Journal articles: 'Public 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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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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Connellan, Mary, and Euan M. Wallace. "Prevention of perinatal group B streptococcal disease: screening practice in public hospitals in Victoria." Medical Journal of Australia 172, no. 7 (April 2000): 317–20. http://dx.doi.org/10.5694/j.1326-5377.2000.tb123977.x.

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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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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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MacIntyre, C. Raina, Chris W. Brook, Eugene Chandraraj, and Aileen J. Plant. "Changes in bed resources and admission patterns in acute public hospitals in Victoria, 1987‐1995." Medical Journal of Australia 167, no. 4 (August 1997): 186–89. http://dx.doi.org/10.5694/j.1326-5377.1997.tb138842.x.

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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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Jackson, Terri, and Petia Sevil. "Problems in counting and paying for multidisciplinary outpatient clinics." Australian Health Review 20, no. 3 (1997): 38. http://dx.doi.org/10.1071/ah970038.

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Policy-makers have always found it problematic to formulate fair and consistentcounting rules for public hospital outpatient activities. In the context of output-based funding, such rules have consequences which can affect patient care. This paper reviews the rationale for organising multidisciplinary clinics and reports on a series of focus groups convened in four Melbourne teaching hospitals to consider funding policy for such clinics. It discusses issues of targeting outpatient services, along with implications for payment policy. It evaluates counting rules in terms of intended andunintended consequences in the context of Victoria?s introduction of output-basedfunding for outpatient services.

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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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Leggat, Sandra G. "Hospital Planning: The Risks of Basing the Future on Past Data." Health Information Management Journal 37, no. 3 (October 2008): 6–14. http://dx.doi.org/10.1177/183335830803700302.

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Planning for capital development of public hospitals in Victoria is guided by a multi-stage process with comprehensive data analysis and thorough approval processes at each of the stages. The long development timeframes and the limitations in the data available to project service utilisation may negatively impact upon the service planning processes, and in some cases newly developed hospitals have not been sufficiently planned to meet community needs. This paper suggests that service utilisation forecasts derived from administrative databases require a more detailed verification process than currently exists. The process requires consideration of the drivers of demand to document the core assumptions about the future drivers, benchmarks with other jurisdictions, epidemiological, comparative and corporate needs assessment to explain the differences in utilisation rates, and sensitivity analysis. Given the cost of hospital construction and the rate of change in the healthcare sector, it is important that future hospital planning processes do not accept current utilisation trends as valid for future planning without this level of verification.

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Gleeson, Patrick, and Stephen Duckett. "Modeling the Emergency Ambulance Pass-By of Small Rural Hospitals in Victoria, Australia." Journal of Rural Health 21, no. 4 (October 2005): 367–71. http://dx.doi.org/10.1111/j.1748-0361.2005.tb00109.x.

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Wolfram Cox, Julie, and John Hassard. "Discursive Recontextualization in a Public Health Setting." Journal of Applied Behavioral Science 46, no. 1 (March 2010): 119–45. http://dx.doi.org/10.1177/0021886309357443.

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The authors discuss discursive recontextualization as a process of discursive change in which stable referents may be recombined. As such, discursive recontextualization recognizes the interplay of both stability and instability without necessarily privileging the latter. Drawing on intertextual document analysis of a series of public reports published in the wake of a major health policy initiative in Victoria, Australia— Health to 2050—the authors identify a discursive pattern in which descriptions of a disaggregation from large Health Care Networks to smaller Metropolitan Health Services echo those of an earlier aggregation of individual hospitals into the Health Care Networks. The authors suggest that future research into discourse and organizational change will benefit from greater attention to stabilization and such recontextualization as well as to fluidity and instability. They examine implications for change agents and for researchers in the field.

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Russo, P., A. Bull, N. Bennett, C. Boardman, S. Burrell, and M. Richards. "The establishment of a statewide surveillance program for hospital-acquired infections in large acute care public hospitals in Victoria, Australia." American Journal of Infection Control 33, no. 5 (June 2005): e174-e175. http://dx.doi.org/10.1016/j.ajic.2005.04.224.

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Dwyer, Alison J. "Roles, attributes and career paths of medical administrators in public hospitals: survey of Victorian metropolitan Directors of Medical Services." Australian Health Review 34, no. 4 (2010): 506. http://dx.doi.org/10.1071/ah09750.

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Aim. To document the roles, the perceived skills and attributes and experience required of Medical Administrators in contemporary public hospitals. Method. Interviews with Directors of Medical Services (DMS) from Victorian metropolitan public hospitals between March 2005 and May 2005. Results. A total of 14 of the 21 DMS in Victoria were interviewed. Key roles: Managing Medical Staff; Clinical Governance and Quality Improvement; Strategy and Service development; and Medical advisor to CEO. Key attributes and skills aligned with roles. Most respondents hold Fellowship of Royal Australasian College of Medical Administrators (FRACMA) with over half employed for less than 2 years. Discussion. Core roles identified mirrored in key international literature. Recommendations for further study includes systematic review of literature; the influence of the medically-trained Chief Executive on roles; and further analysis of high turnover. Conclusion. This study clarifies the roles undertaken and skills required by Medical Administrators in contemporary public hospitals, providing: (1) role benchmarking for Chief Executives; (2) reduced ambiguity among the broader medical staff of the roles, to assist those who may need Medical Administrator assistance with providing patient care; (3) assisting the Medical Administration profession and RACMA to provide tailored education and training; and (4) to inform aspiring future Medical Administrators of the broad nature of such roles. What is known about the topic? There is little current Australian literature surrounding the roles and skills and experience required of Medical Administrators in Director of Medical Service positions within contemporary healthcare organisations. The roles are often poorly understood by the greater medical profession and other health professionals. This study provides clarity around the current roles and skills and experience required. What does this paper add? This study illustrates the key roles for Medical Administrators in contemporary public hospitals as (1) Managing Medical Staff (2) Clinical Governance and Quality Improvement (3) Strategy and organisational service development (4) Clinical and Medical advisor to CEO. This study also highlights the key attributes and skills that reflect the needs of the roles, with most respondents holding a Fellowship of the Royal Australasian College of Medical Administrators (RACMA). In addition, there is a high turnover with more than 50% having been in the roles less than 2 years. What are the implications for practitioners? This study clarifies the roles undertaken and skills required by Medical Administrators in contemporary public hospitals. This study (1) assists Chief Executives to benchmark appropriate roles for Medical Administrators in their hospital (2) reduces ambiguity and increases awareness amongst the broader medical staff within a hospital of the roles of a Medical Administrator. The medical staff often need to access the skills of a Medical Administrator to assist them with providing patient care (3) assists the Medical Administration profession and RACMA to tailor education and training for such roles and (4) provides aspiring future Medical Administrators with an understanding of the broad nature of such roles in hospitals.

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Wilson, Beth. "Issues in Service Delivery for Women Statewide: The Consumer Context." Australian Journal of Primary Health 4, no. 3 (1998): 72. http://dx.doi.org/10.1071/py98032.

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This article presents data from two sources. The first set of data comes from complaints received by the Health Services Commissioner (Health Ombudsman) in Victoria from Consumers of Health Services about health service providers. The second set of data has been provided by 92 public hospitals using the health complaints information program. The Health Complaints Resolution Process is described and the data are presented in the hope that they may assist in formulating policies for women's health.

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McDonald, Paul. "From Streets to Sidewalks: Developments in Primary Care Services for Injecting Drug Users." Australian Journal of Primary Health 8, no. 1 (2002): 65. http://dx.doi.org/10.1071/py02010.

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Primary Health Care for the Injecting Drug User (IDU) has been established in Victoria in recognition of the serious health needs of IDUs, which require a relevant and effective response. Research shows the medical consequences that flow from drug abuse, ranging from the onset of blood borne viruses to cardiovascular conditions, and the propensity of drug users to access health services only through accident and emergency areas of hospitals. In 1999, the Victorian government announced the funding of five Local Drug Strategies in five of Melbourne's 'hotspot' street drug areas to address both the needs of users and communities in relation to substance abuse. This funding was an impetus to establish and trial the concept of primary health services, combining both a fixed site and a mobile outreach service. These services are designed to meet the primary health needs of street-based injecting drug users who are at high risk of experiencing overdose or other forms of drug-related harm.

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Jones, Graeme I., Katrina A. Alford, Ursula J. Russell, and David Simmons. "Removing the Roadblocks to Medical and Health Student Training in Rural Hospitals in Victoria." Australian Journal of Rural Health 11, no. 5 (October 2003): 218–23. http://dx.doi.org/10.1111/j.1440-1584.2003.00523.x.

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Jones, Graeme I., Katrina A. Alford, Ursula J. Russell, and David Simmons. "REMOVING THE ROADBLOCKS TO MEDICAL AND HEALTH STUDENT TRAINING IN RURAL HOSPITALS IN VICTORIA." Australian Journal of Rural Health 11, no. 5 (June 28, 2008): 218–23. http://dx.doi.org/10.1111/j.1440-1584.2003.tb00541.x.

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McKenzie, Kirsten, and Sue Wood. "Asthma Terminology and Classification in Hospital Records." Health Information Management 34, no. 2 (June 2005): 27–33. http://dx.doi.org/10.1177/183335830503400203.

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Asthma is a national health priority area in Australia, and there is significant interest in capturing relevant detail about hospitalisations as a result of asthma. A public submission received by the National Centre for Classification in Health from a large teaching hospital in Victoria suggested that current classification terminology in ICD-10-AM did not adequately reflect the terms recorded in clinical inpatient records, and that patterns and severity of asthma better reflected current clinical terminology in Australian hospitals. The purpose of this study was to determine the validity of the public submission and inform future changes to ICD-10-AM. A representative sample of over 3000 asthma records across Australia and New Zealand were extracted, and the asthma terminology documented and codes assigned were recorded and analysed. The study concluded that there was little support for either pattern terminology or the current classification terminology; however, severity of asthma was commonly used in asthma documentation.

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Kimmel, Lara A., Anne E. Holland, Natasha Lannin, Elton R. Edwards, Richard S. Page, Andrew Bucknill, Raphael Hau, and Belinda J. Gabbe. "Clinicians’ perceptions of decision making regarding discharge from public hospitals to in-patient rehabilitation following trauma." Australian Health Review 41, no. 2 (2017): 192. http://dx.doi.org/10.1071/ah16031.

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Objective The aim of the present study was to investigate the perceptions of consultant surgeons, allied health clinicians and rehabilitation consultants regarding discharge destination decision making from the acute hospital following trauma. Methods A qualitative study was performed using individual in-depth interviews of clinicians in Victoria (Australia) between April 2013 and September 2014. Thematic analysis was used to derive important themes. Case studies provided quantitative information to enhance the information gained via interviews. Results Thirteen rehabilitation consultants, eight consultant surgeons and 13 allied health clinicians were interviewed. Key themes that emerged included the importance of financial considerations as drivers of decision making and the perceived lack of involvement of medical staff in decisions regarding discharge destination following trauma. Other themes included the lack of consistency of factors thought to be important drivers of discharge and the difficulty in acting on trauma patients’ requests in terms of discharge destination. Importantly, as the complexity of the patient increases in terms of acquired brain injury, the options for rehabilitation become scarcer. Conclusions The information gained in the present study highlights the large variation in discharge practises between and within clinical groups. Further consultation with stakeholders involved in the care of trauma patients, as well as government bodies involved in hospital funding, is needed to derive a more consistent approach to discharge destination decision making. What is known about the topic? Little is known about the drivers for referral to, or acceptance at, in-patient rehabilitation following acute hospital care for traumatic injury in Victoria, Australia, including who makes these decisions of behalf of patients and how these decisions are made. What does this paper add? This paper provides information regarding the perceptions of acute hospital consultant surgeons and allied health, as well as rehabilitation clinicians, in terms of discharge destination decision making from the acute hospital following trauma. The use of case studies further highlights differences between, and within, these specialities with regard to this decision making. This research also highlights the importance of financial considerations as drivers of decision making, and the lack of consistency of the factors thought to be important drivers of discharge between these different clinical groupings. What are the implications for practitioners? This research shows that financial factors are significant drivers of discharge destination decision making for trauma patients. The present study highlights opportunities to engage with stakeholders (acute care, rehabilitation, administration, government and patients) to develop more consistent discharge processes that optimise the use of rehabilitation resources for those patients who could benefit from in-patient rehabilitation.

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Bennett, Noleen J., Ann L. Bull, David R. Dunt, Lyle C. Gurrin, Michael J. Richards, Philip L. Russo, and Denis W. Spelman. "A profile of smaller hospitals: Planning for a novel, statewide surveillance program, Victoria, Australia." American Journal of Infection Control 34, no. 4 (May 2006): 170–75. http://dx.doi.org/10.1016/j.ajic.2005.05.011.

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Eastwood, Kathryn, Stuart Howell, Ziad Nehme, Judith Finn, Karen Smith, Peter Cameron, Dion Stub, and Janet E. Bray. "Impact of a mass media campaign on presentations and ambulance use for acute coronary syndrome." Open Heart 8, no. 2 (October 2021): e001792. http://dx.doi.org/10.1136/openhrt-2021-001792.

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ObjectiveBetween 2009 and 2013, the National Heart Foundation of Australia ran mass media campaigns to improve Australian’s awareness of acute coronary syndrome (ACS) symptoms and the need to call emergency medical services (EMS). This study examined the impact of this campaign on emergency department (ED) presentations and EMS use in Victoria, Australia.MethodsThe Victorian Department of Health and Human Services provided data for adult Victorian patients presenting to public hospitals with an ED diagnosis of ACS or unspecified chest pain (U-CP). We modelled changes in the incidence of ED presentations, and the association between the campaign period and (1) EMS arrival and (2) referred to ED by a general practitioner (GP). Models were adjusted for increasing population size, ACS subtype and demographics.ResultsBetween 2003 and 2015, there were 124 632 eligible ED presentations with ACS and 536 148 with U-CP. In patients with ACS, the campaign period was associated with an increase in ED presentations (incidence rate ratio: 1.11; 95% CI 1.07 to 1.15), a decrease in presentations via a GP (adjusted OR (AOR): 0.77; 95% CI 0.70 to 0.86) and an increase in EMS use (AOR: 1.10; 95% CI 1.05 to 1.17). Similar, but smaller associations were seen in U-CP.ConclusionsThe Warning Signs Campaign was associated with improvements in treatment seeking in patients with ACS—including increased EMS use. The increase in ACS ED presentations corresponds with a decrease in out-of-hospital cardiac arrest over this time. Future education needs to focus on improving EMS use in ACS patient groups where use remains low.

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Briggs, Russell J., Katrina M. Smith, Ebony M. Dejager, John T. Callahan, Jennifer A. Abernethy, Eddie J. Dunn, and David J. Hunter-Smith. "The active management of surgical waiting lists: a urological surgery case study." Australian Health Review 35, no. 4 (2011): 399. http://dx.doi.org/10.1071/ah10923.

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Elective surgery waiting list management is a major public healthcare issue. This case study describes an integrated multifaceted approach to waiting list management at Peninsula Health, a public health service in Victoria, Australia. At the commencement of this study it was recognised that several issues associated with the urological surgical service constituted potential clinical risk. These included: recall mechanisms for multiple surveillance procedures; significant resource deficits; and long surgery waiting times. Responding to these issues a multifaceted approach to wait list management was implemented including: audit; direct lines of communication between clinical and administrative staff; urgent caseload management; utilisation of the Elective Surgery Access Scheme; financial and resource analysis justifying the appointment of a full-time urologist, and the establishment of a urology service from a satellite campus; implementation of a recall database; development of an outpatient service; and commencement of a day surgery initiative. This approach yielded results that included a 67% reduction in the number of ‘ready for care’ patients and a 78% reduction in the number of patients classified as ‘overdue for surgery’. Average wait time for semi-urgent and non-urgent patients reduced from 248 days to 180 days in the 10-month period. What is known about the topic? Currently there are ~3000 people on the elective surgery waiting list in Victoria. Reasons for delays are multifactorial including shortage of beds, lack of surgeons, theatres and equipment. Patients are placed on the surgery waiting list according to a clinical urgency category assigned by their specialist. These categories are used by the hospitals to ensure that the patients with the greatest need are treated in the shortest period of time. Despite this, the numbers on the elective waiting lists within certain surgical specialities continue to grow and the numbers seen within the recommended time decreases. What does this paper add? This paper outlines a management strategy for the urology wait list at a large Victorian hospital. It outlines six approaches, the implementation of which had a measurable positive effect on the waiting list numbers. What are the implications for practitioners? The strategies put into place have been sustainable and continue to ensure that the urology waiting list is well managed.

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Forster, Della A., Heather McKay, Rhonda Powell, Emma Wahlstedt, Tanya Farrell, Rachel Ford, and Helen L. McLachlan. "The structure and organisation of home-based postnatal care in public hospitals in Victoria, Australia: A cross-sectional survey." Women and Birth 29, no. 2 (April 2016): 172–79. http://dx.doi.org/10.1016/j.wombi.2015.10.002.

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Friedman, N. Deborah, Ann L. Bull, Philip L. Russo, Lyle Gurrin, and Michael Richards. "Performance of the National Nosocomial Infections Surveillance Risk Index in Predicting Surgical Site Infection in Australia." Infection Control & Hospital Epidemiology 28, no. 1 (January 2007): 55–59. http://dx.doi.org/10.1086/509848.

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Background.The Victorian Hospital Acquired Infection Surveillance System (VICNISS) hospital-acquired infection surveillance system was established in 2002 in Victoria, Australia, and collates surgical site infection (SSI) surveillance data from public hospitals in Australia.Objective.To evaluate the association between the US National Nosocomial Infections Surveillance (NNIS) system's risk index and SSI rates for 7 surgical procedures.Methods.SSI surveillance was performed with NNIS definitions and methods for surgical procedures performed between November 2002 and September 2004. Correlations were assessed using the Goodman-Kruskal γ statistic.Results.Data were submitted for the following numbers of procedures: appendectomy, 545; coronary artery bypass graft (CABG), 4,632; cholecystectomy, 1,001; colon surgery, 623; cesarean section, 4,857; hip arthroplasty, 3,825; and knee arthroplasty, 2,416. NNIS risk index and increasing SSI rate were moderately well correlated for appendectomy (γ = 0.55), colon surgery (γ = 0.48), and cesarean section (γ = 0.42). A fairly positive correlation was found for cholecystectomy (γ = 0.17), hip arthroplasty (γ = 0.2), and knee arthroplasty (γ = 0.16). However, for CABG surgery, a poor association was found (γ = 0.02).Conclusions.The NNIS risk index was positively correlated with an increasing SSI rate for all 7 procedures; the strongest correlation was found for appendectomy, cesarean section, and colon surgery, and the poorest correlation was found for CABG surgery. We believe that risk stratification with the NNIS risk index is appropriate for comparison of data for most procedures and superior to use of no risk adjustment. However, for some procedures, particularly CABG, further studies of alternative risk indexes are needed to better stratify patients.

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Moje, Christine, Terri J. Jackson, and Peter McNair. "Adverse events in Victorian admissions for elective surgery." Australian Health Review 30, no. 3 (2006): 333. http://dx.doi.org/10.1071/ah060333.

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Objectives: To investigate a method to identify and understand patterns of adverse events by utilising secondary data analysis; to identify the types of complications associated with elective surgery; to identify any specific ?adverse eventprone? elective procedures; and to consider the implications of these patterns for hospital patient safety programs. Setting: Public hospitals in Victoria. Design: Secondary analysis of data on acute hospital admissions for elective surgery in the period 1 July 2000 to 30 June 2001, for nonobstetric patients older than 15 years (n = 177 533). Main outcome measures: Estimated rates of adverse events for the most commonly performed elective surgery procedures; frequency of the most commonly recorded adverse event types. Results: Of all admissions, 15.5% had at least one complication of care. The most frequent firstrecorded single complication code, in 9.6% of cases with a complication, was ?Haemorrhage and haematoma complicating a procedure?. The most common adverse event categories were cardiac and circulatory complications (23%), symptomatic complications (18%), and surgical and drug-related complications (17%). The procedure blocks most frequently associated with an adverse event were coronary artery bypass surgery (67%), colectomy (52%), hip and knee arthroplasty (42% and 36%, respectively), and hysterectomy (20%). The types of complications associated with the four most adverse eventprone procedures were cardiac arrhythmias, surgical adverse events (haemorrhage or laceration), intestinal obstruction, anaemia, and symptomatic complications. Conclusion: Routinely collected data are valuable in obtaining information on complication types associated with elective surgery. International Classification of Diseases codes and surgical procedure ?blocks? allow very sophisticated investigation of types of complications and differences in complication rates for different surgical approaches. The usefulness of such data relies on good documentation in the medical record, thorough coding and periodic data audit. The limitations of the method described here include the lack of follow-up after discharge, variable coding standards between institutions and over time (potentially distorting information on rates), lack of information on the causative factors for some adverse events, and a limited capacity to support investigation of particular cases. Hospitals should consider monitoring complication rates for individual elective procedures or blocks of similar procedures, and comparing adverse event rates over time and with peer hospitals as an integral part of their patient safety programs.

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Campbell, Sharon, Paul Fox-Hughes, Penelope Jones, Tomas Remenyi, Kate Chappell, Christopher White, and Fay Johnston. "Evaluating the Risk of Epidemic Thunderstorm Asthma: Lessons from Australia." International Journal of Environmental Research and Public Health 16, no. 5 (March 7, 2019): 837. http://dx.doi.org/10.3390/ijerph16050837.

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Epidemic thunderstorm asthma (ETA) is an emerging public health threat in Australia, highlighted by the 2016 event in Melbourne, Victoria, that overwhelmed health services and caused loss of life. However, there is limited understanding of the regional variations in risk. We evaluated the public health risk of ETA in the nearby state of Tasmania by quantifying the frequency of potential ETA episodes and applying a standardized natural disaster risk assessment framework. Using a case–control approach, we analyzed emergency presentations in Tasmania’s public hospitals from 2002 to 2017. Cases were defined as days when asthma presentations exceeded four standard deviations from the mean, and controls as days when asthma presentations were less than one standard deviation from the mean. Four controls were randomly selected for each case. Independently, a meteorologist identified the dates of potential high-risk thunderstorm events. No case days coincided with thunderstorms during the study period. ETA was assessed as a very low risk to the Tasmanian population, with these findings informing risk prioritization and resource allocation. This approach may be scaled and applied in other settings to determine local ETA risk. Furthermore, the identification of hazards using this method allows for critical analysis of existing public health systems.

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Walker, C. F. "The role of the print media in informing the community about safety in public hospitals in Victoria, Australia: the case of 'golden staph'." International Journal for Quality in Health Care 17, no. 2 (April 1, 2005): 167–72. http://dx.doi.org/10.1093/intqhc/mzi019.

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Journal articles on the topic 'Public hospitals Victoria'

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