Journal articles: 'Hospitals (Victoria)'

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Sundararajan, Vijaya, Kaye Brown, Toni Henderson, and Don Hindle. "Effects of increased private health insurance on hospital utilisation in Victoria." Australian Health Review 28, no. 3 (2004): 320. http://dx.doi.org/10.1071/ah040320.

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The proportion of Victorians and Australians generally with private health insurance (PHI) increased from 31% in 1998 to 45% in 2001. We analysed a dataset containing all hospital separations throughout Victoria to determine whether changes in the level of private health insurance have had any impact on patterns of public and private hospital utilisation in Victoria. Total utilisation of private hospitals grew by 31% from 1998?99 to 2002?03, whereas utilisation of public hospitals increased by 18%. Total bed-days have increased in both private hospitals and public hospitals by 12%. The proportion of all separations at private hospitals has remained relatively stable between these 2 years, with 33% of all separations being private patients in private hospitals in 1998? 99, increasing slightly to 35% by 2002?03. Analysis of a number of specific DRGs shows that patients with more severe disease are more likely to be seen at public hospitals; notably this trend has strengthened between 1998?99 and 2002?03. The number of patients treated in Victorian public hospitals has continued to grow, despite a rapid increase in the utilisation of private hospitals. Given the limited extent of the shift in caseload share between the two sectors, the effectiveness of the Commonwealth?s subsidy of private health insurance as a mechanism to reduce pressure on the public sector needs to be carefully examined.

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Rezaei-Darzi, Ehsan, Janneke Berecki-Gisolf, and Dasamal Tharanga Fernando. "How representative is the Victorian Emergency Minimum Dataset (VEMD) for population-based injury surveillance in Victoria? A retrospective observational study of administrative healthcare data." BMJ Open 12, no. 12 (December 2022): e063115. http://dx.doi.org/10.1136/bmjopen-2022-063115.

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ObjectiveThe Victorian Emergency Minimum Dataset (VEMD) is a key data resource for injury surveillance. The VEMD collects emergency department data from 39 public hospitals across Victoria; however, rural emergency care services are not well captured. The aim of this study is to determine the representativeness of the VEMD for injury surveillance.DesignA retrospective observational study of administrative healthcare data.Setting and participantsInjury admissions in 2014/2015–2018/2019 were extracted from the Victorian Admitted Episodes Dataset (VAED) which captures all Victorian hospital admissions; only cases that arrived through a hospital’s emergency department (ED) were included. Each admission was categorised as taking place in a VEMD-contributing versus a non-VEMD hospital.ResultsThere were 535 477 incident injury admissions in the study period, of which 517 207 (96.6%) were admitted to a VEMD contributing hospital. Male gender (OR 1.13 (95% CI 1.10 to 1.17)) and young age (age 0–14 vs 45–54 years, OR 4.68 (95% CI 3.52 to 6.21)) were associated with VEMD participating (vs non-VEMD-participating) hospitals. Residing in regional/rural areas was negatively associated with VEMD participating (vs non-VEMD participating) hospitals (OR=0.11 (95% CI 0.10 to 0.11)). Intentional injury (assault and self-harm) was also associated with VEMD participation.ConclusionsVEMD representativeness is largely consistent across the whole of Victoria, but varies vastly by region, with substantial under-representation of some areas of Victoria. By comparison, for injury surveillance, regional rates are more reliable when based on the VAED. For local ED-presentation rates, the bias analysis results can be used to create weights, as a temporary solution until rural emergency services injury data is systematically collected and included in state-wide injury surveillance databases.

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Duckett, Stephen, and Amanda Kenny. "Hospital outpatient and emergencyservices in rural Victoria." Australian Health Review 23, no. 4 (2000): 115. http://dx.doi.org/10.1071/ah000115.

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Outpatient and emergency services in rural hospitals have rarely been studied. This paper analyses routinely collecteddata, together with data from a survey of hospitals, to provide a picture of these services in Victorian public hospitals.The larger rural hospitals provide the bulk of rural outpatients and emergency services, particularly so for medicaloutpatients. Cost per service varies with the size of the hospital, possibly reflecting differences in complexity. Fundingpolicies for rural hospital outpatient and emergency services should be sufficiently flexible to take into account thedifferences between rural hospitals.

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Antioch, Kathryn M., Michael K. Walsh, David Anderson, and Richard Brice. "Forecasting hospital expenditure in Victoria: Lessons from Europe and Canada." Australian Health Review 22, no. 1 (1999): 133. http://dx.doi.org/10.1071/ah990133.

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This paper specifies an econometric model to forecast State government expenditure on recognised public hospitals in Victoria. The OECD's recent cross-country econometric work exploring factors affecting health spending was instructive. The model found that Victorian Gross State Product, population aged under 4 years, the mix of public and private patients in public hospitals, introduction of case mix funding and funding cuts, the proportion of public beds to total beds in Victoria and technology significantly impacted on expenditure. The model may have application internationally for forecasting health costs, particularly in short and medium-term budgetary cycles.

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McNair, Peter, and Stephen Duckett. "Funding Victoria's public hospitals: The casemix policy of 2000-2001." Australian Health Review 25, no. 1 (2002): 72. http://dx.doi.org/10.1071/ah020072.

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On 1 July 1993 Victoria became the first Australian state to use casemix information to set budgets for its public hospitals commencing with casemix funding for inpatient services. Victoria's casemix funding approach now embracesinpatient, outpatient and rehabilitation services.

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Lee, Peter, Angela L. Brennan, Dion Stub, Diem T. Dinh, Jeffrey Lefkovits, Christopher M. Reid, Ella Zomer, and Danny Liew. "Estimating the economic impacts of percutaneous coronary intervention in Australia: a registry-based cost burden study." BMJ Open 11, no. 12 (December 2021): e053305. http://dx.doi.org/10.1136/bmjopen-2021-053305.

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ObjectivesIn this study, we sought to evaluate the costs of percutaneous coronary intervention (PCI) across a variety of indications in Victoria, Australia, using a direct per-person approach, as well as to identify key cost drivers.DesignA cost-burden study of PCI in Victoria was conducted from the Australian healthcare system perspective.SettingA linked dataset of patients admitted to public hospitals for PCI in Victoria was drawn from the Victorian Cardiac Outcomes Registry (VCOR) and the Victorian Admitted Episodes Dataset. Generalised linear regression modelling was used to evaluate key cost drivers. From 2014 to 2017, 20 345 consecutive PCIs undertaken in Victorian public hospitals were captured in VCOR.Primary outcome measuresDirect healthcare costs attributed to PCI, estimated using a casemix funding method.ResultsKey cost drivers identified in the cost model included procedural complexity, patient length of stay and vascular access site. Although the total procedural cost increased from $A55 569 740 in 2014 to $A72 179 656 in 2017, mean procedural costs remained stable over time ($A12 521 in 2014 to $A12 185 in 2017) after adjustment for confounding factors. Mean procedural costs were also stable across patient indications for PCI ($A9872 for unstable angina to $A15 930 for ST-elevation myocardial infarction) after adjustment for confounding factors.ConclusionsThe overall cost burden attributed to PCIs in Victoria is rising over time. However, despite increasing procedural complexity, mean procedural costs remained stable over time which may be, in part, attributed to changes in clinical practice.

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Bagot, Kathleen L., Christopher F. Bladin, Michelle Vu, Joosup Kim, Peter J. Hand, Bruce Campbell, Alison Walker, Geoffrey A. Donnan, Helen M. Dewey, and Dominique A. Cadilhac. "Exploring the benefits of a stroke telemedicine programme: An organisational and societal perspective." Journal of Telemedicine and Telecare 22, no. 8 (October 30, 2016): 489–94. http://dx.doi.org/10.1177/1357633x16673695.

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We undertook a qualitative analysis to identify the broader benefits of a state-wide acute stroke telemedicine service beyond the patient-clinician consultation. Since 2010, the Victorian Stroke Telemedicine (VST) programme has provided a clinical service for regional hospitals in Victoria, Australia. The benefits of the Victorian Stroke Telemedicine programme were identified through document analysis of governance activities, including communications logs and reports from hospital co-ordinators of the programme. Discussions with the Victorian Stroke Telemedicine management were undertaken and field notes were also reviewed. Several benefits of telemedicine were identified within and across participating hospitals, as well as for the state government and community. For hospitals, standardisation of clinical processes was reported, including improved stroke care co-ordination. Capacity building occurred through professional development and educational workshops. Enhanced networking, and resource sharing across hospitals was achieved between hospitals and organisations. Governments leveraged the Victorian Stroke Telemedicine programme infrastructure to provide immediate access to new treatments for acute stroke care in regional areas. Standardised data collection allowed routine quality of care monitoring. Community awareness of stroke symptoms occurred with media reports on the novel technology and improved patient outcomes. The value of telemedicine services extends beyond those involved in the clinical consultation to healthcare funders and the community.

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Sharwood, Penny, and Bernadette O'Connell. "Assessing the relationship between inpatient and outpatient activity:a clinical specialty analysis." Australian Health Review 23, no. 3 (2000): 137. http://dx.doi.org/10.1071/ah000137a.

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General and specialist services in public acute hospital outpatient departments play a key role in the health care systemand represent a vital interface between inpatient and community care. Typically outpatient services involve millionsof patient visits within a very short time frame and in Victoria alone between 8-10 million outpatient occasions ofservice are provided each year. Drawing on the first full year of data from the Victorian Ambulatory ClassificationSystem (VACS) this paper examines the patterns underlying the distribution of inpatient separations and outpatientencounters at 16 major Victorian public hospitals and assesses the relationship between inpatient and outpatientactivity at the clinical specialty level.

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Shih, S., R. Carter, S. Heward, and C. Sinclair. "Costs Related to Skin Cancer Prevention in Victoria and Australia." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 9s. http://dx.doi.org/10.1200/jgo.18.10800.

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Background: The aim of this presentation is to provide an update on the economic evaluation of the Australian SunSmart program as well as outline the cost of skin cancer treatment to the Victorian public hospital system. This follows the publication of two recently released published economic evaluations that discusses the potential effects of skin cancer prevention inventions. Aim: 1. To highlight the cost effectiveness of skin cancer prevention in Australia 2. To highlight the costs of skin cancer treatment in the Victorian public hospital system 3. To provide strong evidence to inform governments of the value of skin cancer prevention to reduce the costs of treatment in future years. Methods: Program cost was compared with cost savings to determine the investment return of the program. In a separate study, a prevalence-based cost approach was undertaken in public hospitals in Victoria. Costs were estimated for inpatient admissions, using state service statistics, and outpatient services based on attendance at three hospitals in 2012-13. Cost-effectiveness for prevention was estimated from 'observed vs expected' analysis, together with program expenditure data. Results: With additional $AUD 0.16 ($USD 0.12) per capita investment into skin cancer prevention across Australia from 2011 to 2030, an upgraded SunSmart Program would prevent 45,000 melanoma and 95,000 NMSC cases. Potential savings in future healthcare costs were estimated at $200 million, while productivity gains were significant. A future upgraded SunSmart Program was predicted to be cost-saving from the funder perspective, with an investment return of $3.20 for every additional dollar the Australian governments/funding bodies invested into the program. In relation to the costs to the Victorian public hospital system, total annual costs were $48 million to $56 million. Skin cancer treatment in public hospitals ($9.20∼$10.39 per head/year) was 30-times current public funding in skin cancer prevention ($0.37 per head/year). Conclusion: The study demonstrates the strong economic credentials of the SunSmart Program, with a strong economic rationale for increased investment. Increased funding for skin cancer prevention must be kept high on the public health agenda. This would also have the dual benefit of enabling hospitals to redirect resources to nonpreventable conditions.

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Thompson, Sandra C., and Maureen Norris. "Hepatitis B Vaccination of Personnel Employed in Victorian Hospitals: Are Those at Risk Adequately Protected?" Infection Control & Hospital Epidemiology 20, no. 01 (January 1999): 51–54. http://dx.doi.org/10.1086/501552.

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AbstractObjective:To examine the policies and practices in hospitals within the state of Victoria, Australia, with respect to vaccination of staff against hepatitis B infection.Design:A written self-administered questionnaire to be completed by the infection control officer (or designated officer for hepatitis B vaccination) within each hospital.Setting:Public (teaching and nonteaching) and private hospitals, including metropolitan and rural institutions in Victoria.Participants:A random sample of 30% of Victorian hospitals were asked to participate in the survey. Of 78 eligible institutions, 69 (88%) completed and returned questionnaires.Results:There was no consistent hepatitis B prevention policy in place across Victoria. Of the 69 responding hospitals, 63 (91%) offered hepatitis B vaccination to staff, and 58 (84%) of these also paid all costs of vaccination. Of the 63 hospitals offering vaccination to staff, 39 offered vaccination to all staff, 23 offered vaccination based on job title, and one offered vaccination based on anticipated exposure. In many institutions, postexposure protocols were recalled more readily than preexposure vaccination guidelines. Numerous respondents indicated a need for clear guidelines on policy and clarification on practical matters of management, such as acceptable immune levels, management of nonresponders to the primary series, and the need for, and timing of, booster doses of vaccine. Eleven (18%) of the 63 hospitals offering hepatitis B vaccination to staff undertook routine prevaccination screening, a practice not generally regarded as cost-effective in Australia. Fifty-five of these hospitals (91%) also undertook postvaccination screening.Conclusions:It is evident from this study that a considerable number of potentially susceptible healthcare personnel in Victorian hospitals remain unprotected against hepatitis B infection. A more reliable and consistent approach to preexposure hepatitis B vaccination is recommended

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McDougall, Rosalind, Barbara Hayes, Marcus Sellars, Bridget Pratt, Anastasia Hutchinson, Mark Tacey, Karen Detering, Cade Shadbolt, and Danielle Ko. "'This is uncharted water for all of us': challenges anticipated by hospital clinicians when voluntary assisted dying becomes legal in Victoria." Australian Health Review 44, no. 3 (2020): 399. http://dx.doi.org/10.1071/ah19108.

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ObjectiveThe aim of this study was to identify the challenges anticipated by clinical staff in two Melbourne health services in relation to the legalisation of voluntary assisted dying in Victoria, Australia. MethodsA qualitative approach was used to investigate perceived challenges for clinicians. Data were collected after the law had passed but before the start date for voluntary assisted dying in Victoria. This work is part of a larger mixed-methods anonymous online survey about Victorian clinicians’ views on voluntary assisted dying. Five open-ended questions were included in order to gather text data from a large number of clinicians in diverse roles. Participants included medical, nursing and allied health staff from two services, one a metropolitan tertiary referral health service (Service 1) and the other a major metropolitan health service (Service 2). The data were analysed thematically using qualitative description. ResultsIn all, 1086 staff provided responses to one or more qualitative questions: 774 from Service 1 and 312 from Service 2. Clinicians anticipated a range of challenges, which included burdens for staff, such as emotional toll, workload and increased conflict with colleagues, patients and families. Challenges regarding organisational culture, the logistics of delivering voluntary assisted dying under the specific Victorian law and how voluntary assisted dying would fit within the hospital’s overall work were also raised. ConclusionsThe legalisation of voluntary assisted dying is anticipated to create a range of challenges for all types of clinicians in the hospital setting. Clinicians identified challenges both at the individual and system levels. What is known about the topic?Voluntary assisted dying became legal in Victoria on 19 June 2019 under the Voluntary Assisted Dying Act 2017. However there has been little Victorian data to inform implementation. What does this paper add?Victorian hospital clinicians anticipate challenges at the individual and system levels, and across all clinical disciplines. These challenges include increased conflict, emotional burden and workload. Clinicians report concerns about organisational culture, the logistics of delivering voluntary assisted dying under the specific Victorian law and effects on hospitals’ overall work. What are the implications for practitioners?Careful attention to the breadth of staff affected, alongside appropriate resourcing, will be needed to support clinicians in the context of this legislative change.

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Pilcher, David V., Graeme Duke, Melissa Rosenow, Nicholas Coatsworth, Genevieve O’Neill, Tracey A. Tobias, Steven McGloughlin, et al. "Assessment of a novel marker of ICU strain, the ICU Activity Index, during the COVID-19 pandemic in Victoria, Australia." Critical Care and Resuscitation 23, no. 3 (September 6, 2021): 300–307. http://dx.doi.org/10.51893/2021.3.oa7.

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OBJECTIVES: To validate a real-time Intensive Care Unit (ICU) Activity Index as a marker of ICU strain from daily data available from the Critical Health Resource Information System (CHRIS), and to investigate the association between this Index and the need to transfer critically ill patients during the coronavirus disease 2019 (COVID-19) pandemic in Victoria, Australia. DESIGN: Retrospective observational cohort study. SETTING: All 45 hospitals with an ICU in Victoria, Australia. PARTICIPANTS: Patients in all Victorian ICUs and all critically ill patients transferred between Victorian hospitals from 27 June to 6 September 2020. MAIN OUTCOME MEASURE: Acute interhospital transfer of one or more critically ill patients per day from one site to an ICU in another hospital. RESULTS: 150 patients were transported over 61 days from 29 hospitals (64%). ICU Activity Index scores were higher on days when critical care transfers occurred (median, 1.0 [IQR, 0.4–1.7] v 0.6 [IQR, 0.3–1.2]; P < 0.001). Transfers were more common on days of higher ICU occupancy, higher numbers of ventilated or COVID-19 patients, and when more critical care staff were unavailable. The highest ICU Activity Index scores were observed at hospitals in north-western Melbourne, where the COVID-19 disease burden was greatest. After adjusting for confounding factors, including occupancy and lack of available ICU staff, a rising ICU Activity Index score was associated with an increased risk of a critical care transfer (odds ratio, 4.10; 95% CI, 2.34–7.18; P < 0.001). CONCLUSIONS: The ICU Activity Index appeared to be a valid marker of ICU strain during the COVID-19 pandemic. It may be useful as a real-time clinical indicator of ICU activity and predict the need for redistribution of critical ill patients.

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Jayasuriya, Rohan, and A. B. Sim. "Strategic planning in hospitals in two Australian States: An exploratory study of its practice using planning documentation." Australian Health Review 21, no. 3 (1998): 17. http://dx.doi.org/10.1071/ah980017.

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Hospitals are under pressure to respond to new challenges and competition. Manyhospitals have used strategic planning to respond to these environmental changes. Thisexploratory study examines the extent of strategic planning in hospitals in twoAustralian States, New South Wales and Victoria, using a sample survey. Based onplanning documentation, the study indicated that 47% of the hospitals surveyed didnot have a strategic or business plan. A significant difference was found in thecomprehensiveness of the plans between the two States. Plans from Victorian hospitalshad more documented evidence of external/internal analysis, competitor orientation and customer orientation compared with plans from New South Wales hospitals. The paper discusses the limitations of the study and directions for future research.

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Green, David T. "The autopsy in private hospitals in Victoria." Medical Journal of Australia 174, no. 3 (February 2001): 152–53. http://dx.doi.org/10.5694/j.1326-5377.2001.tb143198.x.

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Bennett, Noleen J., Ann L. Bull, David R. Dunt, Lyle C. Gurrin, Denis W. Spelman, Philip L. Russo, and Michael J. Richards. "MRSA infections in smaller hospitals, Victoria, Australia." American Journal of Infection Control 35, no. 10 (December 2007): 697–99. http://dx.doi.org/10.1016/j.ajic.2006.12.011.

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O’Connor, Siobhán, Peta L. Hitchens, and Lauren V. Fortington. "Hospital-treated injuries from horse riding in Victoria, Australia: time to refocus on injury prevention?" BMJ Open Sport & Exercise Medicine 4, no. 1 (February 2018): e000321. http://dx.doi.org/10.1136/bmjsem-2017-000321.

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BackgroundThe most recent report on hospital-treated horse-riding injuries in Victoria was published 20 years ago. Since then, injury countermeasures and new technology have aimed to make horse riding safer for participants. This study provides an update of horse-riding injuries that required hospital treatment in Victoria and examines changes in injury patterns compared with the earlier study.MethodsHorse-riding injuries that required hospital treatment (hospital admission (HA) or emergency department (ED) presentations) were extracted from routinely collected data from public and private hospitals in Victoria from 2002–2003 to 2015–2016. Injury incidence rates per 100 000 Victorian population per financial year and age-stratified and sex-stratified injury incidence rates are presented. Poisson regression was used to examine trends in injury rates over the study period.ResultsED presentation and HA rates were 31.1 and 6.6 per 100 000 person-years, increasing by 28.8% and 47.6% from 2002 to 2016, respectively. Female riders (47.3 ED and 10.1 HA per 100 000 person-years) and those aged between 10 and 14 years (87.8 ED and 15.7 HA per 100 000 person-years) had the highest incidence rates. Fractures (ED 29.4%; HA 56.5%) and head injuries (ED 15.4%; HA 18.9%) were the most common injuries. HA had a mean stay of 2.6±4.1 days, and the mean cost per HA was $A5096±8345.ConclusionHorse-riding injuries have remained similar in their pattern (eg, types of injuries) since last reported in Victoria. HA and ED incidence rates have increased over the last 14 years. Refocusing on injury prevention countermeasures is recommended along with a clear plan for implementation and evaluation of their effectiveness in reducing injury.

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McAuley, Elise, Chandana Unnithan, and Sofie Karamzalis. "Implementing Scanned Medical Record Systems in Australia." International Journal of E-Adoption 4, no. 4 (October 2012): 29–54. http://dx.doi.org/10.4018/jea.2012100103.

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In recent years, influenced by the pervasive power of technology, standards and mandates, Australian hospitals have begun exploring digital forms of keeping this record. The main rationale is the ease of accessing different data sources at the same time by varied staff members. The initial step in this transition was implementation of scanned medical record systems, which converts the paper based records to digitised form, which required process flow redesign and changes to existing modes of work. For maximising the benefits of scanning implementation and to better prepare for the changes, Austin Hospital in the State of Victoria commissioned this research focused on elective admissions area. This structured case study redesigned existing processes that constituted the flow of external patient forms and recommended a set of best practices at the same time highlighting the significance of user participation in maximising the potential benefits anticipated. In the absence of published academic studies focused on Victorian hospitals, this study has become a conduit for other departments in the hospital as well as other hospitals in the incursion.

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Stanton, Pauline. "Employment relationships in Victorian public hospitals: the Kennett years." Australian Health Review 23, no. 3 (2000): 193. http://dx.doi.org/10.1071/ah000193a.

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From 1992 to 1999, the Kennett government in Victoria moved to competitive market models of service delivery andthe measurement of service provision through casemix funding. Public hospital managers were given greateraccountability for the costs and provision of service delivery and a new range of service providers, many from theprivate sector, entered the public health market. The decentralisation of the industrial relations system led to newdevelopments in bargaining that brought both opportunities and problems. In the Victorian public health system therewas an increasing emphasis on decentralisation in both service provision and employment relations. In this paper Isuggest that there were contradictions in these developments for government, and new challenges and difficulties foremployers, employees and trade unions.

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Watson, Lyndsey F., Jo-Anne Rayner, and Judith M. Lumley. "Hospital ethics approval for a population-based case–control study of very preterm birth." Australian Health Review 31, no. 4 (2007): 514. http://dx.doi.org/10.1071/ah070514.

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Aim: To describe the process involved in obtaining ethics approval for a study aiming to recruit women from all maternity hospitals in Victoria, Australia. Design: Observational data of the application process involving 85 hospitals throughout Victoria in 2001. Results: Twenty-three of the 85 hospitals had a Human Research Ethics Committee (HREC) constituted in accordance with the National Health and Medical Council requirements; 27 agreed to accept decisions from other hospitals having HRECs and 27 relied on ethics advisory committees, hospital managers, clinical staff, quality assurance committees or lawyers for ethics decisions. Four of the latter did not approve the study. Eight hospitals no longer provided maternity services in the recruitment period. The process took 16 months, 26 000 sheets of paper, 258 copies of the application and the cost was about $30 000. Approval was eventually obtained for recruitment at 73 hospitals. Discussion: Difficulties exist in obtaining timely ethics approval for multicentre studies due to a complex uncoordinated system. All hospitals should have explicit protocols for dealing with research ethics applications so that they can be processed in a straightforward and timely manner. To facilitate this, those without properly constituted HRECs should be affiliated with one hospital that has an HREC.

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Wong, Joseph Zhi Wen, Helen M. Dewey, Bruce C. V. Campbell, Peter J. Mitchell, Mark Parsons, Thanh Phan, Ronil V. Chandra, et al. "Door-in-door-out times for patients with large vessel occlusion ischaemic stroke being transferred for endovascular thrombectomy: a Victorian state-wide study." BMJ Neurology Open 5, no. 1 (January 2023): e000376. http://dx.doi.org/10.1136/bmjno-2022-000376.

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BackgroundTime to reperfusion is an important predictor of outcome in ischaemic stroke from large vessel occlusion (LVO). For patients requiring endovascular thrombectomy (EVT), the transfer times from peripheral hospitals in metropolitan and regional Victoria, Australia to comprehensive stroke centres (CSCs) have not been studied.AimsTo determine transfer and journey times for patients with LVO stroke being transferred for consideration of EVT.MethodsAll patients transferred for consideration of EVT to three Victorian CSCs from January 2017 to December 2018 were included. Travel times were obtained from records matched to Ambulance Victoria and the referring centre via Victorian Stroke Telemedicine or hospital medical records. Metrics of interest included door-in-door-out time (DIDO), inbound journey time and outbound journey time.ResultsData for 455 transferred patients were obtained, of which 395 (86.8%) underwent EVT. The median DIDO was 107 min (IQR 84–145) for metropolitan sites and 132 min (IQR 108–167) for regional sites. At metropolitan referring hospitals, faster DIDO was associated with use of the same ambulance crew to transport between hospitals (75 (63–90) vs 124 (99–156) min, p<0.001) and the administration of thrombolysis prior to transfer (101 (79–133) vs 115 (91–155) min, p<0.001). At regional centres, DIDO was consistently longer when patients were transported by air (160 (127–195) vs 116 (100–144) min, p<0.001). The overall door-to-door time by air was shorter than by road for sites located more than 250 km away from the CSC.ConclusionTransfer times differ significantly for regional and metropolitan patients. A state-wide database to prospectively collect data on all interhospital transfers for EVT would be helpful for future study of optimal transport mode at regional sites and benchmarking of DIDO across the state.

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O'Hara, Denise, and Chris Brook. "The utilisation of public and private hospitals in Victoria: An issue of access?" Australian Health Review 19, no. 3 (1996): 40. http://dx.doi.org/10.1071/ah960040b.

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Consumers regard access to hospital services as one of the key components of qualityin health care delivery. A mixed public/private system operates in Victoria, but amorbidity collection from private hospitals was commenced only relatively recently.In 1993?94 the collection covered 82- per cent of private hospital separations, andit was considered timely to examine the utilisation patterns in the private system andcompare them with those in the public system. Medical and surgical emergencies andother complex conditions and procedures are serviced largely in the public sector,whereas private hospitals are utilised for elective and less complex surgery and non-urgentconditions. Occupancy rates are around 79- per cent in public hospitals and67- per cent in private hospitals. Elective surgery waiting list data suggest that whileurgent cases are treated within a month, significant proportions wait six months ormore for non-urgent surgery. Private health insurance is the main factor indetermining access to and the utilisation private hospitals. The current MedicareAgreement and the move to separate the role of purchaser and provider may allowthe maximal utilisation of private hospitals and diminish the burden of chronicillness.

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Allison, Stephen, Tarun Bastiampillai, Jeffrey CL Looi, David Copolov, and Vinay Lakra. "Real-world performance of Victorian hospitals during the COVID-19 lockdowns." Australasian Psychiatry 30, no. 2 (April 2022): 239–42. http://dx.doi.org/10.1177/10398562221079281.

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Objective Victoria has low numbers of general adult psychiatric beds per capita by Australian and international standards. Hospital key performance indicators (KPIs) such as bed occupancy rates, emergency department waiting times and inpatient lengths of stay are proximal measures of the effects any shortfall in beds. We investigate the real-world performance of Victorian hospitals during the first year of the COVID-19 pandemic and the extended lockdowns in 2020. Conclusions The Victorian inpatient psychiatric system is characterised by high bed occupancies in many regions, extended stays in emergency departments awaiting a bed, and short inpatient lengths of stay, except for patients with excessively long stays on acute units (over 35 days) who are unable to be admitted to non-acute facilities. At the end of 2020, bed occupancies were high (above 90%) in 10 regions, with three regions having bed occupancies over 100%. However, state-wide average bed occupancy improved between 2019 (94%) and 2020 (88%). Other KPIs remained steady because acute hospitals did not experience the expected pandemic mental health demand-surge. For a more complete picture of the impact of the pandemic, Australia needs interconnected, centralised data systems.

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New, Gishel, Hatish Jangwal, Hella Parker, Louise Roberts, Bill Barger, Karen Smith, Geoffery Toogood, et al. "PRE-HOSPITAL NOTIFICATION OF STEMI (PNS): COLLABORATION BETWEEN THE VICTORIAN CARDIAC CLINICAL NETWORK, AMBULANCE VICTORIA AND PARTICIPATING HOSPITALS." Journal of the American College of Cardiology 61, no. 10 (March 2013): E120. http://dx.doi.org/10.1016/s0735-1097(13)60121-7.

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Bennett, N., C. Boardman, A. Bull, M. Richards, and P. Russo. "Surgical Antibiotic Prophylaxis in Smaller Hospitals, Victoria, Australia." American Journal of Infection Control 34, no. 5 (June 2006): E82—E83. http://dx.doi.org/10.1016/j.ajic.2006.05.152.

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RAMAN, RAMYA, and ANANTANARAYANAN RAMAN. "Public hospitals in Madras and people associated with them." National Medical Journal of India 35 (November 1, 2022): 112–17. http://dx.doi.org/10.25259/nmji_35_2_112.

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In this follow-up article, we refer to the other public hospital facilities of Madras, viz. the Lock and Naval Hospitals, the Native Infirmary, Lunatic Asylum, Eye Infirmary, Maternity Hospital (Egmore), and the Queen Victoria Hospital for Caste and Gosha Women, some of which are operational today. We also include brief notes on a few of the pioneering men and women, who contributed to the development of these facilities.

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Antioch, Kathryn, and Michael Walsh. "Funding issues for Victorian hospitals:the risk-adjusted vision beyond casemix funding." Australian Health Review 23, no. 3 (2000): 145. http://dx.doi.org/10.1071/ah000145.

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This paper discusses casemix funding issues in Victoria impacting on teaching hospitals. For casemix payments to beacceptable, the average price and cost weights must be set at an appropriate standard. The average price is based ona normative, policy basis rather than benchmarking. The 'averaging principle' inherent in cost weights has resulted insome AN-DRG weights being too low for teaching hospitals that are key State-wide providers of high complexityservices such as neurosurgery and trauma. Casemix data have been analysed using international risk adjustmentmethodologies to successfully negotiate with the Victorian State Government for specified grants for several highcomplexity AN-DRGs. A risk-adjusted capitation funding model has also been developed for cystic fibrosis patientstreated by The Alfred, called an Australian Health Maintenance Organisation (AHMO). This will facilitate thedevelopment of similar models by both the Victorian and Federal governments.

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Hanning, Brian W. T. "Impact on public hospitals if private health insurance rates in Victoria declined." Australian Health Review 28, no. 3 (2004): 330. http://dx.doi.org/10.1071/ah040330.

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The additional cost of treating acute care type Victorian private patients as public patients in Victorian public hospitals based on the current public sector payment model and rates was calculated, as was the loss of health fund income to public hospitals. If all private cases became public the net recurrent cost would be $1.05 billion assuming all patients were still treated. If private health insurance (PHI) uptake had declined to 23.3% as was projected without Lifetime Health Cover and the 30% rebate, the additional operating cost and income loss would be $385 million. This compares to the Victorian cost of the 30% rebate for acute hospital cases of $383 million. This takes no account of capital costs and possible public sector access problems. The analysis suggests that 31 extra operating theatres would be needed in the public sector (had the transfer of surgical patients from the public sector to the private sector not occurred). This analysis suggests that without the PHI rebate the current stresses on Victorian public hospitals would be increased, not decreased.

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Fernando, Dasamal Tharanga, Angela Clapperton, and Janneke Berecki-Gisolf. "Suicide following hospital admission for mental health conditions, physical illness, injury and intentional self-harm in Victoria, Australia." PLOS ONE 17, no. 7 (July 11, 2022): e0271341. http://dx.doi.org/10.1371/journal.pone.0271341.

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Objective The majority of suicide decedents have had contact with health services close to their death. Some of these contacts include admissions to hospitals for physical and mental health conditions, injury and intentional self-harm. This study aims to establish and quantify the risks of suicide following hospital admission for a range of mental and physical illnesses. Methods A retrospective analysis was carried out on existing morbidity and mortality data in Victoria. Data was extracted from the Victorian Admitted Episodes Dataset and the Victorian Suicide Register. Unplanned hospital admissions among adult patients (> = 15 years of age), discharged between 01 January 2011 and 31 December 2016 (2,430,154 admissions), were selected. Standardised Mortality Ratios were calculated for conditions with at least five linked suicides within one year of discharge from hospital. Results Forty-three conditions defined at the three-digit level of the International Statistical Classification of Diseases and Related Health Problems 10th Revision, were associated with at least five subsequent suicides (within one year of hospital discharge); 14 physical illnesses, 5 symptoms, signs and abnormal clinical and laboratory findings, 12 mental health conditions, and 12 types of injury and poisonings. The highest Standardised Mortality Ratios were for poisonings (range; 27.8 to 140.0) and intentional self-harm (78.8), followed by mental health conditions (range; 15.5 to 72.9), symptoms, signs and abnormal clinical and laboratory findings (range; 1.4 to 43.2) and physical illnesses (range; 0.7 to 4.9). Conclusions Hospital admissions related to mental health conditions and injury and poisonings including self-harm were associated with a greater risk of suicide than physical conditions. Mental health conditions such as depressive episodes, personality disorders and psychotic episodes, injuries caused by intentional-self-harm and poisonings by certain types of drugs, carbon monoxide and hormones such as insulin can be prioritised for targeting suicide prevention initiatives for persons discharged from hospitals.

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Samaroo, Bethan. "Assessing Palliative Care Educational Needs of Physicians and Nurses: Results of a Survey." Journal of Palliative Care 12, no. 2 (June 1996): 20–22. http://dx.doi.org/10.1177/082585979601200205.

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The Greater Victoria Hospital Society (GVHS) Palliative Care Committee surveyed medical and nursing staff from four hospitals and The Victoria Hospice Society in February, 1993. The purpose of the survey was to identify physicians’ and nurses’ perceived educational needs related to death and dying. Programs that focus on the dying process; patient pain, symptom, and comfort control; and patient and family support were identified as necessary to meet the educational needs of physicians and nurses in providing quality palliative care. Physicians and nurses identified communication skills as being paramount. Communications concerning ethical issues were highlighted as the most difficult to cope with.

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McLEAN, RALPH. "Small Rural Hospitals and Casemix Funding: Victoria, 1993-94." Australian Journal of Rural Health 2, no. 4 (August 1994): 33–36. http://dx.doi.org/10.1111/j.1440-1584.1994.tb00129.x.

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Canaway, Rachel, Marie Bismark, David Dunt, and Margaret Kelaher. "Public reporting of hospital performance data: views of senior medical directors in Victoria, Australia." Australian Health Review 42, no. 5 (2018): 591. http://dx.doi.org/10.1071/ah17120.

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Objective The aim of the present study was to better understand senior medical directors’ perceptions of public reporting of hospital performance data, how public reporting affects institutional behavioural change towards quality improvement and how it could be improved. Methods Interviews were undertaken with 17 medical directors representing 26 metropolitan and regional public hospitals in Victoria, Australia, between June and August 2016. Data were analysed thematically. Results Medical directors are well placed to comment on clinical and administrative aspects of quality, safety and performance monitoring in public hospitals. Their responses largely suggested that public reporting of hospital performance data in Australia is immature and not fulfilling its potential. There was little consensus among informants around what public reporting is, who it is for or its purpose. Although public reporting was considered to have important functions for hospitals and consumers, it was generally considered to lack robustness and have underutilised potential to inform consumers, build trust and drive quality and performance improvements within hospitals. Conclusions The next steps needed to advance public reporting of hospital performance data in Australia include engaging clinicians and patients in selection and development of metrics, improving timeliness of reporting, and improving communication of information so that it is accessible and meaningful for different audiences. What is known about the topic? Public reporting of hospital performance data is a mechanism increasingly used in the Australian health system, but it has attracted little research. What does this paper add? This paper reveals a lack of shared understanding among medical directors in Victoria, Australia, on what public reporting of hospital performance data is, who it is for and its purpose. The paper highlights the potential importance of public reporting of hospital performance data for rural and regional healthcare consumers and how it may be strengthened. What are the implications for practitioners? Stronger systems of public reporting of hospital performance data have the potential to increase consumer engagement and improve hospital performance, quality and safety. Awareness of the discourse around public reporting of hospital performance data can increase practitioners’ engagement in debate and development of reporting systems.

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Clay, Fiona J., and Joan Ozanne-Smith. "Private hospital insurance status among a state-wide injured population." Australian Health Review 30, no. 2 (2006): 252. http://dx.doi.org/10.1071/ah060252.

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Injury is a leading cause of inpatient hospital episodes. Over a 4-year period (1997?2000) the Australian Government introduced measures to support the private health insurance industry by providing incentives for people to take up private health insurance (PHI) in order to take the pressure off public hospitals. This study examined the levels of PHI for moderately and severely injured people in Victoria as a way of determining the effectiveness of government incentives. The method involved an analysis of all Victorian public and private hospital injury admissions between July 2000 and June 2003. We found that people with injuries, either unintentional or intentional, had lower levels of PHI than state norms. While numbers of injured patients occupying private hospital beds initially increased, levels then dropped below the levels before the introduction of the incentives. The burden of injury is substantial and suggests that incentives need to be targeted towards at-risk groups.

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Peck, Blake, Daniel Terry, and Kate Kloot. "The Socioeconomic Characteristics of Childhood Injuries in Regional Victoria, Australia: What the Missing Data Tells Us." International Journal of Environmental Research and Public Health 18, no. 13 (June 30, 2021): 7005. http://dx.doi.org/10.3390/ijerph18137005.

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Background: Injury is the leading cause of death among those between 1–16 years of age in Australia. Studies have found that injury rates increase with socioeconomic disadvantage. Rural Urgent Care Centres (UCC) represent a key point of entry into the Victorian healthcare system for people living in smaller rural communities, often categorised as lower socio-economic groups. Emergency presentation data from UCCs is not routinely collated in government datasets. This study seeks to compare socioeconomic characteristics of children aged 0–14 attending a UCC to those who attend a 24-h Emergency Departments with an injury-related emergency presentation. This will inform gaps in our current understanding of the links between socioeconomic status and childhood injury in regional Victoria. Methods: A network of rural hospitals in South West Victoria, Australia provide ongoing detailed de-identified emergency presentation data as part of the Rural Acute Hospital Data Register (RAHDaR). Data from nine of these facilities was extracted and analysed for children (aged 0–14 years) with any principal injury-related diagnosis presenting between 1 February 2017 and 31 January 2020. Results: There were 10,137 injury-related emergency presentations of children aged between 0–14 years to a participating hospital. The relationship between socioeconomic status and injury was confirmed, with overall higher rates of child injury presentations from those residing in areas of Disadvantage. A large proportion (74.3%) of the children attending rural UCCs were also Disadvantaged. Contrary to previous research, the rate of injury amongst children from urban areas was significantly higher than their more rural counterparts. Conclusions: Findings support the notion that injury in Victoria differs according to socioeconomic status and suggest that targeted interventions for the reduction of injury should consider socioeconomic as well as geographical differences in the design of their programs.

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Ribonson, Priscilla, and Mark F. Gilheany. "Is there a role for podiatric surgeons in public hospitals? An audit of surgery to the great toe joint in Victoria, 1999–2003." Australian Health Review 33, no. 4 (2009): 690. http://dx.doi.org/10.1071/ah090690.

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This project aimed to describe and compare the frequencies of procedures performed by podiatric surgeons and orthopaedic surgeons for elective surgery to the great toe joint, an area of identified clinical need. The objective was to determine whether podiatric surgeons in the Australian context possess a surgical skill set which can be utilised in the public health sector. The Medicare Benefits Schedule (Medicare Australia) was reviewed to identify all codes relating to great toe joint surgery and frequency data were obtained for the period July 1999 to June 2003. A separate audit of the activity of Victorian podiatric surgeons was conducted. During the 4 years in Victoria, the number of procedures performed on this joint by 152 orthopaedic surgeons was 5882. Two podiatric surgeons in Victoria performed 1260 operations on this joint over this period (17.6% of great toe joint surgery on average each year in the private sector). Utilising orthopaedic workforce figures and on a per-surgeon basis, during this period the podiatric surgeons performed this type of surgery between 2 and 16 times more often than the orthopaedic surgeons, and consideration should be given to using these skills in the public sector to address the growing demand.

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Caples, Amanda. "Victoria taking biotechnology from strength to strength." Microbiology Australia 31, no. 2 (2010): 95. http://dx.doi.org/10.1071/ma10095.

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Victoria is Australia?s leading biotechnology location, with strengths in cancer, neuroscience, stem cells, infectious disease and immunity, and agricultural biotechnology. With its clusters of world-class universities, teaching hospitals, research institutions and industry, the state continues to advance in its aim to become one of the top five biotechnology locations worldwide.

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O'Hara, Denise A., and Norman J. Carson. "Reporting of adverse events in hospitals in Victoria, 1994‐1995." Medical Journal of Australia 166, no. 9 (May 1997): 460–63. http://dx.doi.org/10.5694/j.1326-5377.1997.tb123216.x.

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Collopy, Brian T. "Reporting of adverse events in hospitals in Victoria 1994‐1995." Medical Journal of Australia 167, no. 6 (September 1997): 342. http://dx.doi.org/10.5694/j.1326-5377.1997.tb125090.x.

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O'Hara, Denise A. "Reporting of adverse events in hospitals in Victoria 1994‐1995." Medical Journal of Australia 167, no. 6 (September 1997): 342–43. http://dx.doi.org/10.5694/j.1326-5377.1997.tb125091.x.

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Lumley, Judith. "THE SAFETY OF SMALL MATERNITY HOSPITALS IN VICTORIA 1982-84." Community Health Studies 12, no. 4 (February 12, 2010): 386–93. http://dx.doi.org/10.1111/j.1753-6405.1988.tb00604.x.

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Tran, Aimy H. L., Danny Liew, Rosemary S. C. Horne, Joanne Rimmer, and Gillian M. Nixon. "Cost and economic determinants of paediatric tonsillectomy." Australian Health Review 46, no. 2 (April 5, 2022): 153–62. http://dx.doi.org/10.1071/ah21100.

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Objective Hospital utilisation research is important in pursuing cost-saving healthcare models. Tonsillectomy is one of the most common paediatric surgeries and the most frequent reason for paediatric hospital readmission. This study aimed to report the government-funded costs of paediatric tonsillectomy in the state of Victoria, Australia, extrapolate costs across Australia, and identify the cost determinants. Methods A population-based longitudinal study was conducted with a bottom-up costing approach using linked datasets containing all paediatric tonsillectomy and tonsillectomy with adenoidectomy surgeries performed in the state of Victoria between 2010 and 2015. Results The total average annual cost of tonsillectomy hospitalisation in Victoria was A$21 937 155 with a median admission cost of A$2224 (interquartile range (IQR) 1826–2560). Inflation-adjusted annual tonsillectomy costs increased during 2010–2015 (P < 0.001), not explained by the rising number of surgeries. Hospital readmissions resulted in a total average annual cost of A$1 427 716, with each readmission costing approximately A$2411 (IQR 1936–2732). The most common reason for readmission was haemorrhage, which was associated with the highest total cost. The estimated total annual expenditure of both tonsillectomy and resulting readmissions across Australia was A$126 705 989. Surgical cost in the upper quartile was associated with younger age, male sex, lower socioeconomic status, surgery for reasons other than infection alone, overnight vs day case surgery, public hospitals and metropolitan hospitals. Surgery for obstructed breathing during sleep had the strongest association to high surgical cost. Conclusions This study highlights the cost of paediatric tonsillectomy and associated hospital readmissions. The study findings will inform healthcare reform and serve as a basis for strategies to optimise patient outcomes while reducing both postoperative complications and costs.

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Ore, Timothy. "Trends and disparities in sepsis hospitalisations in Victoria, Australia." Australian Health Review 40, no. 5 (2016): 511. http://dx.doi.org/10.1071/ah15106.

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Objective The aim of the present study was to determine the clinical and epidemiological characteristics of patients with sepsis admitted to hospitals in Victoria, Australia, during the period 2004–14. The data include incidence, severity and mortality. Methods In all, 44 222 sepsis hospitalisations were identified between 2004–05 and 2013–14 from the Victorian Admitted Episodes Dataset. The dataset contains clinical and demographic information on all admissions to acute public and private hospitals. Using the International Classification of Diseases (10th Revision) Australian Modification codes, incidence rates, severity of disease and mortality were calculated. Results Sepsis hospitalisation rates per 10 000 population increased significantly (P < 0.01) over the period, from 6.9 (95% confidence interval (CI) 5.6–7.8) to 10.0 (95% CI 9.1–11.1), an annual growth rate of 3.8%. The age-standardised in-hospital death rates per 100 000 population grew significantly (P < 0.01) from 9.2 (95% CI 7.8–10.4) in 2004–05 to 13.0 (95% CI 11.7–14.6) in 2013–14, an annual growth rate of 3.1%. Among people under 45 years of age, the 0–4 years age group had the highest hospitalisation rate (3.0 per 10 000 population; 95% CI 2.7–3.4). Nearly half (46.2%) of all sepsis hospitalisations were among patients born overseas, with a rate of 14.5 per 10 000 population (95% CI 12.4–16.2) in that group compared with a rate of 5.9 per 10 000 population (95% CI 5.3–6.7) for patients born in Australia. The age-standardised sepsis hospitalisation rate was 2.6-fold greater in the lowest compared with highest socioeconomic areas (12.7 per 10 000 population (95% CI 11.2–13.8) vs 4.8 per 10 000 population (95% CI 4.1–5.7), respectively). Conclusion This paper shows a significant upward trend in both sepsis separation rates and in-hospital death rates over the period; unlike sepsis, in-hospital death rates from all diagnoses fell over the same period. The results can be used to stimulate review of clinical practice. Greater understanding of the epidemiology of sepsis could improve care quality and outcomes. What is known about the topic? Sepsis is associated with high mortality rates and severe sepsis is the most common cause of death in intensive care units (ICU). The last published study of sepsis in Victoria (in 2005) showed a gradual rise in rates; since then, there is little information as to whether there has been any significant improvement in treatment outcomes. What does this paper add? This paper provides new information by analysing trends and variations in sepsis hospitalisations in Victoria by several demographic groups from 2004–05 to 2013–14. What are the implications for practitioners? Patients with severe sepsis consume approximately half the ICU resources. Reliable and recent data on the growth of this disease are important for prevention, allocation of resources and to track the effectiveness of care. A key area for intervention is promoting greater adherence to clinical guidelines.

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Jangwal, H., H. Parker, B. Barger, K. Smith, G. Toogood, K. Soon, Y. Malaiapan, et al. "Pre-Hospital Notification Trial for Primary PCI: A Collaboration between the Victorian Cardiac Clinical Network (Department of Health), Ambulance Victoria and Participating Victorian Public Hospitals." Heart, Lung and Circulation 21 (January 2012): S168—S169. http://dx.doi.org/10.1016/j.hlc.2012.05.419.

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Cheng, Choon, Anthony Scott, Vijaya Sundararajan, and Jongsay Yong. "On measuring the quality of hospitals." Journal of Health Organization and Management 32, no. 7 (October 8, 2018): 842–59. http://dx.doi.org/10.1108/jhom-03-2018-0088.

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Purpose Researchers, policymakers and hospital managers often encounter numerous quality measures when assessing hospital quality. The purpose of this paper is to address the challenge of summarising, interpreting and comparing multiple quality measures across different quality dimensions by proposing a simple method of constructing a composite quality index. The method is applied to hospital administrative data to demonstrate its use in analysing hospital performance. Design/methodology/approach Logistic and fixed effects regression analyses are applied to secondary admitted patient data from all hospitals in the state of Victoria, Australia for the period 2000/2001–2011/2012. Findings The derived composite quality index was used to rank hospital performance and to assess changes in state-wide average hospital quality over time. Further regression analyses found private hospitals, day hospitals and non-acute hospitals were associated with higher composite quality, while small hospitals were associated with lower quality. Practical implications The method will enable policymakers and hospital managers to better monitor the performance of hospitals. It allows quality to be related to other attributes of hospitals such as size and volume, and enables policymakers and managers to focus on hospitals with relevant characteristics such that quantity and quality changes can be better understood, monitored and acted upon. Originality/value A simple method of constructing a composite quality is an indispensable practical tool in tracking the quality of hospitals when numerous measures are used to capture different aspects of quality. The derived composite quality can be used to summarise hospital performance and to identify factors associated with quality via regression analyses.

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Smith, Courtney, Allison Griffiths, Sandra Allison, Dee Hoyano, and Linda Hoang. "Escherichia coli O103 outbreak associated with minced celery among hospitalized individuals in Victoria, British Columbia, 2021." Canada Communicable Disease Report 48, no. 1 (January 26, 2022): 46–50. http://dx.doi.org/10.14745/ccdr.v48i01a07.

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Background: In April 2021, a Shiga toxin-producing Escherichia coli (E. coli) (STEC) O103 outbreak was identified among patients at two hospitals in Victoria, British Columbia (BC). The objective of this study is to describe this outbreak investigation and identify issues of food safety for high-risk products prepared for vulnerable populations. Methods: Confirmed cases of E. coli O103 were reported to the Island Health communicable disease unit. The provincial public health laboratory conducted whole genome sequencing on confirmed case isolates, as per routine practice for STEC in BC. Exposure information was obtained through case interviews and review of hospital menus. Federal and local public health authorities conducted an inspection of the processing plant for the suspect source. Results: Six confirmed cases of E. coli O103 were identified, all related by whole genome sequencing. The majority of cases were female (67%) and the median age was 61 years (range 24–87 years). All confirmed cases were inpatients or outpatients at two hospitals and were exposed to raw minced celery within prepared sandwiches provided by hospital food services. A local processor supplied the minced celery exclusively to the two hospitals. Testing of product at the processor was infrequent, and chlorine rinse occurred before mincing. The spread of residual E. coli contamination through the mincing process, in addition to temperature abuse at the hospitals, are thought to have contributed to this outbreak. Conclusion: Raw vegetables, such as celery, are a potential source of STEC and present a risk to vulnerable populations. Recommendations from this outbreak include more frequent testing at the processor, a review of the chlorination and mincing process and a review of hospital food services practices to mitigate temperature abuse.

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Fehlberg, Trafford, John Rose, Glenn Douglas Guest, and David Watters. "The surgical burden of disease and perioperative mortality in patients admitted to hospitals in Victoria, Australia: a population-level observational study." BMJ Open 9, no. 5 (May 17, 2019): e028671. http://dx.doi.org/10.1136/bmjopen-2018-028671.

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ObjectivesComprehensive reporting of surgical disease burden and outcomes are vital components of resilient health systems but remain under-reported. The primary objective was to identify the Victorian surgical burden of disease necessitating treatment in a hospital or day centre, including a thorough epidemiology of surgical procedures and their respective perioperative mortality rates (POMR).DesignRetrospective population-level observational study.SettingThe study was conducted in Victoria, Australia. Access to data from the Victorian Admitted Episodes Dataset was obtained using the Dr Foster Quality Investigator tool. The study included public and private facilities, including day-case facilities.ParticipantsFrom January 2014 to December 2016, all admissions with an International Statistical Classification of Diseases-10 code matched to the Global Health Estimates (GHE) disease categories were included.Primary and secondary outcome measuresAdmissions were assigned a primary disease category according to the 23 GHE disease categories. Surgical procedures during hospitalisations were identified using the Australian Refined Diagnosis Related Groups (AR-DRG). POMR were calculated for GHE disease categories and AR-DRG procedures.ResultsA total of 4 865 226 admitted episodes were identified over the 3-year period. 1 715 862 (35.3%) of these required a surgical procedure. The mortality rate for those undergoing a procedure was 0.42%, and 1.47% for those without. The top five procedures performed per GHE category were lens procedures (162 835 cases, POMR 0.001%), caesarean delivery (76 032 cases, POMR 0.01%), abortion with operating room procedure (65 451 cases, POMR 0%), hernia procedures (52 499 cases, POMR 0.05%) and other knee procedures (47 181 cases, POMR 0.004%).ConclusionsConditions requiring surgery were responsible for 35.3% of the hospital admitted disease burden in Victoria, a rate higher than previously published from Sweden, New Zealand and the USA. POMR is comparable to other studies reporting individual procedures and conditions, but has been reported comprehensively across all GHE disease categories for the first time.

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Duckett, Stephen J. "REGULATING THE CONSTRUCTION OF HOSPITALS OR VICE VERSA: THE COURTS AND PRIVATE HOSPITAL PLANNING IN VICTORIA." Community Health Studies 13, no. 4 (March 26, 2010): 431–40. http://dx.doi.org/10.1111/j.1753-6405.1989.tb00701.x.

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Castle, David J. "Letter from Australia: mental healthcare in Victoria." Advances in Psychiatric Treatment 17, no. 1 (January 2011): 2–4. http://dx.doi.org/10.1192/apt.bp.110.008375.

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SummaryMental health services in the state of Victoria, Australia, have undergone enormous change over the past 15 years, with the closure of all stand-alone psychiatric hospitals and a shift of resources and services into the community. Although successful overall, various areas cause concern, including pressure on acute beds, a paucity of alternative residential options, and suboptimal integration of government and non-government agencies concerned with the care of people with mental illnesses. Certain groups, notably those with complex symptom sets such as substance use and mental illness, intellectual disability and forensic problems, remain poorly catered for by the system. Finally, community stigma and lack of work inclusion for mentally ill individuals are ongoing challenges.

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Carlon, Nicole, and Andrea Quanchi. "Private midwives in Public Hospitals: Creating choice for birthing families in Victoria." Women and Birth 30 (October 2017): 46. http://dx.doi.org/10.1016/j.wombi.2017.08.122.

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Thompson, J., C. Batey, S. Borrell, L. Houston, G. Land, P. Bass, A. Lickliter, K. Watson, C. Stansfield, and G. Harrington. "The Alfred Hospitals Emergency Department response as H1N1 (Swine flu) griped Victoria." Australasian Emergency Nursing Journal 12, no. 4 (November 2009): 166. http://dx.doi.org/10.1016/j.aenj.2009.08.051.

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Elliott, Rohan A., Michael C. Woodward, and C. Alice Oborne. "Quality of Prescribing for Elderly Inpatients at Nine Hospitals in Victoria, Australia." Journal of Pharmacy Practice and Research 33, no. 2 (June 2003): 101–5. http://dx.doi.org/10.1002/jppr2003332101.

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Journal articles on the topic 'Hospitals (Victoria)'

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