Australian Health Review
Volume 48 Number 3 2024
AH24090Big talk, little action: the enduring narrative of primary care reform
What is known about the topic? Governments acknowledge that current health arrangements are unsustainable, and a better resourced, integrated, and connected primary care system is central to the future. What does this paper add? This paper calls out the most significant barriers to implementing the required national reform and poses potential solutions in addressing them. What are the implications for practitioners? Without action, we will see increased system cost, and decreased service access and quality for Australian communities.
What is known about the topic? There is a need to undertake more proactive and in-depth analyses of the general practice accreditation process and outcomes to improve the quality and safety within this healthcare sector. What does this paper add? Attempt of the self-assessment does not predict indicator conformity at the site visit overall, and appropriate levels of consistency of indicator assessment between surveyors at the site visit were identified. What are the implications for practitioners? We present empirical evidence as to the consistency of assessment with general practice accreditation to inform future standards and (re)accreditation assessments.
AH23235 Abstract | AH23235 Full Text | AH23235PDF (686 KB) Open Access Article
What is known about the topic? Minimal empirical evaluation of the 5th edition standards for accreditation have occurred since their implementation. What does this paper add? Our findings suggest that more than half of the indicators currently do not adequately distinguish practices at the site assessment. What are the implications for practitioners? These findings may suggest that a review of individual indicators and the standards structure is required.
AH24059The creation of Grampians Health – a case study focusing on lessons learned from a health service merger
What is known about the topic? Studies on the effect of mergers have largely focused on economic parameters rather than on quality of care or stakeholder perceptions. What does this paper add? This article provides practical insights into the experiences of key people impacted by a health services amalgamation. What are the implications for practitioners? The lessons learnt discussed in the article may assist health services staff in their planning and approach for future amalgamation of health services in a regional/rural setting.
AH24059 Abstract | AH24059 Full Text | AH24059PDF (729 KB) | AH24059Supplementary Material (560 KB) Open Access Article
AH23180Health systems model for chronic disease secondary prevention in rural and remote areas – Chronic disease: Road to health
What is known about the topic? Cardiac rehabilitation is known to improve health outcomes and reduce hospitalisations, but referrals and attendance are low (30%). What does this paper add? A revised systems-based model for improved access to secondary prevention for people with heart and related chronic diseases in rural and remote areas of North Queensland is proposed: Chronic disease: Road to health. What are the implications for practitioners? A functional system from hospitalisation to local healthcare services has been designed to improve access to secondary prevention. Staff require support and education to improve skills, better manage care and improve job satisfaction.
AH23180 Abstract | AH23180 Full Text | AH23180PDF (1.3 MB) Open Access Article
What is known about the topic? Waitlist reduction strategies are required to deal with long surgical waitlists. Rural surgical services are declining due to centralisation of these services in larger hospitals. What does this paper add? Significant positive benefits arise from providing an ambulatory, rural surgical service. This paper provides an evidence base for rural hospitals to explore the benefits of re-activating, or increasing utilisation of, existing operating theatre facilities. What are the implications for practitioners? Significant reductions in surgical waitlists within health services can be safely achieved by servicing rural patients at their local hospital for some ambulatory procedures.
AH23191 Abstract | AH23191 Full Text | AH23191PDF (672 KB) Open Access Article
What is known about the topic? The scale of non-compliant Medicare billing is contested. What does this paper add? This Perspective frames non-compliant Medicare billing (and denial of its existence) as a ubiquitous cultural problem. What are the implications for practitioners? Strategies aimed at reducing non-compliant Medicare billing need to target the normative behaviour of societal actors as well as individual practitioners.
What is known about the topic? The Medicines Purposing Program (MRP) provides a pathway for non-industry actors to have off-label uses of medicines approved and funded if deemed to be of public benefit. What does this paper add? Commercial sponsors can easily sway the prioritisation and selection of candidates under the MRP in their favour, so strategies are recommended to counter this risk. What are the implications for practitioners? The MRP provides an opportunity for the medical community to directly nominate off-label medicines uses for approval and funding improving access to medicines, but only if commercial interests do not intervene.
What is known about the topic? Since the introduction of Lifetime Health Cover (LHC) in mid-2000, the participation rate for private health insurance that includes hospital cover (PHI-HC) has remained relatively stable, but the PHI-HC population has aged faster than the general population. What does this paper add? This paper makes a novel distinction between ‘active’ and ‘passive’ age-based adverse selection to explain LHC’s role in the excess ageing of the PHI-HC risk pool. What are the implications for practitioners? Governments need to be vigilant for the emergence of distortions in the age distribution of the PHI-HC risk pool and respond with targeted interventions to normalise the age distribution, or risk problematic passive age-based adverse selection.
AH24016What are the cost and resource implications of voluntary assisted dying and euthanasia?
What is known about the topic? Voluntary assisted dying (VAD) legislation has now been passed in all Australian states. Although VAD has been operating internationally for a considerable time, there have been calls for more data to understand the resources required to implement VAD. What does this paper add? We found a paucity of empirically informed detail regarding the actual costs required to implement VAD. Hence, we tabulated a list of potential costs that could be used for subsequent evaluation and outline a research agenda. What are the implications for practitioners? Given that a significant number of practitioners may be directly or indirectly involved in VAD it is important that associated costs are clearly outlined so that appropriate resource allocation can be considered.
What is known about the topic? Transformational leadership has clear benefits for patients, staff and organisations. What does this paper add? The personal and organisational attributes supporting transformation leadership are not well understood. What are the implications for practitioners? Transformational leadership was unrelated to gender or years of experience but was strongly associated with manager educational preparation and emotional intelligence.
AH23179 Abstract | AH23179 Full Text | AH23179PDF (798 KB) | AH23179Supplementary Material (541 KB) Open Access Article
AH23236Workforce training needs to address social and emotional wellbeing in home-based Aboriginal and Torres Strait Islander aged care
What is known about the topic? Supporting social and emotional wellbeing is an important aspect of delivering quality aged care for Aboriginal and Torres Strait Islander peoples. What does this paper add? Insights into workforce training needs which support the social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples in home-based aged care. What are the implications for practitioners? Ongoing practice-based learning opportunities, training and resources are needed to enhance peer-learning and support workforce in supporting Aboriginal and Torres Strait Islander peoples’ social and emotional wellbeing in aged care.
AH23236 Abstract | AH23236 Full Text | AH23236PDF (720 KB) Open Access Article
AH23107Is HealthPathways viewed as a useful and trustworthy source of information by health professionals?
What is known about the topic? Evidence from New Zealand suggests that HealthPathways is viewed as a useful and trusted source of information by health professionals during critical and emergency events, and when information needs are subject to frequent change. What does this paper add? This paper provides evidence in the Australian context that health professionals access specific pages in HealthPathways at higher rates during critical and emergency events. What are the implications for practitioners? HealthPathways has the capacity to provide timely and accurate information to health professionals during critical and emergency events, as well as to identify their emerging information needs.
AH23275Familiarity, confidence and preference of artificial intelligence feedback and prompts by Australian breast cancer screening readers
What is known about the topic? Artificial intelligence (AI) holds promise in providing computer-aided detection in health care, however, current research suggests that standalone AI applications in clinical practice fall short of matching the accuracy of a single radiologist. What does this paper add? The study showed a significant preference among clinicians for using AI as a supplementary tool, serving as a second-reader. Such an integrated approach, where AI aids in flagging suspicious areas on mammograms or offers automatic classification, reflects the ideal cooperation between breast screening readers and AI systems. What are the implications for practitioners? These insights shed light on clinicians’ familiarity with and expectations of AI tools that can boost the effectiveness of breast screening programs.
What is known about the topic? Next-day discharge following hip or knee arthroplasty in Australian public hospital settings is uncommon and little has been published reflecting enhanced recovery principles in this local context. What does this paper add? This paper describes the development and piloting of an enhanced recovery program using a novel approach to achieve next-day discharge following hip and knee replacement. What are the implications for practitioners? Other health services may leverage this approach to design and implement an enhanced recovery program to reduce hospital length of stay and improve patient and health service outcomes.
AH23222Partnering with consumers and practising clinicians to establish research priorities for public hospital maternity services
What is known about the topic? Establishment of research agendas often neglects the participation of research end-users, consumers and practising clinicians, consequently limiting relevance and translation. What does this paper add? Prioritised specific maternity research questions were jointly generated by consumers and front-line clinicians to highlight areas of focus for research funding and support. What are the implications for practitioners? By partnering with consumers and practising clinicians health service research priorities can be established to optimise patient outcomes and ensure future research is both translational and relevant.
What is known about the topic? The magnitude of suffering on both the Israeli and Palestinian sides of the current war is beyond comprehension. What does this paper add? The conflict has sparked a surge of politics in healthcare, which in turn has led to a lack of cultural safety for patients, their families, and healthcare staff. What are the implications for practitioners? The medical community must focus on upholding the principles of health and care for all people and avoid political entanglements to ensure that healthcare remains a neutral, safe space for everyone.
AH23278_COCorrigendum to: Taking a value based commissioning approach to non-clinical and clinical support services
AH23278_CO Full Text | AH23278_COPDF (654 KB) Open Access Article
AH22142_COCorrigendum to: COVID-19 vaccine hesitancy, acceptance and informational needs in an Australian cancer population: a cross-sectional survey
AH22142_CO Full Text | AH22142_COPDF (657 KB) Open Access Article