Australian Health Review
Volume 48 Number 5 2024
What is known about the topic? Little is known about what actions are occurring to make healthcare more sustainable and to reduce the carbon footprint of healthcare in Australia. What does this paper add? This paper provides a snapshot of publicly available documents from healthcare providers and professional organisations as they relate to healthcare sustainability and helps reveal the gaps and siloed nature of current actions. What are the implications for practitioners? This paper can help jurisdictions identify gaps or areas for improvement and may aid in targeted and coordinated interventions, especially as they relate to decarbonised clinical care.
AH24065 Abstract | AH24065 Full Text | AH24065PDF (372 KB) | AH24065Supplementary Material (859 KB) Open Access Article
What is known about the topic? Deep brain stimulation (DBS) is a US Federal Drug Administration (FDA)-approved and highly effective treatment for late-stage PD; however, inequities in access to DBS for PD exist across high-income countries, likely stemming from differences in DBS cost and utilisation. What does this paper add? Our study is the first to use cost and utilisation data to calculate a PD-DBS treatment gap informing accessibility barriers. What are the implications for practitioners? The results of this study can be utilised to guide future national policy decisions and advocacy efforts by patient organisations and specialist societies.
What is known about the topic? Multiparametric magnetic resonance imaging (mpMRI) is increasingly used in the diagnosis of prostate cancer. In 2018, it was included in the Medicare Benefits Schedule with the expectation that the number of prostate biopsies performed would decrease. What does this paper add? By 2022, biopsies increased nearly 12% with over a 50% increase in the 80–89 age group – those least likely to benefit from curative treatment. What are the implications for practitioners? The criteria for funding mpMRI and the performance of prostate biopsies should be altered to enable better use of resources.
AH24081Variation in direct healthcare costs to the health system by residents living in long-term care facilities: a Registry of Senior Australians study
What is known about the topic? Residents living in long-term care facilities have high health and care needs, but little research exists on how downstream healthcare costs vary based on facility and individual characteristics. What does this paper add? Using linked national aged care and healthcare data, this study determined that the average annual healthcare cost per resident was $9233 (95% CI $9150–$9295), with hospitalisation accounting for nearly half of these costs. Furthermore, healthcare costs varied based on facility ownership and size, as well as whether individuals had dementia. What are the implications for practitioners? Understanding sectoral variation and learning from long-term care facilities with lower hospitalisation rates could be a strategic approach to reducing healthcare costs for long-term care residents.
AH24081 Abstract | AH24081 Full Text | AH24081PDF (958 KB) | AH24081Corrigendum (589 KB) | AH24081Supplementary Material (441 KB) Open Access Article
AH24176Hospital staff perspectives on the cost and efficiency of peripheral intravenous catheter use: a case study from three Australian hospitals
What is known about the topic? Peripheral intravenous catheters (PIVCs) are required in most hospital admissions, but multiple insertion attempts, device failure and post-insertion complications are common, resulting in poor patient outcomes and wasted healthcare resources. What does this paper add? This case study explored how clinical and executive hospital staff in three Australian hospitals view PIVC insertion from a cost and resourcing perspective, in order to better understand attitudes around PIVC use and practice. What are the implications for practitioners? Hospital staff reported that PIVC insertions are considered as part of routine care and therefore the varying and unpredictable costs of successful cannulation are largely ‘hidden’. Improved escalation procedures and investment in advanced insertion skills (including ultrasound-guided cannulation) may help reduce inefficiencies and waste.
AH24111A preference-based value framework to assess healthcare provision in an oil and gas industry
What is known about the topic? It has been challenging for oil and gas companies to deliver and evaluate value-based healthcare services to improve workers’ wellbeing, supplementing essential emergency services and occupational health. What does this paper add? The Remote Health Value Framework (RHVF), developed and tested in this work, offers a blueprint for designing and evaluating models of care considering the companies’ and workers’ priorities. What are the implications for practitioners? The RHVF’s application has the potential to improve industry standards, enabling a data-driven approach to healthcare investments that closely align with both corporate objectives and employee wellbeing.
What is known on this topic? Previous studies investigated trends in medical device implants on either a particular medical procedure or total procedures conducted on particular anatomical sites. What this study adds? Unlike previous studies, this study investigates a general population-level trend analysis of all major device implants using the most recent national-level database, covering all hospitals in Australia. What are the implications for practitioners? Findings from this study are useful for future healthcare planning and allocation of resources for the healthcare delivery of necessary healthcare to patients in Australia. In addition, the results can be used to inform efforts to improve post-marked surveillance of medical devices by providing estimates of the volume and standardised rates of procedures for type of devices.
AH23126 Abstract | AH23126 Full Text | AH23126PDF (4 MB) | AH23126Supplementary Material (440 KB) Open Access Article
What is known about the topic? Surveillance of antimicrobial use is a useful tool to identify overuse or inappropriate use and enable targeted interventions to optimise antimicrobial prescribing and reduce the risk of antimicrobial resistance. What does this paper add? The methodology currently used to monitor antimicrobial use in Australian hospitals could be utilised to conduct facility-level surveillance in Australian prisons and would provide a mechanism to benchmark use between facilities and identify unexpected or inappropriate use. What are the implications for practitioners? Surveillance of antimicrobial use in prisons would support prison healthcare workers to monitor use over time, identify any increasing or unexpected trends in use, and target educational interventions to ensure compliance with antimicrobial prescribing guidelines.
AH24185Turnover factors and retention strategies for chief executive officers in Australian hospitals
What is known about the topic? High turnover rates among hospital chief executive officers (CEOs) negatively impact organisational stability and healthcare quality, causing disruptions in strategic decision-making, decreased employee morale, and potential declines in patient care standards. What does this paper add? This study identifies stress, lack of board support, and resource constraints as key factors driving CEO turnover in Australian hospitals. It also offers effective retention strategies, including fostering mutual respect between CEOs and boards, fulfilling training needs, and ensuring clear role definitions. What are the implications for practitioners? Implementing supportive organisational cultures, clear role definitions, and robust succession planning can enhance CEO retention. These measures will improve stability, strategic planning, and healthcare management, ultimately benefiting staff and patient care.
What is known about this topic? Clinical care ratios are useful in benchmarking allied health workplace activities. More experienced allied health professionals undertake more non-clinical activity. What does this research add? Non-clinical tasks represent a significant proportion of allied health workplace activities within Health New Zealand. What are the implications for practitioners? Clinical care ratios may be useful for managers and funders to understand allied health work demands and support more effective workforce planning. Measurement of non-clinical activities can ensure allied health professionals have time allocated for non-patient work.
What is known about this topic? Clinical care ratios are a useful tool to quantify, monitor and compare workloads of allied health professionals. What does this paper add? This paper confirms that clinical care ratios are a useful workforce planning tool and that when developing roles and models of care, clinical care ratios need to be incorporated into staffing requests and considered as part of workload management tools. What are the implications for practitioners? Clinical care ratios enable the quantification and benchmarking of direct and clinical support activity components of a workload and can be used when planning new services and reviewing current services.
AH24079 Abstract | AH24079 Full Text | AH24079PDF (405 KB) Open Access Article
AH24101Australian medical practitioners: trends in demographics and regions of work 2013–2022
What is known about the topic? Changes in the medical workforce over time are likely to impact health service delivery. What does this paper add? This paper examined changes in the gender, age, origin of qualification, and the region of work of Australia’s medical workforce from 2013 to 2022. What are the implications for practitioners? An increase in gender parity and a decrease in the mean hours worked suggests improvements in workforce participation and sustainability, but lack of growth in medical workforce was noted in remote and very remote regions of Australia.
AH24104Evaluating anti-bullying training in surgery: surgeons’ perceptions from Australia and Aotearoa New Zealand
What is known about this topic? Anti-bullying interventions, including training, are prevalent in healthcare; however, there is conflicting data on their effectiveness. What does this paper add? This study addresses a gap in the literature on the effectiveness of anti-bullying training from the perspective of supervisory surgeons in Australia and Aotearoa New Zealand. What are the implications for practitioners? Practitioners should consider implementing a multifaceted and sustained approach to anti-bullying reform, including anti-bullying training, well-drafted policies, increased accountability, and improved complaints mechanisms to reduce bullying and improve workplace culture.
AH24104 Abstract | AH24104 Full Text | AH24104PDF (356 KB) Open Access Article
AH24070A collaborative approach to support people with a disability living in Australian group homes during the COVID-19 pandemic: a case study
What is known about the topic? People with a disability (PWD) are at higher risk of morbidity and mortality following COVID-19 infection but little is known about how PWD were supported during the COVID-19 pandemic. What does this paper add? Describes one local health district (LHD's) approach to prevent, manage and minimise COVID-19 outbreaks in disability group homes along with insights from the disability group home managers on their experience of support provided by the LHD and other stakeholders. What are the implications for practitioners? Awareness of effective strategies supporting PWD that could be replicated in health organisations.
What is known about the topic? Previous research varied in methodology, using self-reports and healthcare data to understand COVID-19 social distancing public health measures’ effects on mental health. What does this paper add? This study introduces robust, objective data via a natural experiment design, examining the impact of successive lockdowns on mental health service usage and medication expenditures in specific Australian regions. What are the implications for practitioners? Findings highlight the need for flexible mental health services that can swiftly respond to increased demands during prolonged restrictions, without necessarily increasing medication use, guiding future policy and resource allocation.
AH23271Informing the management of the post-COVID condition: insights from the Western Australian experience comparing those who tested positive and negative to early COVID-19 strains
What is known about the topic? COVID-19 evokes multi-system sequelae including persistent physical and mental health symptoms, functional impairments and poorer quality of life. What does this paper add? A COVID+ group had equivalent physical recovery over 12 months; but higher prevalence of fatigue, dyspnoea and anxiety/depression symptoms at ~8 months compared to a COVID− group. What are the implications for practitioners? Health authorities and employers should know that while adequate physical function may return within months, post-acute sequelae of COVID-19 impair sufferers for over 6 months, likely necessitating healthcare support and workplace adjustments to optimise timely return to participation.
AH23271 Abstract | AH23271 Full Text | AH23271PDF (1 MB) | AH23271Supplementary Material (450 KB) Open Access Article
AH24081_COCorrigendum to: Variation in direct healthcare costs to the health system by residents living in long-term care facilities: a Registry of Senior Australians study
AH24081_CO Full Text | AH24081_COPDF (589 KB) Open Access Article