Australian Health Review
Volume 48 Number 6 2024
AH24196Medicare-reimbursed psychiatric consultations before and after telehealth expansion in Australia: a time series study
What is known about the topic? A large rise in telepsychiatry consultations with increased total consultations and reduced face-to-face consultations followed the pandemic-triggered expansion of Medicare Benefits Schedule telehealth items. What does this paper add? We demonstrated that after adjusting for pre-existing trends, seasonality, and COVID-related restrictions, telehealth expansion was associated positively with all consultations and negatively with face-to-face consultations at clinically significant levels. What are the implications for practitioners? Policy changes widening telepsychiatry services have possibly led to increased uptake of psychiatric care by addressing previously unmet needs. Hybrid face-to-face/telehealth care may become the new norm.
AH24196 Abstract | AH24196 Full Text | AH24196PDF (1.6 MB) Open Access Article
AH24121Utilisation of Medicare chronic disease management item numbers for people with cancer in Queensland, Australia
What is known about the topic? Comorbid chronic conditions are common in people with cancer, but the uitlisation of Medicare chronic disease management (CDM) item numbers for them remained unexplored. What does this paper add? Approximately half of the cancer survivors had General Practitioner Management Plan and Team Care Arrangements, and just over two-fifths utilised subsidised allied health services, with notable variations by people with cancers’ characteristics. What are the implications for practitioners? The findings underscore the need for further investigation to examine the contributing factors for the variation in CDM plans and the low utilisation of allied health services, particularly those living in the outer regional or remote areas.
AH24126Standardising workforce cost estimates across Australian jurisdictions: genomic testing as a use case
What is known about the topic? Workforce costs are known to be a significant contributor to the cost of health services and complex health technologies. What does this paper add? This paper systematically quantifies the variation in workforce costs across five Australian states, demonstrating that these differences are substantial enough to influence cost-effectiveness outcomes for genomic testing services. By identifying key areas of cost variation – such as base salaries, superannuation contributions, and allowances – this paper highlights how jurisdictional variations can contribute to differential health service costs, potentially impacting the affordability and sustainability of health programs and technologies, across states. What are the implications for practitioners? We provide reproducible estimates of workforce costs for use by health economists and policymakers conducting economic evaluations. The framework presented in this paper can also be adapted by other professionals in health economics and health workforce planning to assess jurisdictional variations and their implications for resource allocation and service delivery.
What is known about the topic? Shortage of hospital beds may lead to cancellation of surgeries. What does this paper add? Historical data could be used to predict hospital bed utilisation for post-surgical care. What are the implications for practitioners? A predictive tool is proposed, which may provide decision support to the planning of surgeries and bed management.
What is known about this topic? Barriers to accessing allied health services in primary care in Australia exist, especially among those in need. What does this paper add? We show that hotspots (areas with greater density) versus coldspots (areas with lower density) of potentially preventable hospitalisations were significantly more disadvantaged. Hotspots also had poorer access to allied health services. What are the implications for practitioners? This provides evidence to practitioners and policy makers for advocating greater access to allied health services in areas of socioeconomic disadvantage.
AH24204External validation and comparative analysis of the HOSPITAL score and LACE index for predicting readmissions among patients hospitalised with community-acquired pneumonia in Australia
What is known about the topic? The HOSPITAL score and LACE index are used to predict readmissions, but their utility and comparative effectiveness in Australian healthcare settings are unclear. What does this paper add? This study found that both the HOSPITAL score and LACE index have modest and comparable abilities in predicting community-acquired pneumonia readmissions in Australian settings. What are the implications for practitioners? There is a need for further refinement of readmission prediction models to better suit Australian healthcare conditions.
AH24154The carbon footprint of total knee replacements
What is known about the topic? The environmental footprint of health care itself is important. Carbon footprinting of surgical operations are becoming more common, although detailed analyses are rare. What does this paper add? The carbon footprint of a total knee replacement was 132 kg CO2e, i.e. the equivalent of driving >900 km in a typical 2022 Australian car. Orthopaedic surgery itself contributed to 80% of the emissions, with anaesthesia and operating room energy use contributing 10% each to the total carbon footprint. What are the implications for practitioners? By replacing single-use with reusable equipment, and by using 100% renewable energy for decontamination, the greenhouse gas emissions for a total knee replacement can become negligible.
AH23270Utility of a digital app to enhance patient–nurse communications and patient involvement in bedside handover: patient and nurse perceptions
What is known about the topic? Involving patients in communications about their health care can improve the experience and quality of care and reduce miscommunication. Digital technologies, such as mobile apps, can enable patient-centred care through improved patient–clinician communication, however, their utility for patient–bedside nurse communication has not been widely studied. What does this paper add? This prototype app shows early promise for enabling patients to articulate their care priorities to bedside nurses, and to facilitate patient-centred care. However, user perceptions regarding the influence of the app on patient involvement in bedside handover were mixed. What are the implications for practitioners? This digital app has potential to improve the safety and quality of care through improved patient–nurse communication about what matters most to patients.
AH24089Leading innovation in transdisciplinary care
What is known about this topic? Much research has been generated around the benefit of teamwork in healthcare, little has been generated around how to achieve this at an organisational level. What does this paper add? This paper specifically seeks to bridge the gap in understanding how teamwork can be enabled at an organisational level, and the pathways organisations have undertaken to achieve this way of working. What are the implications for practitioners? This paper identifies the key themes across three exemplar organisations that have enabled team working at an organisational level for potential application.
AH24089 Abstract | AH24089 Full Text | AH24089PDF (318 KB) Open Access Article
What is known about the topic? People living with severe mental illness experience a 20-year reduced life expectancy due to a combination of modifiable lifestyle factors and increased rates of chronic disease. What does this paper add? This paper describes the Living Well, Living Longer integrated care program, which introduces various strategies to address this problem. What are the implications for practitioners? Living Well, Living Longer demonstrates that with strong executive support, multidisciplinary collaboration, and engagement with lived experience expertise, effective care pathways can be implemented to improve the health of people living with severe mental illness.
AH24199Models of care for voluntary assisted dying: a qualitative study of Queensland’s approach in its first year of operation
What is known about the topic? Voluntary assisted dying (VAD) is generally operating as intended in Australia but access barriers remain. What does this paper add? Queensland implemented VAD differently with a statewide VAD support service that assists with provision of VAD and a Health Service Directive requiring all Health and Hospital Services to provide publicly-funded VAD services. This is the first research on the Queensland VAD system’s operation. What are the implications for practitioners? VAD is likely to be provided by practitioners in the public sector. Consistency in VAD provision, resourcing and VAD workforce sustainability are ongoing challenges.
AH24199 Abstract | AH24199 Full Text | AH24199PDF (298 KB) | AH24199Supplementary Material (297 KB) Open Access Article
AH24286A digitally enabled health workforce for Australia
What is known about the topic? Digital health has a lot of strength and potential in healthcare, but implementation remains a primary concern. What does this paper add? Workforce training recommendations to fully embrace a digitally enabled health system. What are the implications for practitioners? A better understanding of digitally enabled health systems and well-supported training.
AH24286 Abstract | AH24286 Full Text | AH24286PDF (288 KB) Open Access Article
AH24165Accreditation as a lever for change in the development of the collaborative practitioner in the Australian health system
What is known about the topic? Patients expect coordinated, collaborative practice in the Australian healthcare system. Health services, education institutions, and accreditation authorities must work together to achieve this goal. What does this paper add? While the value of collaborative practice is embedded through consistent curriculum messages and positive role modelling in health professional courses, accreditation authorities, education institutions, health service practitioners, and consumers need to work together to facilitate the development of collaborative practice through attention to policy and processes, curriculum activities, student participation, health service activities, and resource allocation. What are the implications for practitioners? Through working together on curriculum and health service activities and practice, health service providers, education institutions, and accreditation authorities can develop collaborative practice.
AH24165 Abstract | AH24165 Full Text | AH24165PDF (285 KB) Open Access Article
What is known about the topic? High chief executive officer (CEO) turnover in hospitals leads to instability, financial costs, and disruptions in patient care. Effective retention strategies are essential but often lack comprehensive, context-specific models. What does this paper add? This paper presents a tailored CEO retention model for Australian hospitals, integrating mutual respect, organisational culture, competitive rewards, recruitment practices, and professional development, aligned with Transformational Leadership Theory. What are the implications for practitioners? Practitioners can use this model to implement comprehensive retention strategies, enhancing organisational stability and reducing CEO turnover in hospitals.
AH24142Voluntary assisted dying: impacts on health professionals
What is known about the topic? The implementation of voluntary assisted dying (VAD) legislation poses challenges for clinicians. Understanding clinician perspectives on VAD is important for future practice and policy decisions. What does this paper add? Clinicians are impacted by inadequate remuneration, barriers to training and an emotional toll. What are the implications for practitioners? Unaddressed impacts may lead to burnout and workforce sustainability challenges. Recommendations include Medicare Benefits Schedule items for remuneration, training incentives and emotional support strategies for VAD clinicians.
AH24142 Abstract | AH24142 Full Text | AH24142PDF (590 KB) | AH24142Supplementary Material (203 KB) Open Access Article
AH24146Feasibility of an allied health led, workplace delivered Long COVID service for hospital staff: a mixed-methods study
What is known about the topic? Self-management strategies and multidisciplinary rehabilitation with self-monitoring are considered best practice for treatment of Long COVID. What does this paper add? A workplace delivered outpatient multidisciplinary service was feasible in terms of demand, acceptability and practicality and provided valued support for hospital staff experiencing Long COVID. What are the implications for practitioners? A flexible, workplace delivered multidisciplinary service was acceptable and convenient to hospital staff with Long COVID. Further research is required to confirm the effectiveness of such a service on patient outcomes.