted. However, online counselling for young people is provided by only a few community organisations such as Kids Help Line within Australia. School-based counselling services which are integral to most secondary schools in Australia, seem slow to provide this service in spite of initial interest and enthusiasm by individual school counsellors. This discussion is the product of reflection on the potential benefits of this trial with a consideration of relevant research of the issues raised. It highlights the need for further research into the use of computer-mediated communication in the provision of counselling within a school setting.
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Wilson, Sally G., Michael Tsui, Nicholas Tong, David I. Wilson, and Colin B. Chapman. "Hospital pharmacy service provision in Australia—1998." American Journal of Health-System Pharmacy 57, no. 7 (April 1, 2000): 677–80. http://dx.doi.org/10.1093/ajhp/57.7.677.
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van Spijker, Bregje A., Jose A. Salinas-Perez, John Mendoza, Tanya Bell, Nasser Bagheri, Mary Anne Furst, Julia Reynolds, et al. "Service availability and capacity in rural mental health in Australia: Analysing gaps using an Integrated Mental Health Atlas." Australian & New Zealand Journal of Psychiatry 53, no. 10 (June 28, 2019): 1000–1012. http://dx.doi.org/10.1177/0004867419857809.
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Objective: Access to services and workforce shortages are major challenges in rural areas worldwide. In order to improve access to mental health care, it is imperative to understand what services are available, what their capacity is and where existing funds might be spent to increase availability and accessibility. The aim of this study is to investigate mental health service provision in a selection of rural and remote areas across Australia by analysing service availability, placement capacity and diversity. Method: This research studies the health regions of Western New South Wales and Country Western Australia and their nine health areas. Service provision was analysed using the DESDE-LTC system for long-term care service description and classification that allows international comparison. Rates per 100,000 inhabitants were calculated to compare the care availability and placement capacity for children and adolescents, adults and older adults. Results: The lowest diversity was found in northern Western Australia. Overall, Western New South Wales had a higher availability of non-acute outpatient services for adults, but hardly any acute outpatient services. In Country Western Australia, substantially fewer non-acute outpatient services were found, while acute services were much more common. Acute inpatient care services were more common in Western New South Wales, while sub-acute inpatient services and non-acute day care services were only found in Western New South Wales. Conclusion: The number and span of services in the two regions showed discrepancies both within and between regions, raising issues on the equity of access to mental health care in Australia. The standard description of the local pattern of rural mental health care and its comparison across jurisdictions is critical for evidence-informed policy planning and resource allocation.
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Fauk, Nelsensius Klau, Anna Ziersch, Hailay Gesesew, Paul Ward, Erin Green, Enaam Oudih, Roheena Tahir, and Lillian Mwanri. "Migrants and Service Providers’ Perspectives of Barriers to Accessing Mental Health Services in South Australia: A Case of African Migrants with a Refugee Background in South Australia." International Journal of Environmental Research and Public Health 18, no. 17 (August 24, 2021): 8906. http://dx.doi.org/10.3390/ijerph18178906.
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International mobility has increased steadily in recent times, bringing along a myriad of health, social and health system challenges to migrants themselves and the host nations. Mental health issues have been identified as a significant problem among migrants, with poor accessibility and underutilisation of the available mental health services (MHSs) repeatedly reported, including in Australia. Using a qualitative inquiry and one-on-one in-depth interviews, this study explored perspectives of African migrants and service providers on barriers to accessing MHSs among African migrants in South Australia. The data collection took place during the COVID-19 pandemic with lockdown and other measures to combat the pandemic restricting face to face meetings with potential participants. Online platforms including Zoom and/or WhatsApp video calls were used to interview 20 African migrants and 10 service providers. Participants were recruited from community groups and/or associations, and organisations providing services for migrants and/or refugees in South Australia using the snowball sampling technique. Thematic framework analysis was used to guide the data analysis. Key themes centred on personal factors (health literacy including knowledge and the understanding of the health system, and poor financial condition), structural factors related to difficulties in navigating the complexity of the health system and a lack of culturally aware service provision, sociocultural and religious factors, mental health stigma and discrimination. The findings provide an insight into the experiences of African migrants of service provision to them and offer suggestions on how to improve these migrants’ mental health outcomes in Australia. Overcoming barriers to accessing mental health services would need a wide range of strategies including education on mental health, recognising variations in cultures for effective service provision, and addressing mental health stigma and discrimination which strongly deter service access by these migrants. These strategies will facilitate help-seeking behaviours as well as effective provision of culturally safe MHSs and improvement in access to MHSs among African migrants.
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Tabatabaei-Jafari, Hossein, Jose A. Salinas-Perez, Mary Anne Furst, Nasser Bagheri, John Mendoza, David Burke, Peter McGeorge, and Luis Salvador-Carulla. "Patterns of Service Provision in Older People’s Mental Health Care in Australia." International Journal of Environmental Research and Public Health 17, no. 22 (November 17, 2020): 8516. http://dx.doi.org/10.3390/ijerph17228516.
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Australia has a population of around 4 million people aged 65 years and over, many of whom are at risk of developing cognitive decline, mental illness, and/or psychological problems associated with physical illnesses. The aim of this study was to describe the pattern of specialised mental healthcare provision (availability, placement capacity, balance of care and diversity) for this age group in urban and rural health districts in Australia. The Description and Evaluation of Services and DirectoriEs for Long Term Care (DESDE-LTC) tool was used in nine urban and two rural health districts of the thirty-one Primary Health Networks across Australia. For the most part service provision was limited to hospital and outpatient care across all study areas. The latter was mainly restricted to health-related outpatient care, and there was a relative lack of social outpatient care. While both acute and non-acute hospital care were available in urban areas, in rural areas hospital care was limited to acute care. Limited access to comprehensive mental health care, and the uniformity in provision across areas in spite of differences in demographic, socioeconomic and health characteristics raises issues of equity in regard to psychogeriatric care in this country. Comparing patterns of mental health service provision across the age span using the same classification method allows for a better understanding of care provision and gap analysis for evidence-informed policy.
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Rudd, Cobie J. "Topic: Current issues in mental health service provision in Australia." Collegian 14, no. 3 (January 2007): 3–4. http://dx.doi.org/10.1016/s1322-7696(08)60556-9.
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Procter, Nicholas G. "Topic: Current issues in mental health service provision in Australia." Collegian 14, no. 3 (January 2007): 4. http://dx.doi.org/10.1016/s1322-7696(08)60557-0.
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Bourke, Sharon L., Claire Harper, Elianna Johnson, Janet Green, Ligi Anish, Miriam Muduwa, and Linda Jones. "Health Care Experiences in Rural, Remote, and Metropolitan Areas of Australia." Online Journal of Rural Nursing and Health Care 21, no. 1 (May 4, 2021): 67–84. http://dx.doi.org/10.14574/ojrnhc.v21i1.652.
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Background: Australia is a vast land with extremes in weather and terrain. Disparities exist between the health of those who reside in the metropolitan areas versus those who reside in the rural and remote areas of the country. Australia has a public health system called Medicare; a basic level of health cover for all Australians that is funded by taxpayers. Most of the hospital and health services are located in metropolitan areas, however for those who live in rural or remote areas the level of health service provision can be lower; with patients required to travel long distances for health care.
Purpose: This paper will explore the disparities experienced by Australians who reside in regional and remote areas of Australia.
Method: A search of the literature was performed from healthcare databases using the search terms: healthcare, rural and remote Australia, and social determinants of health in Australia.
Findings: Life in the rural and remote areas of Australia is identified as challenging compared to the metropolitan areas. Those with chronic illnesses such as diabetes are particularly vulnerable to morbidities associated with poor access to health resources and the lack of service provision.
Conclusion: Australia has a world class health system. It has been estimated that 70% of the Australian population resides in large metropolitan areas and remaining 30% distributed across rural and remote communities. This means that 30% of the population are not experiencing their health care as ‘world-class’, but rather are experiencing huge disparities in their health outcomes.
Keywords: rural and remote, health access, mental health issues, social determinants
DOI: https://doi.org/10.14574/ojrnhc.v21i1.652
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Reifels, Lennart, Bridget Bassilios, and Jane Pirkis. "National telemental health responses to a major bushfire disaster." Journal of Telemedicine and Telecare 18, no. 4 (May 22, 2012): 226–30. http://dx.doi.org/10.1258/jtt.2012.110902.
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In response to the Victorian bushfire disaster in 2009, various telemental health services were provided by three national agencies: Kids Helpline (BoysTown), MensLine Australia (Crisis Support Services) and Lifeline Australia. All provider agencies used their existing national service structures and staff resources, which were expanded to respond to bushfire-related service demand. We examined service provider reports and conducted key informant interviews. Despite a lack of quantitative data on consumer outcomes and perspectives, it appears that all three telemental health services experienced significant increases in overall service uptake levels in the wake of the bushfires. Uptake of specialized telephone-, web-, email- and crisis counselling services was substantial, although that of callback services was very limited. Potential clients encountered specific barriers in relation to service access and the callback model. The bushfire experience highlighted the impact of transitory living circumstances and the increased complexity of post-disaster calls on service provision. Telemental health services need to be integrated into mainstream services and disaster response structures.
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Schmied, Virginia, Cathrine Fowler, Chris Rossiter, Caroline Homer, Sue Kruske, and The CHoRUS team. "Nature and frequency of services provided by child and family health nurses in Australia: results of a national survey." Australian Health Review 38, no. 2 (2014): 177. http://dx.doi.org/10.1071/ah13195.
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Objective Australia has a system of universal child and family health (CFH) nursing services providing primary health services from birth to school entry. Herein, we report on the findings of the first national survey of CFH nurses, including the ages and circumstances of children and families seen by CFH nurses and the nature and frequency of the services provided by these nurses across Australia. Methods A national survey of CFH nurses was conducted. Results In all, 1098 CFH nurses responded to the survey. Over 60% were engaged in delivering primary prevention services from a universal platform. Overall, 82.8% reported that their service made first contact with families within 2 weeks of birth, usually in the home (80.7%). The proportion of respondents providing regular support to families decreased as the child aged. Services were primarily health centre based, although 25% reported providing services in other locations (parks, preschools).The timing and location of first contact, the frequency of ongoing services and the composition of families seen by nurses varied across Australian jurisdictions. Nurses identified time constraints as the key barrier to the delivery of comprehensive services. Conclusions CFH nurses play an important role in supporting families across Australia. The impact of differences in the CFH nursing provision across Australia requires further investigation. What is known about the topic? Countries that offer universal well child health services demonstrate better child health and developmental outcomes than countries that do not. Australian jurisdictions offer free, universal child and family health (CFH) nursing services from birth to school entry. What does this paper add? This paper provides nation-wide data on the nature of work undertaken by CFH nurses offering universal care. Across Australia, there are differences in the timing and location of first contact, the frequency of ongoing services and the range of families seen by nurses. What are the implications for practitioners? The impact for families of the variation in CFH nursing services offered across Australia is not known. Further research is required to investigate the outcomes of the service provision variations identified in the present study.
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Byrne, Louise, Michael Wilson, Karena J. Burke, Cadeyrn J. Gaskin, and Brenda Happell. "Mental health service delivery: a profile of mental health non-government organisations in south-east Queensland, Australia." Australian Health Review 38, no. 2 (2014): 202. http://dx.doi.org/10.1071/ah13208.
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Objective Non-government organisations make a substantial contribution to the provision of mental health services; despite this, there has been little research and evaluation targeted at understanding the role played by these services within the community mental health sector. The aim of the present study was to examine the depth and breadth of services offered by these organisations in south-east Queensland, Australia, across five key aspects of reach and delivery. Methods Representatives from 52 purposively targeted non-government organisations providing mental health services to individuals with significant mental health challenges were interviewed regarding their approach to mental health service provision. Results The findings indicated a diverse pattern of service frameworks across the sector. The results also suggested a positive approach to the inclusion of consumer participation within the organisations, with most services reporting, at the very least, some form of consumer advocacy within their processes and as part of their services. Conclusions This paper offers an important first look at the nature of non-government service provision within the mental health sector and highlights the importance of these organisations within the community sector. What is known about the topic? Non-government organisations make a substantial contribution to the multisectorial provision of services to mental health consumers in community settings. Non-government organisations in Australia are well established, with 79.9% of them being in operation for over 10 years. There is an increasing expectation that consumers influence the development, delivery and evaluation of mental health services, especially in the community sector. What does this paper add? This paper provides a profile of non-government organisations in one state in Australia with respect to the services they provide, the consumers they target, the practice frameworks they use, the use of peer workers and consumer participation, the success they have had with obtaining funding and the extent to which they collaborate with other services. What are the implications for practitioners? This paper provides readers with an understanding of the non-government organisations and the services they provide to people with mental health conditions. In addition, the findings provide an opportunity to learn from the experience of non-government organisations in implementing consumer participation initiatives.
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Singh, Yolisha, John Kasinathan, and Andrew Kennedy. "Incarcerated youth mental and physical health: parity of esteem." International Journal of Human Rights in Healthcare 10, no. 3 (July 10, 2017): 203–12. http://dx.doi.org/10.1108/ijhrh-03-2017-0011.
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Purpose The purpose of this paper is to describe physical and mental health characteristics of incarcerated youth both internationally and in New South Wales (NSW) Australia. To outline current practices in the provision of mental and physical healthcare for incarcerated youth internationally and in NSW. Design/methodology/approach Population relevant literature will be outlined as applicable. Health service delivery will be discussed, with an emphasis on the experiences of NSW physical and mental health service provision for incarcerated youth. Findings This paper illustrates that in NSW there was a parity of provision between physical and mental healthcare, though there were deficits in what should ideally be provided. Internationally there was clear evidence that current minimum standards of healthcare in both physical and mental healthcare domains remain unmet. Practical implications Provision of physical and mental healthcare for incarcerated youth warrants global improvement. Further research into current provisions, across jurisdictions and subsequent standardisation of practice, will improve health outcomes for this vulnerable group. Originality/value This is the first paper to describe mental and physical healthcare provision in NSW for incarcerated youth framed within the broader context of international health service provision for similar populations.
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Martin, Louise, Bonita Lloyd, Paul Cammell, and Frank Yeomans. "Transference-Focused Psychotherapy in Australian psychiatric training and practice." Australasian Psychiatry 25, no. 3 (September 27, 2016): 233–35. http://dx.doi.org/10.1177/1039856216671661.
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Objective: This article discusses Transference-Focused Psychotherapy, a contemporary evidence-based and manualised form of psychoanalytic psychotherapy for borderline personality disorder. Transference focused psychotherapy has evolved from decades of research in the object-relations approach developed by Professor Otto Kernberg and his collaborators. It is being adopted increasingly throughout North and South America and Europe, and this article explores the role its adoption might play in psychiatric training as well as public and private service provision contexts in Australia. Conclusions: Transference focused psychotherapy is readily applicable in a range of training, research and public and private service provision contexts in Australia. A numbers of aspects of current Australian psychiatric training and practice, such as the Royal Australian and New Zealand College of Psychiatrists advanced training certificate, and the Australian medicare schedule, make it especially relevant for this purpose.
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Whitla, Mardie, Gordon Walker, and Ailsa Drent. "School psychological and guidance services in Australia: Critical issues and implications for future directions." Journal of Psychologists and Counsellors in Schools 2 (November 1992): 1–15. http://dx.doi.org/10.1017/s1037291100002223.
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Psychological services delivered at school level play a significant role in the overall educational development and health of students. Across Australia, guidance and counselling services are currently in a state of flux, with reductions or redirections of services in most states. Some critical issues are raised in regard to present and future service provision for students, teachers and families. This paper presents a ‘case study’ of Victorian services, and an Australian ‘snapshot’ of existing school guidance services, as at April 1992.
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Crissman, Belinda, Catrin Smith, Janet Ransley, and Troy Allard. "Women’s Health in Queensland Prisons." International Journal of Offender Therapy and Comparative Criminology 61, no. 5 (July 28, 2016): 582–603. http://dx.doi.org/10.1177/0306624x15598960.
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Internationally, best practice for prison health care recommends transferring health service provision from corrections to health authorities. Although it is expected that this change will result in improved health care, there is little evidence of evaluation. This article used qualitative interviews with health service providers to gain insight into the health needs of women’s prisons in Queensland, Australia, both prior to and after the transition in health care service provision. We found that service providers identified that problems persisted regardless of service provider and that improvement required increased resources and more fundamental structural changes within prison environments.
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Fox, Haylee, Emily Callander, Daniel Lindsay, and Stephanie M. Topp. "Is there unwarranted variation in obstetric practice in Australia? Obstetric intervention trends in Queensland hospitals." Australian Health Review 45, no. 2 (2021): 157. http://dx.doi.org/10.1071/ah20014.
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ObjectiveThe aim of this study was to report on the rates of obstetric interventions within each hospital jurisdiction in the state of Queensland, Australia. MethodsThis project used a whole-of-population linked dataset that included the health and cost data of all mothers who gave birth in Queensland, Australia, between 2012 and 2015 (n=186789), plus their babies (n=189909). Adjusted and unadjusted rates of obstetric interventions and non-instrumental vaginal delivery were reported within each hospital jurisdiction in Queensland. ResultsHigh rates of obstetric intervention exist in both the private and public sectors, with higher rates demonstrated in the private than public sector. Within the public sector, there is substantial variation in rates of intervention between hospital and health service jurisdictions after adjusting for confounding variables that influence the need for obstetric intervention. ConclusionsDue to the high rates of obstetric interventions statewide, a deeper understanding is needed of what factors may be driving these high rates at the health service level, with a focus on the clinical necessity of the provision of Caesarean sections. What is known about the topic?Variation in clinical practice exists in many health disciplines, including obstetric care. Variation in obstetric practice exists between subpopulation groups and between states and territories in Australia. What does this paper add?What we know from this microlevel analysis of obstetric intervention provision within the Australian population is that the provision of obstetric intervention varies substantially between public sector hospital and health services and that this variation is not wholly attributable to clinical or demographic factors of mothers. What are the implications for practitioners?Individual health service providers need to examine the factors that may be driving high rates of Caesarean sections within their institution, with a focus on the clinical necessity of Caesarean section.
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Kruger, Estie, Irosha Perera, and Marc Tennant. "Primary oral health service provision in Aboriginal Medical Services-based dental clinics in Western Australia." Australian Journal of Primary Health 16, no. 4 (2010): 291. http://dx.doi.org/10.1071/py10028.
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Australians living in rural and remote areas have poorer access to dental care. This situation is attributed to workforce shortages, limited facilities and large distances to care centres. Against this backdrop, rural and remote Indigenous (Aboriginal) communities in Western Australia seem to be more disadvantaged because evidence suggests they have poorer oral health than non-Indigenous people. Hence, provision of dental care for Aboriginal populations in culturally appropriate settings in rural and remote Western Australia is an important public health issue. The aim of this research was to compare services between the Aboriginal Medical Services (AMS)-based clinics and a typical rural community clinic. A retrospective analysis of patient demographics and clinical treatment data was undertaken among patients who attended the dental clinics over a period of 6 years from 1999 to 2004. The majority of patients who received dental care at AMS dental clinics were Aboriginal (95.3%), compared with 8% at the non-AMS clinic. The rate of emergency at the non-AMS clinic was 33.5%, compared with 79.2% at the AMS clinics. The present study confirmed that more Indigenous patients were treated in AMS dental clinics and the mix of dental care provided was dominated by emergency care and oral surgery. This indicated a higher burden of oral disease and late utilisation of dental care services (more focus on tooth extraction) among rural and remote Indigenous people in Western Australia.
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Zeng, Grace, Donna Chung, and Beverley McNamara. "Organisational contexts and practice developments in mental health peer provision in Western Australia." Journal of Health Organization and Management 34, no. 5 (June 8, 2020): 569–85. http://dx.doi.org/10.1108/jhom-09-2019-0281.
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PurposeOver the past decade, the push for recovery-oriented services has birthed a growth in the recruitment of peer providers in mental health services: Persons who live with and manage their mental health challenges and are employed to support persons currently using mental health services. The aim of this paper is to compare the responses of government and non-government organisations to the implementation of peer provision.Design/methodology/approachEmploying a qualitative study design, 15 people who supervised peer providers or who were strategically involved in peer provision were recruited using snowball sampling. Participants completed an in-depth interview that explored how peer provision services operated at their organisation and factors that shaped the way peer provision operates. The interviews were transcribed and analysed using Moore's Strategic Triangle. Synthesised member checking and researcher triangulation ensued to establish trustworthiness.FindingsThe way in which peer provision operated sat along a continuum ranging from adoption (where practices are shaped by the recovery ethos) to co-option (where recovery work may be undertaken, but not shaped by the recovery ethos). Political and legal mandates that affected the operational capacities of each organisation shaped the way peer provision services operated.Research limitations/implicationsThe findings of the study highlight the need to reconsider where peer provision services fit in the mental health system. Research investigating the value of peer provision services may attract the support of funders, service users and policy makers alike.Originality/valueIn employing Moore's strategic triangle to evaluate the alignment of policy (the authorising environment) with the operational capacity and practice of peer provision services (the task environment), this study found that organisational response to peer provision is largely influenced by political and legal mandates externally. The successful implementation of peer provision is mediated by effective supervision of peer providers.
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Hoodless, Mary, and Frank Evans. "The Multipurpose Service Program: The Best Health Service Option for Rural Australia." Australian Journal of Primary Health 7, no. 1 (2001): 90. http://dx.doi.org/10.1071/py01015.
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Small relatively isolated rural communities in Australia have been provided with the opportunity to address the difficulties surrounding the provision of health services. The Multi Purpose Services (MPS) program was initiated in 1991 when it was identified that small rural communities have been disadvantaged by separated Commonwealth and state funding arrangements and the criteria for these arrangements where services were often unable to be sustained separately. The MPS program provided the opportunity for sustainability through flexibility and pooling of resources. The application of a primary health care framework would enable more community consultation and participation in reorientating rural health services. Upper Murray Health and Community Services (UMH&CS), a small rural health service in North East Victoria, embraced the concept and undertook a rigorous Evidence Based Needs Assessment to reorientate its health service. The needs assessment combined a sociodemographic, epidemiological and community consultative approach. Evidence of best practice was identified and the recommendations were used for ongoing service development. UMH&CS represents a highly integrated health service and as such a number of strategies are used to enable the continuum of care. These include point of contact advocacy, continuum and coordination of care and the use of a standardised multidisciplinary assessment and outcome based care plan. This paper expands on these processes and the opportunities the MPS has provided to address the health needs of small rural communities.
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Donoghue, Jed, and Chris Taylor. "Over the rainbow: direct payments and social inclusion." Australian Health Review 34, no. 1 (2010): 127. http://dx.doi.org/10.1071/ah09702.
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This paper examines the impact of direct payments on social isolation. We define what social isolation means, and then evaluate the role of direct payments in the provision of social services in the United Kingdom. Social isolation is a particular problem for older people. In Australia there are an increasing number of older residents who are isolated, but would benefit from having greater choice in terms of how they access and receive social services. Increased access to direct payments could help to reduce waiting lists for traditional social services and address gaps in service provision. What is known about the topic?International research indicates that in some cases direct payments or self-directed service provision helps to reduce social isolation. What does this paper add?The authors argue that based on the available evidence, a system incorporating direct payments would have health benefits for older adults living in the community. What are the implications for practitioners?The paper concludes by suggesting that directs payments have the capacity to reduce social isolation in Australia.
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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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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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Rawson, Helen, and Pranee Liamputtong. "Influence of traditional Vietnamese culture on the utilisation of mainstream health services for sexual health issues by second-generation Vietnamese Australian young women." Sexual Health 6, no. 1 (2009): 75. http://dx.doi.org/10.1071/sh08040.
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Background: The present paper discusses the impact the traditional Vietnamese culture has on the uptake of mainstream health services for sexual health matters by Vietnamese Australian young women. It is part of a wider qualitative study that explored the factors that shaped the sexual behaviour of Vietnamese Australian young women living in Australia. Methods: A Grounded Theory methodology was used, involving in-depth interviews with 15 Vietnamese Australian young women aged 18 to 25 years who reside in Victoria, Australia. Results: The findings demonstrated that the ethnicity of the general practitioner had a clear impact on the women utilising the health service. They perceived that a Vietnamese doctor would hold the traditional view of sex as held by their parents’ generation. They rationalised that due to cultural mores, optimum sexual health care could only be achieved with a non-Vietnamese health professional. Conclusion: It is evident from the present study that cultural influences can impact on the sexual health of young people from culturally diverse backgrounds and in Australia’s multicultural society, provision of sexual health services must acknowledge the specific needs of ethnically diverse young people.
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Spigelman, Allan D., and Shane Rendalls. "Clinical governance in Australia." Clinical Governance: An International Journal 20, no. 2 (April 7, 2015): 56–73. http://dx.doi.org/10.1108/cgij-03-2015-0008.
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Purpose – The purpose of this paper is to overview, background and context to clinical governance in Australia, areas for further development and potential learnings for other jurisdictions. Design/methodology/approach – Commentary; non-systematic review of clinical governance literature; review of web sites for national, state and territory health departments, quality and safety organisations, and clinical colleges in Australia. Findings – Clinical governance in Australia shows variation across jurisdictions, reflective of a fragmented health system with responsibility for funding, policy and service provision being divided between levels of government and across service streams. The mechanisms in place to protect and engage with consumers thus varies according to where one lives. Information on quality and safety outcomes also varies; is difficult to find and often does not drill down to a service level useful for informing consumer treatment decisions. Organisational stability was identified as a key success factor in realising and maintaining the cultural shift to deliver ongoing quality. Research limitations/implications – Comparison of quality indicators with clinical governance systems and processes at a hospital level will provide a more detailed understanding of components most influencing quality outcomes. Practical implications – The information reported will assist health service providers to improve information and processes to engage with consumers and build further transparency and accountability. Originality/value – In this paper the authors have included an in depth profile of the background and context for the current state of clinical governance in Australia. The authors expect the detail provided will be of use to the international reader unfamiliar with the nuances of the Australian Healthcare System. Other studies (e.g. Russell and Dawda, 2013; Phillips et al., n.d.) have been based on deep professional understanding of clinical governance in appraising and reporting on initaitives and structures. This review has utilised resources available to an informed consumer seeking to understand the quality and safety of health services.
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Ward, Bernadette, Julie Ellis, and Karen Anderson. "Barriers to the provision of home and community care services to culturally and linguistically diverse populations in rural Australia." Australian Journal of Primary Health 11, no. 2 (2005): 147. http://dx.doi.org/10.1071/py05033.
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In 2002, qualitative methods in the form of in-depth interviews and focus groups were used to gather data from culturally and linguistically diverse (CALD) population residents, service providers and key stakeholders across rural Victoria, to identify and describe barriers to the effective delivery of home services to people from CALD populations in rural Australia. Barriers to the provision of Home and Community Care (HACC) services to CALD populations in rural areas were not specific to HACC programs. For CALD residents, barriers included lack of information about the range of available services, cultural factors, and negative past and recent experiences in dealing with both the broader community and service providers. Service providers indicated lack of information about the profile of the local CALD population and lack of experience in working with these groups to be barriers. Communication was also an issue both for CALD residents and service providers, in terms of cultural factors and specific communication strategies such as inadequate printed material and under-utilisation of existing resources such as interpreter services. As one of the world?s most ethno-culturally diverse nations, Australia has a responsibility to provide health services that are culturally responsive and acceptable. Greater attention needs to be given to the needs of rural CALD population groups in accessing home services.
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Sawyer, Anne-Maree, and David Green. "Social Inclusion and Individualised Service Provision in High Risk Community Care: Balancing Regulation, Judgment and Discretion." Social Policy and Society 12, no. 2 (November 30, 2012): 299–308. http://dx.doi.org/10.1017/s1474746412000590.
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Since the late twentieth century, health and welfare policy in Australia and the UK has focused on enhancing the freedom, life choices and participation of service users. Public policy, based on the construct of social inclusion, requires greater individualisation of services, active engagement with service users, and innovative partnerships between different providers. At the same time, however, the management of risk through a range of compliance procedures can discourage the exercise of discretion by workers, limit the participation of their clients and reduce incentives for innovative cooperation between services. Drawing on in-depth interviews with community care professionals and their managers engaged in high risk social care in Australia, this article gives particular attention to the relevance of risk to social inclusion and individualised service provision.
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Giles, Lynne C., Julie A. Halbert, Maria Crotty, Ian D. Cameron, and Len C. Gray. "The distribution of health services for older people in Australia: where does transition care fit?" Australian Health Review 33, no. 4 (2009): 572. http://dx.doi.org/10.1071/ah090572.
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Introduction: The purpose of this study was to describe the distribution of hospital and aged care services for older people, with a particular focus on transition care places, across Australia and to determine the relationships between the provision of these services. Methods: Aggregation of health and aged care service indicators by Aged Care Assessment Team (ACAT) region including: public and private acute and subacute (rehabilitation and geriatric evaluation and management) hospital beds, flexible and mainstream aged care places as at 30 June 2006. Results: There was marked variation in the distribution of acute and subacute hospital beds among the 79 ACAT regions. Aged care places were more evenly distributed. However, the distribution of transition care places was uneven. Rural areas had poorer provision of all beds. There was no evidence of coordination in the allocation of hospital and aged care services between the Commonwealth and state/territory governments. There was a weak relationship between the allocation of transition care places and the distribution of health and aged care services. Discussion: Overall, the distribution of services available to older persons is uneven across Australia. While the Transition Care Program is flexible and is providing rural communities with access to rehabilitation, it will not be adequate to address the increasing needs associated with the ageing of the Australian population. An integrated national plan for aged care and rehabilitation services should be considered.
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Freeman, Christopher R., Nabilah Abdullah, Pauline J. Ford, and Meng-Wong Taing. "A national survey exploring oral healthcare service provision across Australian community pharmacies." BMJ Open 7, no. 9 (September 2017): e017940. http://dx.doi.org/10.1136/bmjopen-2017-017940.
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ObjectivesThis study investigated pharmacists’ and pharmacy assistants’ current practices and perspectives with regard to oral healthcare provision across Australian community pharmacies.DesignCross-sectional study. A questionnaire for each pharmacist and pharmacy assistant cohort was developed and administered by online or postal means. Pearson’s χ2test was used to examine relationships between categorical variables.ParticipantsPharmacists and pharmacy assistants working within 2100 randomly selected Australian community pharmacies.ResultsThe overall response rate was 58.5% (644/1100) for the pharmacist cohort and 28% (280/1000) for the pharmacy assistant cohort. This represents pharmacy staff responses from 803 community pharmacies across Australia (approximately 14.6%, 803/5500 of community pharmacies nationally). Overall, the majority of pharmacists (80.2%; 516/644) and pharmacy assistants (83.6%; 234/280) reported providing oral health advice/consultations to health consumers up to five times each week. More than half of community pharmacists and pharmacy assistants were involved in identifying signs and symptoms for oral health problems; and the majority believed health consumers were receptive to receiving oral health advice. Additionally, more than 80% of pharmacists and 60% of pharmacy assistants viewed extended oral healthcare roles positively and supported integrating them within their workplace; extended roles include provision of prevention, early intervention and referral to oral healthcare services. The most commonly reported barriers to enhance pharmacy staff involvement in oral healthcare within Australian community pharmacies include lack of knowledge, ongoing training and resources to assist practice.ConclusionThis study highlights that Australian pharmacists have an important role in oral health and provides evidence supporting the need for growing partnerships/collaborations between pharmacy and dental healthcare professionals and organisations to develop, implement and evaluate evidence-based resources, interventions and services to deliver improved and responsive oral healthcare within Australian communities.
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Benrimoj, Shalom I., and Alison S. Roberts. "Providing Patient Care in Community Pharmacies in Australia." Annals of Pharmacotherapy 39, no. 11 (November 2005): 1911–17. http://dx.doi.org/10.1345/aph.1g165.
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OBJECTIVE To describe Australia's community pharmacy network in the context of the health system and outline the provision of services. DATA SYNTHESIS The 5000 community pharmacies form a key component of the healthcare system for Australians, for whom health expenditures represent 9% of the Gross Domestic Product. A typical community pharmacy dispenses 880 prescriptions per week. Pharmacists are key partners in the Government's National Medicines Policy and contribute to its objectives through the provision of cognitive pharmaceutical services (CPS). The Third Community Pharmacy Agreement included funding for CPS including medication review and the provision of written drug information. Funding is also provided for a quality assurance platform with which the majority of pharmacies are accredited. Fifteen million dollars (Australian) have been allocated to research in community pharmacy, which has focused on achieving quality use of medicines (QUM), as well as developing new CPS and facilitating change. Elements of the Agreements have taken into account QUM principles and are now significant drivers of practice change. Although accounting for 10% of remuneration for community pharmacy, the provision of CPS represents a significant shift in focus to view pharmacy as a service provider. Delivery of CPS through the community pharmacy network provides sustainability for primary health care due to improvement in quality presumably associated with a reduction in healthcare costs. CONCLUSIONS Australian pharmacy practice is moving strongly in the direction of CPS provision; however, change does not occur easily. The development of a change management strategy is underway to improve the uptake of professional and business opportunities in community pharmacy.
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Hunter, Stewart. "Provision of care for congenital heart disease in the United Kingdom." Cardiology in the Young 4, no. 3 (July 1994): 231–34. http://dx.doi.org/10.1017/s1047951100011100.
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The organization of the national health service in the United Kingdom has been under constant review and revision since its inception after the Second World War. Central government spends £35,894 million each year on the Health Service and it is the country's largest employer. Total health expenditure in the United Kingdom accounts for 6.1% of the Gross Domestic Product. This apparently compares unfavorably with 12.4% total health expenditure in the United States.States. However the public health expenditure is identical in the two countries, 5.2%, and this figure is similar in most developed countries including Australia, Denmark, Spain and Switzerland. The overall regional administration of the Health Service in England (Scotland, Wales and Northern Ireland have slightly different organizations) is well established, although the names of the different strata of administration change from time to time. The Secretary of State for Health oversees the Department of Health including the National Health Service Management Executive. Under this Management Executive are 14 Regional Health Authorities covering 100% of the total population.There are within the London area several Special Health Authorities set up in the past because of the particular expertise which they provided. These are under review and will almost certainly lose their special status in the future because of the improvements and increase in services nationwide. The Regional Health Authorities have under their care 177 District Health Authorities and 90 Family Health Service Authorities.They do not manage the National Health Service Trusts—a new development which allows hospitals and other organizations within the Health Service to work autonomously to provide NHS services.
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Kamil, Wisam, Estie Kruger, and Marc Tennant. "Utilisation of Dental Services of Older People in Australia: An Economic Explanatory Model Based on Cost and Geographic Location." Geriatrics 6, no. 4 (October 20, 2021): 102. http://dx.doi.org/10.3390/geriatrics6040102.
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The increased percentage of older people retaining their natural dentition was associated with a burden of poor oral health and increased service demands. This study analyses the dental service utilisation of the ageing population in Australia and develops a modelled cost design that estimates the dental expenditure required to cover dental services for the aged population. Using the Australian Census of Population and Housing, ageing population and socioeconomic data were mapped to geographic boundaries and integrated with dental service provision data to estimate a model for the utilisation of dental services. The estimated financial cost of dental services was calculated based on the mean fees as per the Australian Dental Association’s Dental Fees Survey. The utilisation of the services varied considerably across the states and also by type of service, with limited numbers using periodontic services. However, there was an increase in cost for replacement and restorative services (5020 million AUD), most evident in the socioeconomic deprivation areas. In addition, the average dental services utilisation cost increased noticeably in the lower socioeconomic deciles of all regions outside major cities. The geographic maldistribution of older people significantly affects the utilisation of dental services, especially among disadvantaged communities. A predicted cost model of 6385 million AUD would cover the oral health needs of older Australians.
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St John, Winsome, Heather James, and Shona McKenzie. "Health Service Provision for Community-Dwelling People Suffering Urinary Incontinence: A Case Study of Neglect." Australian Journal of Primary Health 7, no. 3 (2001): 31. http://dx.doi.org/10.1071/py01043.
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Access to health services for common health problems is a fundamental principle of primary health care. Although there have been few Australian prevalence studies, it is estimated that about 900,000 adult Australians suffer from incontinence (National Health and Medical Research Council, 1994). The purpose of this study was to investigate urinary continence services for community-dwelling people in the Gold Coast region of Australia, prior to implementing new services. A case study design was used, including: a survey of general medical practitioners, specialist medical practitioners, physiotherapists, hospitals, and home visiting agencies in the region; a focus group with key stakeholders; and a critical review of the literature in relation to prevalence, treatment-seeking behaviour and service provision. Health practitioners were asked about services provided, policies, clinical pathways, referrals, and their views on what services they would like to see offered in the region. Results showed that while there were some existing continence-specific services in the region, they were inadequate to provide for the numbers of people in need. Many generalist health practitioners demonstrated a lack of interest in and knowledge of the plight of those suffering from incontinence. Links between services were found to be ad hoc, with inconsistent referral patterns between health professionals. These findings are consistent with international studies. It was concluded that, in general, community-dwelling people suffering incontinence were poorly served by health professionals due an inability of available services to meet demand, and a lack of knowledge and/or interest by many generalist health practitioners.
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Giles, S., S. Sreedharan, and M. Mian. "Mental health attendances in Australia during the COVID-19 pandemic: A telehealth success story?" European Psychiatry 64, S1 (April 2021): S698. http://dx.doi.org/10.1192/j.eurpsy.2021.1848.
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IntroductionThe COVID-19 pandemic has significantly impacted the delivery of mental health services globally. Within Australia, the COVID-19 pandemic and subsequent containment measures have led to reduced face-to-face attendances. To maintain access to mental health consultations, new telehealth services were introduced by the Australian Government in late March 2020.ObjectivesWe aimed to quantify the impact of the COVID-19 pandemic on patterns of mental health attendances in Australia using an interrupted time series model.MethodsTo characterise patterns of mental health service utilisation, monthly mental health attendances between January 2016 and June 2020 were extracted from the Medicare database, stratified by clinician type: general practitioner (GP), psychiatrist, and allied health. We used triple exponential smoothing to model attendances between January 2017 and December 2019. Observed and predicted attendances between January and June 2020 were compared with 95% confidence (p<0.05).Results Our models showed decreased mental health attendances in March and April, consistent with all healthcare services during this time. While uptake of telehealth was significant, it only partially covered the reduction in mental health attendances.Conclusions Our modelling highlights the significant impacts of the COVID-19 pandemic on mental health services in Australia, with telehealth only partially compensating for the reduction in face-to-face attendances. These results suggest that telehealth services may not be suitable for all individuals (e.g. those without reliable internet access). Given that telehealth will likely remain a feature of mental health service provision, outreach and face-to-face services should be considered for vulnerable groupsDisclosureNo significant relationships.
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Phillips, Christine B., and Joanne Travaglia. "Low levels of uptake of free interpreters by Australian doctors in private practice: secondary analysis of national data." Australian Health Review 35, no. 4 (2011): 475. http://dx.doi.org/10.1071/ah10900.
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Background. One in thirty-five Australians has poor proficiency in English, and may need language support in health consultations. Australia has the world’s most extensive system of fee-free provision of interpreters for doctors, but the degree of uptake relative to need is unknown. Objective. To assess the current unmet and projected future needs for interpreters in Australia in Medicare-funded medical consultations. Method. Secondary analysis of Australian Census, Medicare and Translating and Interpreting Service (TIS) datasets. Age-specific rates of non-Indigenous populations who had self-reported poor proficiency in English were applied to age-specific attendances to general practitioners (GPs) and private specialists to estimate the need for language-assisted consultations in 2006–07. The proportion of services where language assistance was used when needed was estimated through aggregate data from the Medicare and TIS datasets. Results. We estimate that interpreters from the national fee-free service were used for patients with poor proficiency in English is less than 1 in 100 (0.97%) Medicare-funded consultations. The need for interpreters will escalate in future, particularly among those over 85 years. Discussion. Doctors currently underuse interpreters. Increasing the use of interpreters requires education and incentives, but also sustained investment in systems, infrastructure and interpreters to meet the escalation in demand as the population ages. What is known about this topic? Australia is a multilingual country, with 1 in 35 Australians rating their spoken English as poor. Australia is regarded internationally as a model of service provision in its national fee-free rapid-access telephone interpreter service (the Doctors Priority Line) for doctors charging Medicare-rebateable services. Little is known of the extent of uptake of interpreter services by private doctors, relative to estimated patient need. What does this paper add? Using estimates generated from Medicare statistics, Translating and Interpreting Service statistics and rates calculated from ABS data on language proficiency, we estimate that for every 100 people with poor English proficiency who see a private GP or specialist, only 1 will have an interpreter from the free Doctors Priority Line. Although there are interpreter services funded by States and Territories, these are used very infrequently by GPs and consultants in private practice. The demand for interpreters will increase in future as the population ages. What are the implications for practitioners? Even with a free, rapid-access service, doctors underuse interpreters. Public policy should focus on both education and financial incentives to encourage doctors to use interpreters. Future increases in demand for interpreters will require sustained input into developing the interpreter workforce, and training healthcare practitioners and their businesses to be proactive about using interpreters.
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London, Zoe, Badal Moslehuddin, Philip Mendes, and Judy Cashmore. "National Leaving Care Survey and Research Study: Funded by Australian Research Alliance for Children & Youth." Children Australia 32, no. 4 (2007): 36–48. http://dx.doi.org/10.1017/s1035077200011779.
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Australian child protection services have been slower than some of their overseas counterparts, such as the United Kingdom, to recognise the need for specific services for young people leaving care. The last 10 years, however, have seen a body of research into the needs of young people leaving care in various Australian States, with the resulting establishment of specific services in some States. As each State is governed by different Acts that regulate the services provided to young people in care, the development of new services has, of necessity, been on a state by state basis, with little or no coordination or consistency of service provision across Australia.
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Norman, Richard, and Suzanne Robinson. "Lessons from Albion." Journal of Health Organization and Management 29, no. 7 (November 16, 2015): 925–32. http://dx.doi.org/10.1108/jhom-01-2015-0013.
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Purpose – As Australia struggles to meet increased demand for healthcare and contain expenditure there has been a focus on primary care and its role in demand management and keeping people out of expensive secondary care. However, with domestic policy struggling to find a suitable approach consideration of English policy could well be fruitful in the quest to strengthen and develop primary care in Australia. The purpose of this paper is to consider policy developments in England and explores these in relation to the Australian healthcare system. Design/methodology/approach – The authors highlight the key changes to policy that have occurred in the English healthcare system in recent years, and discuss whether they have proven successful. The authors discuss the barriers to implementing similar approaches in Australia, particularly the difference in system structure that would necessitate policy adaptation. Findings – Whilst there are differences in the structure and organisation of funding and service provision between countries, there are developments in England that are worthy of consideration from an Australian perspective. These include a focus on funding and commissioning that rewards quality not just activity and volume. As Australia sees the development of new primary care organisations that are tasked with commissioning then developments and lessons around the technical and relational aspects will be important to consider. Originality/value – The work highlights that Australia might consider learning from the English experience in this area and the types of incentives that may increase efficiency and quality of health service provision. This is important as it potentially gives greater certainty about those approaches most likely to yield beneficial outcomes for patients and the broader system.
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Manson, Nick. "Telemedicine and the New Children's Hospital (Royal Alexandra Hospital for Children)." Journal of Telemedicine and Telecare 3, no. 1_suppl (June 1997): 46–48. http://dx.doi.org/10.1258/1357633971930337.
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Telemedicine is an important factor in the future strategy of the Royal Alexandra Hospital for Children. As a state, national and international centre of excellence, it is the hospital's role to assist in the development of the best child health services. An important aim is to provide easy access to a full range of paediatric services through the provision of a comprehensive telemedicine service, which encompasses videoconferencing and tele-imaging, and positions the child as the centre of service provision. Experience so far suggests that in Australia, as in other countries, the adoption of telemedicine may outstrip the ability of the legislative and administrative frameworks to keep pace. Thus, the enablers appear to be cultural and technological while the obstacles are rooted in the way in which health systems are financed and administered.
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Clark, Shannon, Rhian Parker, Brenton Prosser, and Rachel Davey. "Aged care nurse practitioners in Australia: evidence for the development of their role." Australian Health Review 37, no. 5 (2013): 594. http://dx.doi.org/10.1071/ah13052.
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Aim To consider evidence surrounding the emerging role of nurse practitioners in Australia with a particular focus on the provision of healthcare to older people. Methods Methods used included keyword, electronic database and bibliographic searches of international literature, as well as review of prominent policy reports in relation to aged care and advanced nursing roles. Results This paper reports on evidence from systematic reviews and international studies that show that nurse practitioners improve healthcare outcomes, particularly for hard to service populations. It also maps out the limited Australian evidence on the impact of nurse practitioners’ care in aged care settings. Conclusions If Australia is to meet the health needs of its ageing population, more evidence on the effectiveness, economic viability and sustainability of models of care, including those utilising nurse practitioners, is required. What is known about the topic? Australia, like many industrialised countries, faces unprecedented challenges in the provision of health services to an ageing population. Attempts to respond to these challenges have resulted in changing models of healthcare and shifting professional boundaries, including the development of advance practice roles for nurses. One such role is that of the nurse practitioner. There is international evidence that nurse practitioners provide high-quality healthcare. Despite being established in the United States for nearly 50 years, nurse practitioners are a relatively recent addition to the Australian health workforce. What does this paper add? This paper positions a current Australian evaluation of nurse practitioners in aged care against the background of the development of the role of nurse practitioners internationally, evidence for the effectiveness of the role, and evidence for nurse practitioners in aged care. Recent legislative changes in Australia now mean that private nurse practitioner roles can be fully implemented and hence evaluated. In the face of the increasing demands of an ageing population, the paper highlights limitations in current Australian evidence for nurse practitioners in aged care and identifies the importance of a national evaluation to begin to address these limitations. What are the implications for practitioners? The success of future healthcare planning and policy depends on implementing effective initiatives to address the needs of older Australians. Mapping the terrain of contemporary evidence for nurse practitioners highlights the need for more research into nurse practitioner roles and their effectiveness across Australia. Understanding the boundaries and limitations to current evidence is relevant for all involved with health service planning and delivery.
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Hawthorne, Graeme, Frida Cheok, Robert Goldney, and Laura Fisher. "The Excess Cost of Depression in South Australia: A Population-Based Study." Australian & New Zealand Journal of Psychiatry 37, no. 3 (June 2003): 362–73. http://dx.doi.org/10.1046/j.1440-1614.2003.01189.x.
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Objective: To establish excess costs associated with depression in South Australia, based on the prevalence of depression (from the Primary Care Evaluation of Mental Disorders (PRIME-MD)) and associated excess burden of depression (BoD) costs. Method: Using data from the 1988 South Australian (SA) Health Omnibus Survey, a properly weighted cross-sectional survey of SA adults, we calculated excess costs using two methods. First, we estimated the excess cost based on health service provision and loss of productivity. Second, we estimated it from loss of utility. Results: We found symptoms of major depression in 7% of the SA population, and 11% for other depression. Those with major depression reported worse health status, took more time off work, reported more work performance limitations, made greater use of health services and reported poorer health-related quality-of-life. Using the service provision perspective excess BoD costs were AUD$1921 million per annum. Importantly, this excluded non-health service and other social costs (e.g. family breakdown, legal costs). With the utility approach, using the Assessment of Quality of Life (AQoL) instrument and a very modest life-value (AUD$50 000), the estimate was AUD$2800 million. This reflects a societal perspective of the value of illness, hence there is no particular reason the two different methods should agree as they provide different kinds of information. Both methods suggest estimating the excess BoD from the direct service provision perspective is too restrictive, and that indirect and societal costs ought be taken into account. Conclusions: Despite the high ranking of depression as a major health problem, it is often unrecognized and undertreated. The findings mandate action to explore ways of reducing the BoD borne by individuals, those affected by their illness, the health system and society generally. Given the limited information on the cost-effectiveness of different treatments, it would seem important that resources be allocated to evaluating alternative depression treatments.
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Salinas-Perez, Jose A., Mencia R. Gutierrez-Colosia, Mary Anne Furst, Petra Suontausta, Jacques Bertrand, Nerea Almeda, John Mendoza, et al. "Patterns of Mental Health Care in Remote Areas: Kimberley (Australia), Nunavik (Canada), and Lapland (Finland): Modèles de soins de santé mentale dans les régions éloignées: Kimberley (Australie), Nunavik (Canada) et Laponie (Finlande)." Canadian Journal of Psychiatry 65, no. 10 (July 28, 2020): 721–30. http://dx.doi.org/10.1177/0706743720944312.
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Objective: Mental health (MH) care in remote areas is frequently scarce and fragmented and difficult to compare objectively with other areas even in the same country. This study aimed to analyze the adult MH service provision in 3 remote areas of Organization for Economic Cooperation and Development countries in the world. Methods: We used an internationally agreed set of systems indicators, terminology, and classification of services (Description and Evaluation of Services and DirectoriEs for Long Term Care). This instrument provided a standard description of MH care provision in the Kimberley region (Australia), Nunavik (Canada), and Lapland (Finland), areas characterized by an extremely low population density and high relative rates of Indigenous peoples. Results: All areas showed high rates of deprivation within their national contexts. MH services were mostly provided by the public sector supplemented by nonprofit organizations. This study found a higher provision per inhabitant of community residential care in Nunavik in relation to the other areas; higher provision of community outreach services in the Kimberley; and a lack of day services except in Lapland. Specific cultural-based services for the Indigenous population were identified only in the Kimberley. MH care in Lapland was self-sufficient, and its care pattern was similar to other Finnish areas, while the Kimberley and Nunavik differed from the standard pattern of care in their respective countries and relied partly on services located outside their boundaries for treating severe cases. Conclusion: We found common challenges in these remote areas but a huge diversity in the patterns of MH care. The implementation of care interventions should be locally tailored considering both the environmental characteristics and the existing pattern of service provision.
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Draper, Brian M., and Annette Koschera. "Do Older People Receive Equitable Private Psychiatric Service Provision Under Medicare?" Australian & New Zealand Journal of Psychiatry 35, no. 5 (October 2001): 626–30. http://dx.doi.org/10.1080/0004867010060511.
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Objective: The objective of this study is to determine the 1998 rates, types, regional variation and Medicare expenditure of private psychiatry services for older people in Australia, as compared with younger adults and with 1985–1986 data. Method: Medicare Benefits Schedule Item Statistics for the psychiatric item numbers 300–352 and item 14224 were obtained from the Health Insurance Commission for each State and Territory. The items were examined in the age groups 15–64 years, 65 years and over and 75 years and over. Main outcome measures were per capita service provision by age group, State and Territory and Medicare expenditure by age group. Results: During 1998, 6.4% (5765.6 per 100 000) of private psychiatric services were to patients aged > 64 years. Patients aged 15–64 received 2.7 times the number of psychiatric services per capita than patients > 64 and 3.6 times that of patients aged > 74 years. Patients aged > 64 received more hospital and nursing home consultations, home visits and electroconvulsive therapy per capita, while younger adults used more office-based consultations, longer consultations, and group therapy. Victoria had the highest per capita rate (7659.2 per 100 000) and the Northern Territory the lowest (540.4 per 100 000), although the highest proportion of services to older patients was in Western Australia. Per capita the proportion of Medicare expenditure allocated to adults aged less than 65 years was 4.1 times that for adults over 64 years. Conclusions: Private psychiatric service provision to older people is inequitable when compared with younger adults. The proportion of Medicare private psychiatry expenditure on older adults has declined since 1985–1986.
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Humphreys, John S. "Social provision and service delivery: Problems of equity, health, and health care in rural Australia." Geoforum 19, no. 3 (January 1988): 323–38. http://dx.doi.org/10.1016/s0016-7185(88)80038-1.
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Stanton, Robert, and Simon Rosenbaum. "Temporal trends in exercise physiology services in Australia—Implications for rural and remote service provision." Australian Journal of Rural Health 27, no. 6 (November 11, 2019): 514–19. http://dx.doi.org/10.1111/ajr.12563.
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Philip, Jennifer, Rachel Wiseman, Peter Eastman, Chi Li, and Natasha Smallwood. "Mapping non-malignant respiratory palliative care services in Australia and New Zealand." Australian Health Review 44, no. 5 (2020): 778. http://dx.doi.org/10.1071/ah19206.
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ObjectiveDespite needs, people with advanced non-malignant respiratory disease are infrequently referred to palliative care services. Integrated models of palliative care and respiratory service delivery have been advocated to address this inequity of access. This study mapped current ambulatory palliative care service provision for patients with advanced non-malignant respiratory disease in Australia and New Zealand. MethodsAn online survey was distributed to the palliative care physician membership of the Australian and New Zealand Society of Palliative Medicine. Information was sought regarding access to specific breathlessness and integrated respiratory and palliative care services, and their operation. Data were described using descriptive statistics. ResultsIn all, 133 respondents (93 from Australia, 40 from New Zealand; representing 55 Australian and 26 New Zealand discrete sites) with complete data were available for analysis. More than half the respondents reported seeing patients with advanced non-malignant respiratory disease frequently (56/97; 58%), and 18 of 81 services (22%) reported having breathlessness or integrated respiratory and palliative care services caring for this patient group. Such services were mostly staffed by respiratory and palliative care doctors and nurses and based in the clinic environment, with limited support available outside this setting. Of the 63 respondents without existing breathlessness or integrated services, 49 (78%) expressed interest in their establishment, with limited resources cited as the most common barrier. ConclusionsThere is limited availability of integrated respiratory and palliative care or specialised breathlessness services in Australia and New Zealand despite widespread support by palliative care physicians. This study provides a snapshot to inform strategic service development. What is known about the topic?People with advanced respiratory disease have very significant morbidity with complex needs equivalent to, and in many cases more intense than, people with end-stage lung cancer; they also have significant mortality. Yet, these people frequently do not access palliative care services. The establishment of integrated respiratory and palliative care services has been advocated as an effective means to overcome the barriers to palliative care access. Such services have demonstrated improved patient and family-reported outcomes, as well as service-level improvements. What does this paper add?This paper maps the availability of integrated respiratory palliative care services in Australia and New Zealand. We reveal that although most palliative care physicians report seeing patients with advanced respiratory disease in practice, just one-fifth of services report having an integrated service approach. There was high interest and enthusiasm for such services (78%), but resources limited their establishment. What are the implications for practitioners?Palliative care services recognise the needs of patients with advanced respiratory disease and the benefits of integrated respiratory and palliative care services to address these needs, but scarcity of resources limits the ability to respond accordingly. This study provides a snapshot of current service level to inform strategic development.
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Wand, Timothy, and Kathryn White. "Building a Model of Mental Health Nurse Practitioner–led Service Provision in Australia." Journal for Nurse Practitioners 11, no. 4 (April 2015): 462–65. http://dx.doi.org/10.1016/j.nurpra.2015.01.008.
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Kelaher, Margaret, Gail Williams, and Lenore Manderson. "Towards Evidence-Based Health Promotion and Service Provision for New Migrants to Australia." Ethnicity & Health 4, no. 4 (November 1999): 305–13. http://dx.doi.org/10.1080/13557859998074.
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Hendrie, Delia, and Duncan Boldy. "Hospital services and casemix in Western Australia." Australian Health Review 25, no. 1 (2002): 173. http://dx.doi.org/10.1071/ah020173.
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The Health Department of WA currently operates as a single integrated funder and purchaser of health services for the State. Health Service Agreements defining the level of health provision are negotiated with the various health services in WA. During the latter part of the 1990s, the funding of public hospitals for acute inpatient care moved away froma historical basis to output-based funding using a casemix approach based on Diagnosis Related Groups (DRGs).Other hospital services are still mainly purchased using historical funding levels, negotiated block funding or bedday payments, with output-based funding mechanisms under investigation. WA has developed its own approach toclassifying admitted patients that recognises differences in complexity of care among episodes grouped to the same DRG. WA also has a unique cost estimation model for calculating DRG cost weights, which is based on a linear estimate of the relationship between nights of stay in hospital and the cost of hospital care for each DRG. Another emerging trendin the provision of public hospital services in WA has been the greater involvement of the private sector through the contracting of private providers to operate public hospitals. While no close examination has been undertaken of the outcomes of these changes in terms of their effect on efficiency or other relevant indicators of hospital performance,current purchasing arrangements are being reviewed following recommendations made in a report by the HealthAdministrative Review Committee. No decision has yet been made as to future changes to the funding policy of WA public hospitals.
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Carroll, Andrew, Jane Pickworth, and David Protheroe. "Service innovations: an Australian approach to community care – the Northern Crisis Assessment and Treatment Team." Psychiatric Bulletin 25, no. 11 (November 2001): 439–41. http://dx.doi.org/10.1192/pb.25.11.439.
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The recent White paper, Modernising Mental Health Services, recommended the provision of home treatment teams for acute mental illness (Department of Health, 1998). Such services are not widespread in the UK and have been the subject of recent debate (Smyth et al, 2000). In Australia, multi-disciplinary teams providing 24–hour community assessment and treatment of psychiatric emergencies have been in place now for over a decade, and form the cornerstone of the public mental health service.