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Hindle, Don. "Health care funding in the Australian Capital Territory: From hospital to community." Australian Health Review 25, no. 1 (2002): 121. http://dx.doi.org/10.1071/ah020121.
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This paper presents an outline of the socio-demographic features of the Australian Capital Territory (the ACT) and of its health care system. I describe how health care resources are allocated in the government sector, present a moredetailed description of the way that hospital services are purchased, and summarise the government's policy directions for health. I argue that the main directions are sensible, and particularly those that support more integrated care that is largely based in the community. There appear to be no major weaknesses in the budget-share output-based funding model used in the purchase of hospital services, although the rationale for some of the components might be clarified.In total, the ACT government appears to be on the right track. However, I argue that more rapid progress might bepossible if there were greater collaboration between the Territory health authority and the relatively powerful private medical profession.
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Kerr, Rhonda, and Delia V. Hendrie. "Is capital investment in Australian hospitals effectively funding patient access to efficient public hospital care?" Australian Health Review 42, no. 5 (2018): 501. http://dx.doi.org/10.1071/ah17231.
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Objective This study asks ‘Is capital investment in Australian public hospitals effectively funding patient access to efficient hospital care?’ Methods The study drew information from semistructured interviews with senior health infrastructure officials, literature reviews and World Health Organization (WHO) reports. To identify which systems most effectively fund patient access to efficient hospitals, capital allocation systems for 17 Organisation for Economic Cooperation and Development (OECD) countries were assessed. Results Australian government objectives (equitable access to clinically appropriate, efficient, sustainable, innovative, patient-based) for acute health services are not directly addressed within Australian capital allocation systems for hospitals. Instead, Australia retains a prioritised hospital investment system for institutionally based asset replacement and capital planning, aligned with budgetary and political priorities. Australian systems of capital allocation for public hospitals were found not to match health system objectives for allocative, productive and dynamic efficiency. Australia scored below average in funding patient access to efficient hospitals. The OECD countries most effectively funding patient access to efficient hospital care have transitioned to diagnosis-related group (DRG) aligned capital funding. Measures of effective capital allocation for hospitals, patient access and efficiency found mixed government–private–public partnerships performed poorly with inferior access to capital than DRG-aligned systems, with the worst performing systems based on private finance. Conclusion Australian capital allocation systems for hospitals do not meet Australian government standards for the health system. Transition to a diagnosis-based system of capital allocation would align capital allocation with government standards and has been found to improve patient access to efficient hospital care. What is known about the topic? Very little is known about the effectiveness of Australian capital allocation for public hospitals. In Australia, capital is rarely discussed in the context of efficiency, although poor built capital and inappropriate technologies are acknowledged as limitations to improving efficiency. Capital allocated for public hospitals by state and territory is no longer reported by Australian Institute of Health and Welfare due to problems with data reliability. International comparative reviews of capital funding for hospitals have not included Australia. Most comparative efficiency reviews for health avoid considering capital allocation. The national review of hospitals found capital allocation information makes it difficult to determine ’if we have it right’ in terms of investment for health services. Problems with capital allocation systems for public hospitals have been identified within state-based reviews of health service delivery. The Productivity Commission was unable to identify the cost of capital used in treating patients in Australian public hospitals. Instead, building and equipment depreciation plus the user cost of capital (or the cost of using the money invested in the asset) are used to estimate the cost of capital required for patient care, despite concerns about accuracy and comparability. What does this paper add? This is the first study to review capital allocation systems for Australian public hospitals, to evaluate those systems against the contemporary objectives of the health systems and to assess whether prevailing Australian allocation systems deliver funds to facilitate patient access to efficient hospital care. This is the first study to evaluate Australian hospital capital allocation and efficiency. It compares the objectives of the Australian public hospitals system (for universal access to patient-centred, efficient and effective health care) against a range of capital funding mechanisms used in comparable health systems. It is also the first comparative review of international capital funding systems to include Australia. What are the implications for practitioners? Clinical quality and operational efficiency in hospitals require access for all patients to technologically appropriate hospitals. Funding for appropriate public hospital facilities, medical equipment and information and communications technology is not connected to activity-based funding in Australia. This study examines how capital can most effectively be allocated to provide patient access to efficient hospital care for Australian public hospitals. Capital investment for hospitals that is patient based, rather than institutionally focused, aligns with higher efficiency.
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Rai, Sumeet, Rhonda Brown, Frank van Haren, Teresa Neeman, Arvind Rajamani, Krishnaswamy Sundararajan, and Imogen Mitchell. "Long-term follow-up for Psychological stRess in Intensive CarE (PRICE) survivors: study protocol for a multicentre, prospective observational cohort study in Australian intensive care units." BMJ Open 9, no. 1 (January 2019): e023310. http://dx.doi.org/10.1136/bmjopen-2018-023310.
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IntroductionThere are little published data on the long-term psychological outcomes in intensive care unit (ICU) survivors and their family members in Australian ICUs. In addition, there is scant literature evaluating the effects of psychological morbidity in intensive care survivors on their family members. The aims of this study are to describe and compare the long-term psychological outcomes of intubated and non-intubated ICU survivors and their family members in an Australian ICU setting.Methods and analysisThis will be a prospective observational cohort study across four ICUs in Australia. The study aims to recruit 150 (75 intubated and 75 non-intubated) adult ICU survivors and 150 family members of the survivors from 2015 to 2018. Long-term psychological outcomes and effects on health-related quality of life (HRQoL) will be evaluated at 3 and 12 months follow-up using validated and published screening tools. The primary objective is to compare the prevalence of affective symptoms in intubated and non-intubated survivors of intensive care and their families and its effects on HRQoL. The secondary objective is to explore dyadic relations of psychological outcomes in patients and their family members.Ethics and disseminationThe study has been approved by the relevant human research ethics committees (HREC) of Australian Capital Territory (ACT) Health (ETH.11.14.315), New South Wales (HREC/16/HNE/64), South Australia (HREC/15/RAH/346). The results of this study will be published in a peer-reviewed medical journal and presented to the local intensive care community and other stakeholders.Trial registration numberACTRN12615000880549; Pre-results.
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Gatenby, Paul A. "Creation of an academic medical centre: Management and service delivery at the Canberra Clinical School." Australian Health Review 19, no. 1 (1996): 107. http://dx.doi.org/10.1071/ah960107.
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The Canberra Clinical School is attached to Woden Valley Hospital, the principalhospital in the Australian Capital Territory. The clinical school arose out of amemorandum of understanding signed between the University of Sydney and theACT Department of Health (as it then was) in March 1993. One of theaspirations of those who negotiated the memorandum of understanding was thatthe creation of the clinical school would lead to a cultural shift in attitudes towardschange within the health care system. This paper looks at the management structureof Woden Valley Hospital and at what the development of a clinical school inCanberra can achieve, particularly in relation to hospital and health servicemanagement.
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Bail, Kasia, Paul Arbon, Marlene Eggert, Anne Gardner, Sonia Hogan, Christine Phillips, Nicole van Dieman, and Gordon Waddington. "Potential scope and impact of a transboundary model of nurse practitioners in aged care." Australian Journal of Primary Health 15, no. 3 (2009): 232. http://dx.doi.org/10.1071/py09009.
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Aged care is a growing issue in Australia and other countries. There are significant barriers to meeting the health needs of this population. Current services have gaps between care and lack communication and integration between care providers. Research was conducted in the Australian Capital Territory to investigate the potential role of the aged care nurse practitioner in health service delivery in aged care settings. A multimethod case study design was utilised, with three student nurse practitioners (SNP) providing care to aged care clients across three sectors of health service delivery (residential aged care facilities, general medical practices and acute care). Data collection consisted of in-depth interviews and journal entries of the SNP, as well as focus groups and surveys of multidisciplinary staff and patients over the age of 65 years in the settings frequented by the SNP. The aged care SNP were found to cross professional and organisational boundaries, cross intra- as well as interorganisational boundaries and to contribute to more seamless patient care as members of a multidisciplinary aged care team. The aged care nurse practitioner role consequently has the potential to function in a networked rather than a hierarchical manner, and this could be a key element in addressing gaps in care across care locales and between disciplines.
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Jakobs, Olivia M., Elizabeth M. O'Leary, Mark F. Cormack, and Guan C. Chong. "A working model for the extraordinary review of clinical privileges for doctors and dentists in the Australian Capital Territory." Australian Health Review 34, no. 2 (2010): 170. http://dx.doi.org/10.1071/ah08694.
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The extraordinary (unplanned) review of clinical privileges is the means by which an organisation can manage specific complaints about individual practitioners’ clinical competence that require immediate investigation. To date, the extraordinary review of clinical privileges for doctors and dentists has not been the subject of much research and there is a pressing need for the evaluation and review of how different legislated and non-legislated administrative processes work and what they achieve. Although it seems a fair proposition that comprehensive processes for the evaluation of the clinical competence of doctors and dentists may improve the overall delivery of an organisation’s clinical services, in fact, little is known about the relationship between the safety and quality of specific clinical services, procedures and interventions and the efficiency or effectiveness of established methodologies for the routine or the extraordinary review of clinical privileges. The authors present a model of a structured approach to the extraordinary review of clinical privileges within a clinical governance framework in the Australian Capital Territory. The assessment framework uses a primarily qualitative methodology, underpinned by a process of systematic review of clinical competence against the agreed standards of the CanMEDS Physician Competency Framework. The model is a practical, working framework that could be implemented on a hospital-, area health service- or state- and territory-wide basis in any other Australian jurisdiction. What is known about the topic?In Australia, there is a national standard for credentialing and defining the scope of clinical practice for doctors working in hospital settings. However, there are no published reports in the national arena on established processes for the extraordinary review of clinical privileges for doctors or dentists and, despite the major inquiries investigating health system failures in Australian hospitals, the effectiveness and adequacy of existing processes for the extraordinary review of clinical privileges has not yet been prioritised nationally as an area for improvement or reform. Internationally, health care organisations have also been slow to establish frameworks for the management of complaints about doctors or dentists. What does this paper add?This paper makes a significant contribution to the national and international safety and quality literature by presenting an exposition of a working model for the extraordinary review of clinical privileges of doctors and dentists. The authors describe a methodology in the public health sector that is territory-wide (not hospital-based), peer-reviewed, objective, fair and responsive. Because the model is a practical, working framework that could be implemented on a hospital-, area health service- or state- and territory-wide basis in any other Australian jurisdiction, this paper provides an opportunity for policy makers and legislators to drive innovative change. Although incursions into the provision of care by other health professionals have been avoided, the model could be readily adopted by clinical leaders from the nursing and allied health professions. What are the implications for practitioners?An organisation dedicated to investigating serious complaints with a real sense of urgency, objectivity and transparency is far less likely to fester a climate of disquiet or anger amongst staff, or to trigger concerns of a ‘cover-up’ or disregard for accountability than an organisation not adopting such an approach. Anecdotal experience suggests the model has the potential to minimise, if not prevent, the occurrence of the kinds of complaints that become much-publicised in the media. This is positive because these types of damaging high profile cases often have the effect of diminishing community confidence in the health care system, in particular, confidence in the medical profession’s ability to self-regulate. Often, they also lead to a misrepresentation of the medical profession in the media, which is unfair since the overwhelming majority of doctors do meet the standards of their profession.
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Parekh, Vanita, Marian Currie, and Cassandra Beaumont Brown. "A Postgraduate Sexual Assault Forensic Medicine Program: Sexual assault medicine from scratch." Medicine, Science and the Law 45, no. 2 (April 2005): 121–28. http://dx.doi.org/10.1258/rsmmsl.45.2.121.
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A government-funded service to provide forensic and medical care to survivors of sexual assault was established in the Australian Capital Territory (ACT) in 2001. Doctors employed by the service lacked the specific skills required to care comprehensively for survivors. Our aim was to develop, implement and evaluate a sexual assault medical education program. It consisted of an `in-house' education program, and external university course and incorporated team-building, networking activities and protocol development. Core elements were: forensic evidence collection, assessment and management of injuries, prevention of sexually transmissible infections and pregnancy, counselling and emotional support. Participant satisfaction and knowledge acquisition were evaluated using a semi-structured interview and a questionnaire. Seven doctors participated in a 16-session program conducted by the director and nurse coordinator with help from local forensic, legal and medical experts. All doctors successfully completed the Certificate in Forensic Medicine, and reported satisfaction with the program and their increased knowledge, particularly associated with collection of forensic evidence and court procedures. A compete set of protocols was developed and cohesive networks established. We have designed an effective education program for doctors working in the field of sexual assault and offer it as a template to other health professionals working in this area.
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Owler, Brian K., Kathryn A. Browning Carmo, Wendy Bladwell, T. Arieta Fa’asalele, Jane Roxburgh, Tina Kendrick, and Andrew Berry. "Mobile pediatric neurosurgery: rapid response neurosurgery for remote or urgent pediatric patients." Journal of Neurosurgery: Pediatrics 16, no. 3 (September 2015): 340–45. http://dx.doi.org/10.3171/2015.2.peds14310.
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OBJECT Time-critical neurosurgical conditions require urgent operative treatment to prevent death or neurological deficits. In New South Wales/Australian Capital Territory patients’ distance from neurosurgical care is often great, presenting a challenge in achieving timely care for patients with acute neurosurgical conditions. METHODS A protocol was developed to facilitate consultant neurosurgery locally. Children with acute, time-critical neurosurgical emergencies underwent operations in hospitals that do not normally offer neurosurgery. The authors describe the developed protocol, the outcome of its use, and the lessons learned in the 9 initial cases where the protocol has been used. Three cases are discussed in detail. RESULTS Nine children were treated by a neurosurgeon at 5 rural hospitals, and 2 children were treated at a smaller metropolitan hospital. Road ambulance, fixed wing aircraft, and medical helicopters were used to transport the Newborn and Paediatric Emergency Transport Service (NETS) team, neurosurgeon, and patients. In each case, the time to definitive neurosurgical intervention was significantly reduced. The median interval from triage at the initial hospital to surgical start time was 3:55 hours, (interquartile range [IQR] 03:29–05:20 hours). The median distance traveled to reach a patient was 232 km (range 23–637 km). The median interval from the initial NETS call requesting patient retrieval to surgical start time was 3:15 hours (IQR 00:47–03:37 hours). The estimated median “time saved” was approximately 3:00 hours (IQR 1:44–3:15 hours) compared with the travel time to retrieve the child to the tertiary center: 8:31 hours (IQR 6:56–10:08 hours). CONCLUSIONS Remote urgent neurosurgical interventions can be performed safely and effectively. This practice is relevant to countries where distance limits urgent access for patients to tertiary pediatric care. This practice is lifesaving for some children with head injuries and other acute neurosurgical conditions.
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LUCAS, PETER. "AUSTRALIAN CAPITAL TERRITORY." Emergency Medicine 3 (August 26, 2009): 213. http://dx.doi.org/10.1111/j.1442-2026.1991.tb00747.x.
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Proctor, Margaret, Laurie Grealish, Margaret Coates, and Penny Sears. "Nurses’ knowledge of palliative care in the Australian Capital Territory." International Journal of Palliative Nursing 6, no. 9 (October 2000): 421–28. http://dx.doi.org/10.12968/ijpn.2000.6.9.9053.
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Freed, Gary L., and Amy R. Allen. "Outpatient consultant physician service usage in Australia by specialty and state and territory." Australian Health Review 43, no. 2 (2019): 200. http://dx.doi.org/10.1071/ah17125.
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Objectives To determine national service usage for initial and subsequent outpatient consultations with a consultant physician and any variation in service-use patterns between states and territories relative to population. Methods An analysis was conducted of consultant physician Medicare claims data from the year 2014 for an initial (item 110) and subsequent consultation (item 116) and, for patients with multiple morbidities, initial management planning (item 132) and review (133). The analysis included 12 medical specialties representative of common adult non-surgical medical care (cardiology, endocrinology, gastroenterology, general medicine, geriatric medicine, haematology, immunology and allergy, medical oncology, nephrology, neurology, respiratory medicine and rheumatology). Main outcome measures were per-capita service use by medical speciality and by state and territory and ratio of subsequent consultations to initial consultations by medical speciality and by state and territory. Results There was marked variation in per-capita consultant physician service use across the states and territories, tending higher than average in New South Wales and Victoria, and lower than average in the Northern Territory. There was variation between and within specialties across states and territories in the ratio of subsequent consultations to initial consultations. Conclusion Significant per-capita variation in consultant physician utilisation is occurring across Australia. Future studies should explore the variation in greater detail to discern whether workforce issues, access or economic barriers to care, or the possibility of over- or under-servicing in certain geographic areas is leading to this variation. What is known about the topic? There are nearly 11million initial and subsequent consultant physician consultations billed to Medicare per year, incurring nearly A$850million in Medicare benefits. Little attention has been paid to per-capita variation in rates of consultant physician service use across states and territories. What does this paper add? There is marked variation in per-capita consultant physician service use across different states and territories both within and between specialties. What are the implications for practitioners? Variation in service use may be due to limitations in the healthcare workforce, access or economic barriers, or systematic over- or under-servicing. The clinical appropriateness of repeated follow-up consultations is unclear.
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Scholz, Brett, Julia Bocking, and Brenda Happell. "How do consumer leaders co-create value in mental health organisations?" Australian Health Review 41, no. 5 (2017): 505. http://dx.doi.org/10.1071/ah16105.
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Objectives Contemporary mental health policies call for consumers to be involved in decision-making processes within mental health organisations. Some organisations have embraced leadership roles for consumers, but research suggests consumers remain disempowered within mental health services. Drawing on a service-dominant logic, which emphasises the co-creation of value of services, the present study provides an overview of consumer leadership within mental health organisations in the Australian Capital Territory. Methods Mental health organisations subscribing to the local peak body mailing list were invited to complete a survey about consumer leadership. Survey data were summarised using descriptive statistics and interpreted through the lens of service-dominant logic. Results Ways in which organisations may create opportunities for consumers to co-create value within their mental health services included soliciting feedback, involving consumer leaders in service design, having consumer leaders involved in hiring decisions and employing consumer leaders as staff or on boards. Strategies that organisations used to develop consumer leaders included induction, workshops and training in a variety of organisational processes and skills. Conclusions The findings of the present study extend the application of a service-dominant logic framework to consumer leadership within mental health organisations through consideration of the diverse opportunities that organisations can provide for consumer co-creation of service offerings. What is known about the topic? Policy calls for consumer involvement in all levels of mental health service planning, implementation and delivery. The extent to which service organisations have included consumer leaders varies, but research suggests that this inclusion can be tokenistic or that organisations choose to work with consumers who are less likely to challenge the status quo. Service literature has explored the way consumers can co-create value of their own health care, but is yet to explore consumers’ co-creation of value at a systemic level. What does the paper add? This paper outlines ways in which mental health organisations report involving consumers in leadership positions, including having consumers on boards, having consumers on recruitment panels and providing leadership training for consumers. These initiatives are considered in terms of the potential value co-created within mental health services by consumers in leadership, suggesting that consumer leaders are a resource to mental health organisations in terms of the value brought to service offerings. What are the implications for practitioners? Research suggests that medical professionals have been resistant to increased consumer leadership within mental health services. The findings of the present study emphasise the value that can be brought to service organisations by consumer leaders, suggesting that mental health practitioners may reconsider their approach and attitudes towards consumer leadership in the sector.
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Shukralla, Heidi, Julie Tongs, Nadeem Siddiqui, and Ana Herceg. "Australian first in Aboriginal and Torres Strait Islander prisoner health care in the Australian Capital Territory." Australian and New Zealand Journal of Public Health 44, no. 4 (July 6, 2020): 324. http://dx.doi.org/10.1111/1753-6405.13007.
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Bonner, Daniel, Paul Maguire, Björn Cartledge, Philip Keightley, Rebecca Reay, Raj Parige, Jeff Cubis, Michael Tedeschi, Peggy Craigie, and Jeffrey CL Looi. "A new graduate medical school curriculum in Psychiatry and Addiction Medicine: reflections on a decade of development." Australasian Psychiatry 26, no. 4 (February 26, 2018): 422–28. http://dx.doi.org/10.1177/1039856218758561.
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Objectives: The aim of this study is to reflect upon the rationale, design and development of the Psychiatry and Addiction Medicine curriculum at the Australian National University Medical School, Canberra, Australian Capital Territory, Australia. Conclusions: We conclude that the development of the fourth-year curriculum of a four-year graduate medical degree was a complex evolutionary process.
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Carmichael, Allan. "Teaching, learning and research: essential elements of health care and the next Australian Health Care Agreements." Australian Health Review 31, no. 5 (2007): 25. http://dx.doi.org/10.1071/ah070s25.
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Australian Health Care Agreements must set out the roles and responsibilities of the Australian, state and territory governments in ensuring the provision of appropriate clinical placements for the additional medical student allocation. The roles of universities and public and private health agencies must also be specified.
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Low, Elizabeth, Jane Kellett, Rachel Bacon, and Nenad Naumovski. "Food Habits of Older Australians Living Alone in the Australian Capital Territory." Geriatrics 5, no. 3 (September 18, 2020): 55. http://dx.doi.org/10.3390/geriatrics5030055.
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The link between adequate nutrition and quality of life for older persons is well established. With the proportion of older adults increasing, policy regarding support and care for the ageing has shifted emphasis to keeping older adults in their homes for as long as possible. Risk of malnutrition is an issue of importance for this population and, while this risk is well researched within the hospital setting, it is still relatively under-researched within the community-dwelling elderly, particularly with respect to the lived experience. This qualitative study (underpinned by interpretative phenomenology philosophy) explores how the lived experiences of community-dwelling older people living in one-person households in the Australian Capital Territory (ACT) influences dietary patterns, food choices and perceptions about food availability. Using purposeful and snowballing sampling, older people (65 years and over) living alone in the community participated in focus group discussions triangulated with their family/carers. Data were thematically analysed using a previously established approach. Participants (n = 22) were interviewed in three focus groups. Three themes were identified: active and meaningful community connectedness; eating well and behaviours to promote dietary resilience. Of these, community connectedness was pivotal in driving food patterns and choices and was a central component influencing behaviours to eating well and maintaining dietary resilience.
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Simpson, Paul L., Megan Williams, Jocelyn Jones, and Tony Butler. "Authors' response to “Australian first in Aboriginal and Torres Strait Islander prisoner health care in the Australian Capital Territory”." Australian and New Zealand Journal of Public Health 44, no. 4 (July 6, 2020): 325. http://dx.doi.org/10.1111/1753-6405.13008.
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Westbury, Juanita, Peter Gee, Tristan Ling, Alex Kitsos, and Gregory Peterson. "More action needed: Psychotropic prescribing in Australian residential aged care." Australian & New Zealand Journal of Psychiatry 53, no. 2 (February 28, 2018): 136–47. http://dx.doi.org/10.1177/0004867418758919.
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Objective: For at least two decades, concerns have been raised about inappropriate psychotropic prescribing in Australian residential aged care facilities, due to their modest therapeutic benefit and increased risk of falls and mortality. To date, the majority of prevalence data has been collected in Sydney exclusively and it is not known if recent initiatives to promote appropriate psychotropic prescribing have impacted utilisation. Thus, we aimed to comprehensively analyse psychotropic use in a large national sample of residential aged care facility residents. Method: A cross-sectional, retrospective cohort study of residents from 150 residential aged care facilities distributed nationally during April 2014–October 2015. Antipsychotic, anxiolytic/hypnotic and antidepressant utilisation was assessed, along with anticonvulsant and anti-dementia drug use. Negative binomial regression analysis was used to examine variation in psychotropic use. Results: Full psychotropic prescribing data was available from 11,368 residents. Nearly two-thirds (61%) were taking psychotropic agents regularly, with over 41% prescribed antidepressants, 22% antipsychotics and 22% of residents taking benzodiazepines. Over 30% and 11% were charted for ‘prn’ (as required) benzodiazepines and antipsychotics, respectively. More than 16% of the residents were taking sedating antidepressants, predominantly mirtazapine. South Australian residents were more likely to be taking benzodiazepines ( p < 0.05) and residents from New South Wales/Australian Capital Territory less likely to be taking them ( p < 0.01), after adjustment for rurality and size of residential aged care facility. Residents located in New South Wales/Australian Capital Territory were also significantly less likely to take antidepressants ( p < 0.01), as were residents from outer regional residential aged care facilities ( p < 0.01). Antipsychotic use was not associated with State, rurality or residential aged care facility size. Conclusion: Regular antipsychotic use appears to have decreased in residential aged care facilities but benzodiazepine prevalence is higher, particularly in South Australian residential aged care facilities. Sedating antidepressant and ‘prn’ psychotropic prescribing is widespread. Effective interventions to reduce the continued reliance on psychotropic management, in conjunction with active promotion of non-pharmacological strategies, are urgently required.
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Dance, Phyll, Roslyn Brown, Gabriele Bammer, and Beverly Sibthorpe. "Aged care services for Indigenous people in the Australian Capital Territory and surrounds:analysing needs and implementing change." Australian and New Zealand Journal of Public Health 28, no. 6 (December 2004): 579–83. http://dx.doi.org/10.1111/j.1467-842x.2004.tb00051.x.
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Arbon, Paul, Kasia Bail, Marlene Eggert, Anne Gardner, Sonia Hogan, Christine Phillips, Nicole van Dieman, and Gordon Waddington. "Reporting a research project on the potential of aged care nurse practitioners in the Australian Capital Territory." Journal of Clinical Nursing 18, no. 2 (January 2009): 255–62. http://dx.doi.org/10.1111/j.1365-2702.2008.02452.x.
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Almado, Haidar, Estie Kruger, and Marc Tennant. "Application of spatial analysis technology to the planning of access to oral health care for at-risk populations in Australian capital cities." Australian Journal of Primary Health 21, no. 2 (2015): 221. http://dx.doi.org/10.1071/py13141.
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Australians are one of the healthiest populations in the world but there is strong evidence that health inequalities exist. Australia has 23.1 million people spread very unevenly over ~20 million square kilometres. This study aimed to apply spatial analysis tools to measure the spatial distribution of fixed adult public dental clinics in the eight metropolitan capital cities of Australia. All population data for metropolitan areas of the eight capital cities were integrated with socioeconomic data and health-service locations, using Geographic Information Systems, and then analysed. The adult population was divided into three subgroups according to age, consisting of 15-year-olds and over (n = 7.2 million), retirees 65 years and over (n = 1.2 million), and the elderly, who were 85 years and over (n = 0.15 million). It was evident that the States fell into two groups; Tasmania, Northern Territory, Australian Capital Territory and Western Australia in one cluster, and Victoria, New South Wales, Queensland and South Australia in the other. In the first group, the average proportion of the population of low socioeconomic status living in metropolitan areas within 2.5 km of a government dental clinic is 13%, while for the other cluster, it is 42%. The clustering remains true at 5 km from the clinics. The first cluster finds that almost half (46%) of the poorest 30% of the population live within 5 km of a government dental clinic. The other cluster of States finds nearly double that proportion (86%). The results from this study indicated that access distances to government dental services differ substantially in metropolitan areas of the major Australian capital cities.
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Matthews, Susan Janet, Brooke Spaeth, Lauren Duckworth, Janet Noreen Richards, Emma Prisk, Malcolm Auld, Tina Quirk, Rodney Omond, and Mark D. S. Shephard. "Sustained Quality and Service Delivery in an Expanding Point-of-Care Testing Network in Remote Australian Primary Health Care." Archives of Pathology & Laboratory Medicine 144, no. 11 (October 27, 2020): 1381–91. http://dx.doi.org/10.5858/arpa.2020-0107-oa.
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Context.— Since 2008, the Northern Territory Point-of-Care Testing Program has improved patient access to pathology testing for acute and chronic disease management for remote health services. Objective.— To evaluate the analytical quality, service delivery, and clinical utility of an expanding remote point-of-care testing network. Design.— Four years (2016–2019) of data on analytical quality, test numbers, and training statistics and 6 months of clinical point-of-care testing data from Abbott i-STATs at remote health services throughout the Northern Territory were analyzed to assess analytical performance, program growth, and clinical utility. Results.— From 2016 to 2019, point-of-care test numbers increased, with chemistry and blood gas testing more than doubling to 8500 and 6000 tests, respectively, troponin I testing almost doubling (to 6000), and international normalized ratio testing plateauing at 8000 tests. Participation in quality control and proficiency testing was high, with quality comparable to laboratory-based analytical goals. A shift toward flexible training and communication modes was noted. An audit of point-of-care test results demonstrated elevated creatinine, associated with chronic kidney disease management, as the most common clinically actionable patient result. Conclusions.— The Northern Territory Point-of-Care Testing Program provides high quality point-of-care testing within remote primary health services for acute and chronic patient management and care. Clinical need, sound analytical performance, flexibility in training provision, and effective support services have facilitated the sustainability of this expanding point-of-care testing model in the remote Northern Territory during the past 11 years.
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Borotkanics, Robert, Cassandra Rowe, Andrew Georgiou, Heather Douglas, Meredith Makeham, and Johanna Westbrook. "Changes in the profile of Australians in 77 residential aged care facilities across New South Wales and the Australian Capital Territory." Australian Health Review 41, no. 6 (2017): 613. http://dx.doi.org/10.1071/ah16125.
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Objective Government expenditure on and the number of aged care facilities in Australia have increased consistently since 1995. As a result, a range of aged care policy changes have been implemented. Data on demographics and utilisation are important in determining the effects of policy on residential aged care services. Yet, there are surprisingly few statistical summaries in the peer-reviewed literature on the profile of Australian aged care residents or trends in service utilisation. Therefore, the aim of the present study was to characterise the demographic profile and utilisation of a large cohort of residential aged care residents, including trends over a 3-year period. Methods We collected 3 years of data (2011–14) from 77 residential aged care facilities and assessed trends and differences across five demographic and three service utilisation variables. Results The median age at admission over the 3-year period remained constant at 86 years. There were statistically significant decreases in separations to home (z = 2.62, P = 0.009) and a 1.35% increase in low care admissions. Widowed females made up the majority (44.75%) of permanent residents, were the oldest and had the longest lengths of stay. One-third of permanent residents had resided in aged care for 3 years or longer. Approximately 30% of residents were not born in Australia. Aboriginal residents made up less than 1% of the studied population, were younger and had shorter stays than non-Aboriginal residents. Conclusion The analyses revealed a clear demographic profile and consistent pattern of utilisation of aged care facilities. There have been several changes in aged care policy over the decades. The analyses outlined herein illustrate how community, health services and public health data can be used to inform policy, monitor progress and assess whether intended policy has had the desired effects on aged care services. What is known about the topic? Characterisation of permanent residents and their utilisation of residential aged care facilities is poorly described in the peer-reviewed literature. Further, publicly available government reports are incomplete or characterised using incomplete methods. What does this paper add? The analyses in the present study revealed a clear demographic profile and consistent pattern of utilisation of aged care facilities. The most significant finding of the study is that one-third of permanent residents had resided in an aged care facility for ≥3 years. These findings add to the overall picture of residential aged care utilisation in Australia. What are the implications for practitioners? The analyses outlined herein illustrate how community, health services and public health data can be utilised to inform policy, monitor progress and assess whether or not intended policy has had the desired effects on aged care services.
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Goller, Jane L., Jacqueline Coombe, Christopher Bourne, Deborah Bateson, Meredith Temple-Smith, Jane Tomnay, Alaina Vaisey, et al. "Patient-delivered partner therapy for chlamydia in Australia: can it become part of routine care?" Sexual Health 17, no. 4 (2020): 321. http://dx.doi.org/10.1071/sh20024.
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Abstract Background Patient-delivered partner therapy (PDPT) is a method for an index patient to give treatment for genital chlamydia to their sexual partner(s) directly. In Australia, PDPT is considered suitable for heterosexual partners of men and women, but is not uniformly endorsed. We explored the policy environment for PDPT in Australia and considered how PDPT might become a routine option. Methods: Structured interviews were conducted with 10 key informants (KIs) representing six of eight Australian jurisdictions and documents relevant to PDPT were appraised. Interview transcripts and documents were analysed together, drawing on KIs’ understanding of their jurisdiction to explore our research topics, namely the current context for PDPT, challenges, and actions needed for PDPT to become routine. Results: PDPT was allowable in three jurisdictions (Victoria, New South Wales, Northern Territory) where State governments have formally supported PDPT. In three jurisdictions (Western Australia, Australian Capital Territory, Tasmania), KIs viewed PDPT as potentially allowable under relevant prescribing regulations; however, no guidance was available. Concern about antimicrobial stewardship precluded PDPT inclusion in the South Australian strategy. For Queensland, KIs viewed PDPT as not allowable under current prescribing regulations and, although a Medicine and Poisons Act was passed in 2019, it is unclear if PDPT will be possible under new regulations. Clarifying the doctor–partner treating relationship and clinical guidance within a care standard were viewed as crucial for PDPT uptake, irrespective of regulatory contexts. Conclusion: Endorsement and guidance are essential so doctors can confidently and routinely offer PDPT in respect to professional standards and regulatory requirements.
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Cameron, Helen E., Frances T. Boreland, Jocelyn R. Morris, David M. Lyle, David A. Perkins, Parker J. Magin, Melanie J. Marshall, and Nicholas A. Zwar. "New South Wales and Australian Capital Territory Researcher Development Program 2005–07: modest investment, considerable outcomes." Australian Journal of Primary Health 19, no. 1 (2013): 59. http://dx.doi.org/10.1071/py11155.
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This evaluation of the Researcher Development Program (RDP) in NSW and ACT aimed to determine whether the RDP was effective in assisting novice researchers to undertake primary health care research. In mid-2008, 47 participants of the NSW and ACT RDP during 2005–07 were invited to participate in a postal survey. The survey included questions regarding previous research training and experience, outcomes during and after participation in the program, and organisational aspects of the program. Follow-up interviews were conducted with selected participants. Interview questions covered time in the program, supervision, organisational support and placement outcomes. Thirty-seven participants responded to the survey and 23 (62%) participants took part in the semi-structured interviews. Seventy-eight per cent of survey respondents felt that the RDP helped them move from novice to a more experienced researcher with effective supervision identified by participants as a key element in determining the success of the program. Many felt that time allocation was inadequate and 20% thought their capacity to maintain their workload was adversely affected by participating. Outcomes were considerable given the modest nature of the program. Notable outcomes were that most participants published their research and presented their research at a conference. Furthermore, one-fifth of survey respondents had enrolled in higher degrees. Several interviewees reported that their research led to changes in practice. Most respondents found the RDP valuable and considered that undertaking the program increased their research knowledge.
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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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Abdel-Latif, Mohamed E., Gen Nowak, Barbara Bajuk, Kathryn Glass, and David Harley. "Variation in hospital mortality in an Australian neonatal intensive care unit network." Archives of Disease in Childhood - Fetal and Neonatal Edition 103, no. 4 (October 26, 2017): F331—F336. http://dx.doi.org/10.1136/archdischild-2017-313222.
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BackgroundStudying centre-to-centre (CTC) variation in mortality rates is important because inferences about quality of care can be made permitting changes in practice to improve outcomes. However, comparisons between hospitals can be misleading unless there is adjustment for population characteristics and severity of illness.ObjectiveWe sought to report the risk-adjusted CTC variation in mortality among preterm infants born <32 weeks and admitted to all eight tertiary neonatal intensive care units (NICUs) in the New South Wales and the Australian Capital Territory Neonatal Network (NICUS), Australia.MethodsWe analysed routinely collected prospective data for births between 2007 and 2014. Adjusted mortality rates for each NICU were produced using a multiple logistic regression model. Output from this model was used to construct funnel plots.ResultsA total of 7212 live born infants <32 weeks gestation were admitted consecutively to network NICUs during the study period. NICUs differed in their patient populations and severity of illness.The overall unadjusted hospital mortality rate for the network was 7.9% (n=572 deaths). This varied from 5.3% in hospital E to 10.4% in hospital C. Adjusted mortality rates showed little CTC variation. No hospital reached the +99.8% control limit level on adjusted funnel plots.ConclusionCharacteristics of infants admitted to NICUs differ, and comparing unadjusted mortality rates should be avoided. Logistic regression-derived risk-adjusted mortality rates plotted on funnel plots provide a powerful visual graphical tool for presenting quality performance data. CTC variation is readily identified, permitting hospitals to appraise their practices and start timely intervention.
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Callander, Emily, Sarah Larkins, and Lisa Corscadden. "Variations in out-of-pocket costs for primary care services across Australia: a regional analysis." Australian Journal of Primary Health 23, no. 4 (2017): 379. http://dx.doi.org/10.1071/py16127.
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The aim of this study is to describe average out-of-pocket costs across different regions of Australia, as defined by Primary Health Network (PHN) boundaries, and assess the association between population characteristics and out-of-pocket costs for selected primary care services. A combination of descriptive and regression analysis was undertaken using administrative data from the Australian Department of Human Services reporting on the health services used across PHNs in Australia. Those in regional areas paid significantly more for Allied Health services than those in capital cities (A$5.68, P=0.006). The proportion of an area’s population aged 65 years and over was inversely related to out-of-pocket charges for Allied Mental Health (–A$79.12, P=0.029). Some areas had both high charges and disadvantaged populations: Country South Australia, Northern Queensland, Country Western Australia, Tasmania and Northern Territory, or populations with poor health: Northern Territory and Tasmania. Although there was a large amount of variation in out-of-pocket charges for primary care services between PHNs in Australia, there was little evidence of inequality based on health, age and socioeconomic characteristics of a population or the proportion of Aboriginal and Torres Strait Islander people.
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Rowlands, Stella, Josephine Holman, and Karen Blades. "An Absenteeism Survey of Clerical Workers in Medical Record Departments." Australian Medical Record Journal 19, no. 2 (June 1989): 63–70. http://dx.doi.org/10.1177/183335838901900206.
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A survey of the patterns of absenteeism among clerical staff working in twenty-seven medical record departments in New South Wales and the Australian Capital Territory revealed that there was not a significant relationship between the bed size of the hospital (the organisation) and absenteeism, or between the medical record department (the work unit) and absenteeism. Absenteeism was defined as a day of sick leave without a medical certificate. Absenteeism was spread throughout the weekdays, and 56 percent of workers had at least one absent day during the period. Age and type of work were not associated with absenteeism, but males had a significantly higher rate than females (p < 0.001). The authors suggest that exchange theory rather than work unit size may better explain absenteeism. (AMRJ 1989, 19(1), 63–70).
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Luther, Matt, Fergus Gardiner, Shane Lenson, David Caldicott, Ryan Harris, Ryan Sabet, Mark Malloy, and Jo Perkins. "An Effective Risk Minimization Strategy Applied to an Outdoor Music Festival: A Multi-Agency Approach." Prehospital and Disaster Medicine 33, no. 2 (March 21, 2018): 220–24. http://dx.doi.org/10.1017/s1049023x18000195.
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Specific Event Identifiersa. Event type: Outdoor music festival.b. Event onset date: December 3, 2016.c. Location of event: Regatta Point, Commonwealth Park.d. Geographical coordinates: Canberra, Australian Capital Territory (ACT), Australia (-35.289002, 149.131957, 600m).e. Dates and times of observation in latitude, longitude, and elevation: December 3, 2016, 11:00-23:00.f. Response type: Event medical support.AbstractIntroductionYoung adult patrons are vulnerable to risk-taking behavior, including drug taking, at outdoor music festivals. Therefore, the aim of this field report is to discuss the on-site medical response during a music festival, and subsequently highlight observed strategies aimed at minimizing substance abuse harm.MethodThe observed outdoor music festival was held in Canberra (Australian Capital Territory [ACT], Australia) during the early summer of 2016, with an attendance of 23,008 patrons. First aid and on-site medical treatment data were gained from the relevant treatment area and service.ResultsThe integrated first aid service provided support to 292 patients. Final analysis consisted of 286 patients’ records, with 119 (41.6%) males and 167 (58.4%) females. Results from this report indicated that drug intoxication was an observed event issue, with 15 (5.1%) treated on site and 13 emergency department (ED) presentations, primarily related to trauma or medical conditions requiring further diagnostics.ConclusionThis report details an important public health need, which could be met by providing a coordinated approach, including a robust on-site medical service, accepting intrinsic risk-taking behavior. This may include on-site drug-checking, providing reliable information on drug content with associated education.LutherM, GardinerF, LensonS, CaldicottD, HarrisR, SabetR, MalloyM, PerkinsJ. An effective risk minimization strategy applied to an outdoor music festival: a multi-agency approach. Prehosp Disaster Med. 2018;33(2):220–224.
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Davis, B. K., M. Schmidt, E. O'Keefe, M. J. Currie, A. M. Baynes, T. Bavinton, M. McNiven, and F. J. Bowden. "8. 'STAMP OUT CHLAMYDIA' PROJECT - BRINGING CHLAMYDIA SCREENING TO TERTIARY STUDENTS IN THE AUSTRALIAN CAPITAL TERRITORY." Sexual Health 4, no. 4 (2007): 287. http://dx.doi.org/10.1071/shv4n4ab8.
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Study's objective: Stamp Out Chlamydia (SOC) is a pilot research project funded by the Commonwealth Department of Health & Aging to devise and implement a cost effective program for education and chlamydia screening for ACT tertiary students aged 16-26 years at The Australian National University (ANU), University of Canberra and Canberra Institutes of Technology, that may be suitable for national implementation. Methodology: A collaborative clinical outreach project between Canberra Sexual Health Centre, Sexual Health and Family Planning ACT and ANU Medical School, whereby the SOC team attends student-initiated events on ACT tertiary campuses to educate and test young people, using self-obtained urine specimens. Summary of Results: The majority of these outreach events were attended by two Registered Nurses and the Health Promotion Officer. To date they have attended 19 events including Orientation Week activities, BBQ's, Easter Scavenger Hunt, Gay Pride Week events and sports events. Promoting the SOC project has been through word of mouth, SOC 'Champions', convenience and media advertising and a dedicated web site. By May 2007 the SOC project had: Interfaced with 1512 tertiary students and offered them the opportunity to participate in the research Screened 445 for chlamydia Found a chlamydia prevalence of 1.8% Treated eight cases and their contacts Of those screened: Male 240 Female 205 Target group 412 Conclusion: ACT tertiary students accept this outreach approach. Of students approached, over a quarter agreed to have screening. The high profile of the SOC project is leading to an increased awareness of chlamydia. Many students are unaware of the high incidence and/or the consequences of chlamydia, if left untreated and report that they would not have attended mainstream services for screening. Ongoing data analysis will determine if this project is cost effective and feasible.
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Munro, Kat. "Breeding behaviour and ecology of the grey fantail (Rhipidura albiscapa)." Australian Journal of Zoology 55, no. 4 (2007): 257. http://dx.doi.org/10.1071/zo07025.
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The grey fantail (Rhipidura albiscapa) is a common Australian flycatcher, yet no detailed reports have been made of its breeding ecology. A population of grey fantails was studied over four seasons in the Australian Capital Territory. Males had large testes and pronounced cloacal protuberances, morphology suggestive of sperm competition. Although two polyandrous trios were observed, most individuals bred as part of a season-long monogamous pair, suggesting that extra-pair copulation may be the principal cause of sperm competition. Indeed, behavioural observations revealed that males regularly intruded other territories, targeting those with building, rather than incubating, females. Intruding males were observed harassing, attempting to copulate and successfully copulating with resident females. Males did not mate guard, but regularly attacked their mates during each building attempt. Despite the probability that extra-pair paternity is common in this species, grey fantails were monomorphic and monochromatic, with a high level of paternal care. Nest depredation was common, with 83% of all clutches depredated before fledging. High levels of male care in care in this species may be better explained by an increase in fledging success associated with high male contribution to offspring care than confidence of paternity.
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Legge, N. A., D. Shein, and I. Callander. "Methods of surfactant administration and early ventilation in neonatal intensive care units in New South Wales and the Australian Capital Territory." Journal of Neonatal-Perinatal Medicine 12, no. 3 (August 30, 2019): 255–63. http://dx.doi.org/10.3233/npm-180074.
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Weeramanthri, Tarun. "Specialist adult physicians in the Top End of the Northern Territory:An analysis of their number and roles." Australian Health Review 21, no. 1 (1998): 50. http://dx.doi.org/10.1071/ah980050.
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The optimal way of delivering specialist services to rural and remote Australia, andparticularly to remote Aboriginal and Torres Strait Islander communities, is a matterof keen debate at present, and is being considered by the Australian Medical WorkforceAdvisory Committee. This paper contributes to that debate by considering onespecialist medical group, namely adult physicians, and discusses both their role andoptimal number in the Top End of the Northern Territory, in light of the generalworkforce literature and recent changes to the organisation of physician services inthe Northern Territory. Models of specialist service delivery need to be explicit, andorganisational methods transparent, if the service is to be equitable, flexible andaccountable to primary care practitioners.
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O’Hara, Claudia A. "From therapy to therapeutic: the continuum of trauma-informed care." Children Australia 44, no. 02 (April 3, 2019): 73–80. http://dx.doi.org/10.1017/cha.2019.4.
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AbstractOn 1st July 2015, Out of Home Care (OOHC) services in the Australian Capital Territory (ACT) joined together to form the ACT Together consortium and aimed to improve outcomes for children and young people who are unable to live with their birth families. Within the consortium, the Therapeutic Services Team (TST) steers the evolution of trauma-informed therapeutic practice, a key focus of which is the establishment of therapeutic care. Current research indicates that a holistic therapeutic approach has the greatest impact in supporting a young person to overcome adverse childhood experiences. This leads to the necessity of a therapeutic care system providing input across the whole domain of OOHC, including trauma-informed therapeutic carers. A common issue met by the TST is the lack of clarity regarding the difference between therapeutic intervention and therapy. This paper defines the concepts of therapy and therapeutic care, discusses how this forms a continuum which flows throughout the whole OOHC system and reflects on what support carers require to make the shift to becoming therapeutic carers, including outlining their role in underpinning better outcomes for the children and young people who pass through their doors.
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Furst, Mary Anne, Jose A. Salinas-Perez, Mencia R. Gutiérrez-Colosia, and Luis Salvador-Carulla. "A new bottom-up method for the standard analysis and comparison of workforce capacity in mental healthcare planning: Demonstration study in the Australian Capital Territory." PLOS ONE 16, no. 7 (July 27, 2021): e0255350. http://dx.doi.org/10.1371/journal.pone.0255350.
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The aims of this study are to evaluate and describe mental health workforce and capacity, and to describe the relationship between workforce capacity and patterns of care in local areas. We conducted a comparative demonstration study of the applicability of an internationally validated standardised service classification instrument—the Description and Evaluation of Services and Directories—DESDE-LTC) using the emerging mental health ecosystems research (MHESR) approach. Using DESDE-LTC as the framework, and drawing from international occupation classifications, the workforce was classified according to characteristics including the type of care provided and professional background. Our reference area was the Australian Capital Territory, which we compared with two other urban districts in Australia (Sydney and South East Sydney) and three benchmark international health districts (Helsinki-Uusima (Finland), Verona (Italy) and Gipuzkoa (Spain)). We also compared our data with national level data where available. The Australian and Finnish regions had a larger and more highly skilled workforce than the southern European regions. The pattern of workforce availability and profile varied, even within the same country, at the local level. We found significant differences between regional rates of identified rates of psychiatrists and psychologists, and national averages. Using a standardised classification instrument at the local level, and our occupational groupings, we were able to assess the available workforce and provide information relevant to planners about the actual capacity of the system. Data obtained at local level is critical to providing planners with reliable data to inform their decision making.
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Novikov, V. S., and N. V. Shershunova. "PRACTICE OF INTERACTION BETWEEN STATE AND BUSINESS IN THE FORM OF PUBLIC-PRIVATE PARTNERSHIP (ON THE EXAMPLE OF SPHERE OF MEDICAL SERVICES)." Scientific bulletin of the Southern Institute of Management, no. 2 (June 30, 2016): 9–17. http://dx.doi.org/10.31775/2305-3100-2016-2-9-17.
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The author analyzes the principles of public-private partnership for the development of virtual services on the service industries, which determined that the Russian specificity of public-private partnership is at the stage of its development, due to the absence of strong regulatory legislative framework in the field of PPP, underestimation mechanism PPP operation, low interest on the part of government agencies. Presented by the author’s vision of the main advantages of PPPs in the field of health services of Krasnodar territory, both for investors and for regional health care system as a whole. It was revealed the role, the nature and value of the fund of venture capital investments in the implementation of IN RIKTS project in sphere of medical services of the Krasnodar Territory.
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Abdel-Latif, Mohamed E., Zsuzsoka Kecskés, and Barbara Bajuk. "Actuarial day-by-day survival rates of preterm infants admitted to neonatal intensive care in New South Wales and the Australian Capital Territory." Archives of Disease in Childhood - Fetal and Neonatal Edition 98, no. 3 (August 9, 2011): F212—F217. http://dx.doi.org/10.1136/adc.2011.210856.
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Long, Robert. "The Galilee Day Program: Alternative education and training strategies for young people in substitute care." Children Australia 23, no. 3 (1998): 29–35. http://dx.doi.org/10.1017/s1035077200008725.
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Comprehensive research undertaken in 1995 and 1997 clearly establishes the educational needs of at-risk young people. Research by Webber and Hayduk (Leaving School Early) and Brooks et al (NYARS report Under-age School Leaving) establishes indicators contributing to under-age school leaving which are discussed in relation to the responsibility of schools in meeting the needs of at-risk students. Without revisiting the tenets of the deschooling movement which have been canvassed in detail in the pages of many books and education journals, the discussion explores the validity of alternative models to mainstream schooling. The paper assumes a certain inability of schooling to meet the needs of at-risk student; indeed it could be argued that the purpose of schooling generates and selects at-risk students. In a schooling culture which propagates the ideology of integration, the paper suggests the validity of an alternative and exclusion-based model of education. One such model has been established in 1997 in the Australian Capital Territory and this alternative education program is evaluated.
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McRae, Ian, and Mai Pham. "When is a GP home-visit program financially viable?" Australian Journal of Primary Health 22, no. 6 (2016): 554. http://dx.doi.org/10.1071/py15074.
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Despite a decline in GP home visits in Australia, these services remain an important aspect of healthcare access and delivery for the aged population. Home visits can both provide better care and decrease use of ambulance and emergency department (ED) services. The net costs of providing GP visits are complex, depending on the relative costs of home visits and ED attendances, the number of ED attendances saved by GP visits, and the number of services provided per day by a visiting GP. The Australian Capital Territory government created the General Practice Aged Day Service (GPADS) program in March 2011. Using data and information from this program as a basis, we examine the financial aspects of a daytime home-visit program in the Australian context. Whether or not a program is financially viable depends on a range of parameters; if all factors are aligned a program can generate net savings. While there is no information available on the net health benefits of home visits relative to ED attendance, these differences need not be large for the program to be cost-effective.
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Singh, Moni Pankhuri, Himanshu Popat, Andrew J. A. Holland, and Karen Walker. "Outcomes in Neonates Following the Surgical Removal of a Teratoma: A NSW and ACT Experience." Journal of Neonatology 36, no. 1 (January 20, 2022): 21–26. http://dx.doi.org/10.1177/09732179211072238.
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Aim To describe the characteristics and outcomes of neonates admitted to tertiary hospitals in New South Wales and Australian Capital Territory who have undergone surgical removal of a teratoma, as there is paucity of Australian data. Methods All neonates admitted to the neonatal intensive care unit with teratoma between 2007 and 2017 inclusive (as per neonatal intensive care units data collection) were included in this retrospective study. Results Forty-three neonates with a diagnosis of teratoma were included in the study. The most common tumors were sacrococcygeal teratomas, accounting for 79% (34) of all the cases. Twenty-four (56%) neonates were diagnosed with teratoma antenatally. Ninety-one percent (39) of the deliveries took place in the tertiary center. Median gestational age of the neonates was 37 weeks and the median weight was 3.39 kg. One or more additional anomalies apart from teratoma were detected in 16 neonates (37%), most common being congenital hydrocephalus and hydronephrosis. Overall survival was 93% at hospital discharge: the 3 neonates who died soon after birth did not undergo surgery and they all were premature with poor Apgar scores. Conclusions Sacrococcygeal teratoma was the most common type of teratoma with more than half of the cases determined antenatally. Overall survival of neonates after surgery for teratoma is high.
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Ali, Hammad, Holly Seale, Kirsten Ward, and Nicholas Zwar. "A picture speaks a thousand words: evaluation of a pictorial post-vaccination care resource in Australia." Australian Journal of Primary Health 16, no. 3 (2010): 246. http://dx.doi.org/10.1071/py10002.
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Evaluating the ‘Common Reactions to Vaccination’ post-vaccination care resource was seen as an opportunity to contribute to the limited literature base in this important area, learn from the strengths and weaknesses of the resource and gain insight into post-vaccination care practices. Semi-structured in-depth interviews were conducted with 12 general practitioners and 29 practice nurses in New South Wales and Australian Capital Territory, Australia. Structured interview guides were used and data was analysed thematically. A self-administered survey was also distributed to parents or guardians during routine childhood vaccination visits. When compared with previous resources, participants felt the new resource was more appropriate as it had a simple layout; it was colourful, incorporated pictures and had basic and practical information. Information about post-vaccination care and common reactions to vaccination must be provided in written form accompanied by a verbal reinforcement so that patients can revisit the information at a later stage if required. The ‘Common Reactions to Vaccination’ post-vaccination care resource provides comprehensive information in an easy-to-understand pictorial way and was appreciated by both vaccination providers and patients.
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Abdel-Latif, Mohamed E., Barbara Bajuk, Kei Lui, and Julee Oei. "Short-term outcomes of infants of substance-using mothers admitted to neonatal intensive care units in New South Wales and the Australian Capital Territory." Journal of Paediatrics and Child Health 43, no. 3 (March 2007): 127–33. http://dx.doi.org/10.1111/j.1440-1754.2007.01031.x.
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White, Kevin, and Fran Collyer. "Health Care Markets in Australia: Ownership of the Private Hospital Sector." International Journal of Health Services 28, no. 3 (July 1998): 487–510. http://dx.doi.org/10.2190/a9u4-jxgx-87y7-5b34.
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Over the past decade, the Australian hospital sector has undergone a massive economic and administrative reorganization with ramifications for both the private and the public sectors. Changes such as privatization, deregulation, and the entry of foreign capital into the hospital sector are occurring in the hospital systems of many countries, including Australia, the United States, and the United Kingdom. These developments are radically transforming the hospital sector, altering established relationships between the state, the medical profession, the consumer, and the corporate investor, and raising important questions about the future of hospital services in regard to equity, accessibility, and quality.
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Mills, Jason, John P. Rosenberg, and Fran McInerney. "Building community capacity for end of life: an investigation of community capacity and its implications for health-promoting palliative care in the Australian Capital Territory." Critical Public Health 25, no. 2 (August 12, 2014): 218–30. http://dx.doi.org/10.1080/09581596.2014.945396.
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Lopez, Violeta, Ann Marie Dunk, Katrina Cubit, Jill Parke, David Larkin, Maria Trudinger, and Margaret Stuart. "Skin tear prevention and management among patients in the acute aged care and rehabilitation units in the Australian Capital Territory: a best practice implementation project." International Journal of Evidence-Based Healthcare 9, no. 4 (December 2011): 429–34. http://dx.doi.org/10.1111/j.1744-1609.2011.00234.x.
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Jones, Tony S., May Matias, Jo Powell, Eriita G. Jones, Joe Fishburn, and Jeffrey C. L. Looi. "Who cares for older people with mental illness? A survey of residential aged care facilities in the Australian Capital Territory: Implications for mental health nursing." International Journal of Mental Health Nursing 16, no. 5 (October 2007): 327–37. http://dx.doi.org/10.1111/j.1447-0349.2007.00482.x.
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Rigby, O. M. "(P2-18) ICU Surge Capacity in Australian Major Trauma Centres." Prehospital and Disaster Medicine 26, S1 (May 2011): s141. http://dx.doi.org/10.1017/s1049023x11004626.
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IntroductionMass casualty incidents (MCIs), requiring Trauma critical care, are increasingly likely. The ability to scale operations up i.e. ‘surge capacity’, is vital for ensuring scarce resources are used efficiently. The number of intensive care unit (ICU) beds is one of the key resources and indicators of a hospital's capacity and thus a vital area to target when assessing a systems ability to surge its Trauma ICU capabilities.ObjectiveThe study attempted to assess whether ICU facilities at major hospitals in large Australian cities would be able to respond to an event on the magnitude of the Madrid tragedy. This is the first report to measure Australia's major hospitals intensive care trauma surge capacity using Madrid as a standard.MethodsIn this prospective, cross-sectional analysis, we conducted a survey of major urban ICU trauma centres in the 8 state and Territory Capital cities of Australia. 14 Trauma Centre ICU's were targeted. The study was composed of two parts, A & B. Part A of the study consisted of an online survey, Part B, consisted of a follow-up telephone questionnaire. Full Ethics approval was sought and obtained.ResultsThere were 8 replies to the survey giving a 57% participation rate. At the time of this snap-shot survey the total number of Physically available ICU beds throughout the 8 Level I trauma centres was 52.5. All hospitals had at least 3 spare beds. This ranged from 3 to 10 beds. After accounting for the flux in beds post admissions & discharges there was a 21% increase in bed availability, which was further increased by a magnitude of 28% to an average of 10.125 beds, if all elective surgical procedures were cancelled. When using the Madrid ICU surge (29 new ICU patients) as a gold standard against which to compare, it was found the largest trauma ICU in Australia could have managed 62% of this surge. On average the 8 trauma centres would have handled only 34.75% of the Madrid ICU surge.ConclusionsIn the event of a major traumatic disaster on the scale of the Madrid atrocity, few if any of Australia's major trauma centres have the capacity to cope with the requisite surge. More research and novel ways of addressing this challenge are needed.
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Kerr, Rhonda, Delia V. Hendrie, and Rachael Moorin. "Investing in acute health services: is it time to change the paradigm?" Australian Health Review 38, no. 5 (2014): 533. http://dx.doi.org/10.1071/ah13226.
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Objective Capital is an essential enabler of contemporary public hospital services funding hospital buildings, medical equipment, information technology and communications. Capital investment is best understood within the context of the services it is designed and funded to facilitate. The aim of the present study was to explore the information on capital investment in Australian public hospitals and the relationship between investment and acute care service delivery in the context of efficient pricing for hospital services. Methods This paper examines the investment in Australian public hospitals relative to the growth in recurrent hospital costs since 2000–01 drawing from the available data, the grey literature and the reports of six major reviews of hospital services in Australia since 2004. Results Although the average annual capital investment over the decade from 2000–01 represents 7.1% of recurrent expenditure on hospitals, the most recent estimate of the cost of capital consumed delivering services is 9% per annum. Five of six major inquiries into health care delivery required increased capital funding to bring clinical service delivery to an acceptable standard. The sixth inquiry lamented the quality of information on capital for public hospitals. In 2012–13, capital investment was equivalent to 6.2% of recurrent expenditure, 31% lower than the cost of capital consumed in that year. Conclusions Capital is a vital enabler of hospital service delivery and innovation, but there is a poor alignment between the available information on the capital investment in public hospitals and contemporary clinical requirements. The policy to have capital included in activity-based payments for hospital services necessitates an accurate value for capital at the diagnosis-related group (DRG) level relevant to contemporary clinical care, rather than the replacement value of the asset stock. What is known about the topic? Deeble’s comprehensive hospital-based review of capital investment and costs, published in 2002, found that investment averages of between 7.1% and 7.9% of recurrent costs primarily replaced existing assets. In 2009, the Productivity Commission and the National Health and Hospitals Reform Commission (NHHRC) recommended capital, for the replacement of buildings and medical equipment, be included in activity-based funding. However, there have been persistent concerns about the reliability and quality of the information on the value of hospital capital assets. What does this paper add? This is the first paper for over a decade to look at hospital capital costs and investment in terms of the services they support. Although health services seek to reap dividends from technology in health care, this study demonstrates that investment relative to services costs has been below sustainable levels for most of the past 10 years. The study questions the helpfulness of the highly aggregated information on capital for public hospital managers striving to improve on the efficient price for services. What are the implications for practitioners? Using specific and accurate information on capital allocations at the DRG level assists health services managers advance their production functions for the efficient delivery of services.
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Volker, Nerida, Lauren T. Williams, Rachel C. Davey, and Thomas Cochrane. "Community-based lifestyle modification workforce: an underutilised asset for cardiovascular disease prevention." Australian Journal of Primary Health 22, no. 4 (2016): 327. http://dx.doi.org/10.1071/py14178.
Full textAbstract:
This paper reports on a qualitative study exploring the capacity of the community sector to support a whole-of-system response to cardiovascular disease prevention in primary health care. As a component of the Model for Prevention (MoFoP) study, community-based lifestyle modification providers were recruited in the Australian Capital Territory to participate in focus group discussions; 34 providers participated across six focus groups: 20 Allied Health Professionals (four groups) and 14 Lifestyle Modification Program providers (two groups). Thematic analysis of focus group transcripts was undertaken using a mixed deductive and inductive approach. Participant responses highlight several barriers to their greater contribution to cardiovascular disease prevention. These included that prevention activities are not valued, limited sector linkages, inadequate funding models and the difficulty of behaviour change. Findings suggest that improvements in the value proposition of prevention for all stakeholders would be supported by improved funding mechanisms and increased opportunities to build relationships across health and community sectors.