Australian Health Review最新文献

{"title":"Clinician perspectives on rapid transition to telehealth during COVID-19 in Australia - a qualitative study.","authors":"Lillian Smyth,&nbsp;Suzannah Roushdy,&nbsp;Jerusha Jeyasingham,&nbsp;Joshua Whitbread,&nbsp;Peta O'Brien,&nbsp;Charles Lloyd,&nbsp;Christian J Lueck,&nbsp;Carolyn A Hawkins,&nbsp;Graham Reynolds,&nbsp;Diana Perriman","doi":"10.1071/AH22037","DOIUrl":"https://doi.org/10.1071/AH22037","url":null,"abstract":"<p><p>Objective The coronavirus disease 2019 (COVID-19) pandemic precipitated a major shift in the use of telehealth in Australia. The changes highlighted gaps in our knowledge regarding the efficacy of, and clinician attitudes to, the use of telehealth. The current study expands and deepens the available evidence as a result of being collected in unique circumstances that removed one of the major barriers (lack of Medicare rebates) and also one major enablers (willingness) of telehealth uptake. Methods Using a semi-structured interview, we invited clinicians (N  = 39) to share their perspectives, attitudes and experiences of using telehealth. Topics covered included perceptions of the strengths and challenges of telehealth, and how experience of using telehealth during the COVID-19 pandemic had influenced clinicians' views and intentions regarding their future practice. Participants included clinicians from five disciplines across public and private practice: paediatrics, neurology, immunology, rural general practice, and orthopaedics. Results We found three key dimensions for consideration when assessing the suitability of telehealth for ongoing practice: the attributes of the patient population, the attributes of the clinical context and environment, and the risks and benefits of a telehealth approach. These findings map to the existing literature and allow us to infer that the experiences of clinicians who previously would have chosen telehealth did not differ significantly from those of our 'pandemic-conscripted' clinicians. Conclusions Our findings map clearly to the existing literature and allow us to infer that the experiences of the clinicians who have chosen telehealth (and are already represented in the literature) did not differ significantly from those trying out telehealth under the unique circumstances of the removal of the Medicare Benefits Scheme barrier and external pressure that over-rides the 'willingness' enabling factor in uptake decisions.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10652012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attendance at, and experiences of, urban hospital outpatient appointments: informing a new model of care for urban-dwelling Aboriginal and Torres Strait Islander patients.","authors":"Karen Wynter,&nbsp;Leanne Mullan,&nbsp;Tanya Druce,&nbsp;Gilbert Freeman,&nbsp;Graeme Maguire,&nbsp;Lauren Davidson,&nbsp;Harin Karunajeewa,&nbsp;Shane Crowe,&nbsp;Bodil Rasmussen","doi":"10.1071/AH21363","DOIUrl":"https://doi.org/10.1071/AH21363","url":null,"abstract":"<p><p>Objectives To compare outpatient attendance rates for Aboriginal and Torres Strait Islander ('Aboriginal') and non-Aboriginal patients at a large metropolitan health service in Melbourne, Australia, and to describe the barriers and enablers experienced by urban-dwelling Aboriginal patients in attending hospital outpatient appointments. Methods This study used a mixed-method approach. Proportions of referred patients who booked and attended outpatient appointments were extracted from a health service database. Aboriginal versus non-Aboriginal cohorts were compared using chi-squared tests. Eleven patients, one parent of a patient and two community nurses were interviewed by telephone to investigate perceived barriers and enablers to attending outpatient appointments among Aboriginal patients. Results Outpatient referrals were greater among Aboriginal than non-Aboriginal people; however, referrals were significantly less likely to result in an outpatient clinic booking and attendance for Aboriginal compared to non-Aboriginal people. Interview participants reported several barriers to attending appointments, related to logistical, quality of care and cultural factors. Suggested facilitators to make appointment attendance easier included: provision of transport support, improving clinic scheduling, utilising a variety of appointment reminder formats, providing food in waiting rooms, flexible appointment timing options, outreach services, access to Aboriginal support workers, improving communication and relationships with Aboriginal people, cultural awareness training for staff and the provision of culturally appropriate spaces. Conclusion Some barriers faced by Aboriginal patients in attending hospital outpatient appointments in urban areas can be addressed through implementation of enablers suggested by participants. Data have informed the development of a tailored, inclusive, culturally and consumer-focused appropriate hospital outpatient service model of care.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10807161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Corrigendum to</i>: Impact of the COVID-19 pandemic on access and use of health services by middle-aged and older Australians.","authors":"Lorraine Ivancic,&nbsp;Diana M Bond,&nbsp;Natasha Nassar","doi":"10.1071/AH22183_CO","DOIUrl":"https://doi.org/10.1071/AH22183_CO","url":null,"abstract":"<p><p>Objectives To examine: the impact of the coronavirus disease 2019 (COVID-19) pandemic on access to health services by middle-aged and older Australians; and the use of telehealth services during the COVID-19 pandemic and its ongoing usefulness. Methods A cross-sectional survey was conducted among participants who completed the COVID-19 supplement in the 45 and Up Study 2020 Survey. Multivariable logistic regression analysis was used to examine the association between socio-demographic characteristics and health conditions with missed/delayed access to health services, changes in health outcomes resulting from missed/delayed access, and use of telehealth services. Results Data for 45 071 participants were analysed (56% female, 72% aged ≥65 years). Almost half (42.2%) reported they had missed/delayed access to health care due to COVID-19; mainly for dental services (26.1%), visits to a general practitioner (GP) (16.3%) and specialists (12.6%). Missed/delayed visits to GPs and specialists were more likely among females, participants from non-English-speaking backgrounds, with disability/illness, living in outer regional/remote areas or with chronic health conditions. People with a disability or high/very high psychological distress were twice as likely to report worse health as a result of missed/delayed care. Half (48.0%) the study participants used telehealth during the COVID-19 pandemic and 81.9% indicated telehealth would be useful post-pandemic. Conclusions The COVID-19 pandemic impacted access to healthcare services, particularly for people with a disability, and chronic or mental health issues who also reported worse health. This may account for their higher use of telehealth services as an alternate way of accessing health care. Ongoing evaluation of telehealth services for vulnerable groups post-pandemic is required.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10707625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A racial bias test with tertiary cancer centre employees: why anti-racist measures are required for First Nations Australians cancer care equity.","authors":"I D'Costa,&nbsp;I Hunt,&nbsp;L Russell,&nbsp;K Adams","doi":"10.1071/AH21113","DOIUrl":"https://doi.org/10.1071/AH21113","url":null,"abstract":"<p><p>Objective To examine implicit bias in employees at a cancer centre using an Australian race (Aboriginal-white) Implicit Association Test (IAT), in an attempt to understand a potential factor for inequitable outcomes of First Nations Australians cancer patients. Methods All employees at an Australian cancer centre were invited to take part in a web-based, cross-sectional study using an Australian race IAT. The results were analysed using Welch t-tests, linear regression and ANOVA. Results Overall, 538/2871 participants (19%) completed the IAT between January and June 2020. The mean IAT was 0.147 (s.d. 0.43, P < 0.001, 95% CI 0.11-0.18), and 60% had a preference for white over First Nations Australians. There was no significant mean difference in IAT scores between sub-groups of gender, age or clinical/non-clinical employees. 21% of employees (95% CI 17.65-24.53) had moderate to strong preference for white over First Nations Australians, compared to 7.1% with moderate to strong preference for First Nations over white Australians (95% CI 5.01-9.09). Conclusions Inequitable cancer survival for First Nations patients has been well established and cancer is now the leading cause of mortality. This paper documents the presence of racial bias in employees at one cancer centre. We argue that this cannot be understood outside the history of colonialism and its effects on First Nations Australians, healthcare workers and our society. Further research is required to evaluate measures of racism, its effect on health care, and how to eliminate it.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10640979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Worsening general health and psychosocial wellbeing of Australian hospital allied health practitioners during the COVID-19 pandemic.","authors":"Danielle Hitch,&nbsp;Sarah Booth,&nbsp;Karen Wynter,&nbsp;Catherine M Said,&nbsp;Kimberley Haines,&nbsp;Bodil Rasmussen,&nbsp;Sara Holton","doi":"10.1071/AH22110","DOIUrl":"https://doi.org/10.1071/AH22110","url":null,"abstract":"<p><p>Objective To describe self-reported general and psychological health for allied health practitioners at an Australian acute public health service over three time points within the coronavirus disease 2019 (COVID-19) pandemic. Methods This study collected data from cross-sectional online surveys at three time points: May-June 2020 (T 1 ), October-November 2020 (T 2 ) and November-December 2021 (T 3 ). The self-report questionnaire consisted of demographic questions, a general health question and the 21-item version of the Depression Anxiety Stress Scales (DASS-21). Results A total of 308 responses were received (T 1 n  = 135, T 2 n  = 78, T 3 n  = 95) from representatives of eight allied health professions. The proportion of allied health practitioners reporting poor general health significantly increased over time, as did mean scores on all DASS-21 sub-scales. General health status was also significantly associated with DASS-21 subscale scores. Anxiety scores increased significantly between T 1 and T 2 , while depression scores increased significantly between T 2 and T 3 . Significant increases in stress scores were recorded across all time intervals. Between T 1 and T 3 , the proportion of allied health practitioners reporting moderate, severe, or extremely severe symptoms increased for depression (10.3-30.9%), anxiety (5.2-18.2%) and stress (13.3-36.3%). Conclusion The general and psychological health of allied health practitioners appears to be worsening as the COVID-19 pandemic continues. Organisational strategies to support the health of the allied health workforce in acute care settings must address the cumulative effects of prolonged pressure on their general and psychosocial health. Support strategies need to be responsive to changes in psychological wellbeing at different phases of the pandemic.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10656200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pandemic planning: data, information and evidence.","authors":"Peter Lewis-Hughes,&nbsp;Peter Brooks","doi":"10.1071/AH22236","DOIUrl":"https://doi.org/10.1071/AH22236","url":null,"abstract":"<p><p>In this article, we examine the role and effectiveness of the Centers for Disease Control and Prevention in the USA and Europe and consider possible lessons for future pandemic planning in Australia. We also 'map' the interjurisdictional communication pathways that have been secured since the election of the new Commonwealth government. We suggest a number of steps that could be taken to upgrade the collection, distribution, accessibility and timelines of key information required to improve pandemic management and national health outcomes. While it may be hard to contemplate a move to a fully integrated National capacity when we are only just emerging from the pandemic, we do have a unique opportunity to at least start the process of review. We should use the lessons we have learned to transform our systems, rather than 'tinker' with them and ensure we are better prepared for next time.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10707612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting the 'First 2000 Days maternal and child healthcare framework' in the aftermath of the COVID-19 pandemic: ensuring equity in the new world.","authors":"Antonio Mendoza Diaz,&nbsp;Ron Brooker,&nbsp;Sara Cibralic,&nbsp;Elisabeth Murphy,&nbsp;Sue Woolfenden,&nbsp;Valsamma Eapen","doi":"10.1071/AH22228","DOIUrl":"https://doi.org/10.1071/AH22228","url":null,"abstract":"<p><p>The purpose of this perspective article is to emphasise the importance of the 'First 2000 Days' policy of life from conception to age five, and to propose new directions in which the policy's implementation could be extended for the benefit of children and families. The proposed approach highlights principles of responsiveness, integration, sustainability and equity, specifying initiatives that embody the kind of innovation each principle aspires to. The article also proposes innovations in data collection and linkages that would strengthen the implementation of first 2000 days policies and frameworks. This perspective proposes a framework that could improve health systems implementation of services in the first 5 years of life, by proposing a well-coordinated continuum of services with integrated physical and digital solutions. This has the potential to transform how the health system monitors and responds to children and families' needs in the critical early years of life during and beyond the current pandemic.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10707115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Commonwealth Criminal Code restricts the use of carriage services to access voluntary assisted dying in Victoria: a perspective.","authors":"Kate Furness,&nbsp;Jim Howe,&nbsp;Mitchell Chipman,&nbsp;Nirasha Parsotam,&nbsp;Margaret O'Connor","doi":"10.1071/AH22192","DOIUrl":"https://doi.org/10.1071/AH22192","url":null,"abstract":"A major barrier to Victorians with a terminal illness accessing voluntary assisted dying is the Commonwealth Criminal Code Amendment (Suicide Related Material Offences) 2005 (the Code), which prohibits the use of any electronic forms of communication when discussing suicide. The proliferation of telehealth as a means of access to medical practitioners as a result of the COVID-19 pandemic has heightened the anachronistic prohibition of such communication in relation to voluntary assisted dying, particularly in Victoria, as the federal law arguably prohibits its use. In this paper we explore the definition of suicide and its application to voluntary assisted dying and argue for a revision of the Code, to enable equitable and timely access to voluntary assisted dying for people of Victoria.","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10642499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Universal Oral Health Coverage: Investigating the Conditions for Implementation of the Historic WHO Resolution in Greece","authors":"Zoi Tsarnava, Maria Tsantidou, T. Konstantinidis, A. Syngelakis","doi":"10.54042/hr628hhsma","DOIUrl":"https://doi.org/10.54042/hr628hhsma","url":null,"abstract":"Oral health is an integral part of overall human health. However, the reduction of public dental funding and chronic weaknesses of the Greek Health System has exacerbated inequalities in access to dental care. In this paper, we aim to uncover the current situation in Greece, regarding the provision of dental care and detect the necessary actions for adopting the historic World Health Organisation (WHO) Resolution on Oral Health (May 2021), which mandates the universal coverage of oral health. Qualitative research was conducted, involving sixteen(16) health system experts, public health officials, as well as representatives of the wider dental community, and patients, who were invited to answer an eleven(11)-item questionnaire, through semi-structured in-depth interviews. The validity of the results was confirmed with the method of triangulation, using multiple data sources. A review of the literature and a search for statistical data in reliable databases were also performed. Low prioritization of oral health, understaffing of National Health System (NHS) dental departments, almost zero public dental funding, wide and deep inequalities, and exclusions of access to dental care were found. A National Oral Health Strategy as well as full integration of Dentistry into the Health System, the adoption of a minimum guaranteed share of public health funding dedicated to oral health, and the creation of an Observatory of Inequalities and Oral Health Policies are considered neces- sary actions for the significant improvement of the oral health status of the Greek population. The WHO Resolution on Oral Health is a call for action toward a modern, universal, effective, efficient, comprehensive, and humancentered health system that gives dental care the place it deserves. Political will, a minimum guaranteed percentage of public health funding dedicated to oral health, and a National Strategy emerge as the pillars of this imperative reform.","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84925654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Costing of Services in Intensive Care Unit by using DRG system in OECD countries","authors":"Maria Mastrogianni, P. Galanis, D. Kaitelidou, T. Katsoulas","doi":"10.54042/hr631hhsma","DOIUrl":"https://doi.org/10.54042/hr631hhsma","url":null,"abstract":"The trend for quality, efficient, and productive financing of health service providers, especially Intensive Care Units (ICUs), has become increasingly evident in recent decades. In this study, we investigate the prospective reimburse- ment method, per case of hospitalization in the ICU, according to the Diagnostic Related Groups (DRGs), in the OECD countries, as well as the appropriateness of using the method, in the particular environment of the ICU. A systematic review of papers published up until July 2022 was conducted. The search was performed on PubMed, Medline, Scopus, ScienceDirect, and Google Scholar. The criteria for inclusion in this review were the calculation by researchers of the appropriateness of using DRGs in the ICU, as a method of reimbursement, through comparison with the actual cost of hospitalization of patients in the ICU. Only sixteen(16) of the scientific papers retrieved met the criteria for inclusion in this review. Ten(10) studies assessed the appropriateness of applying DRGs as a reim- bursement method in adult ICUs and six(6) assessed the appropriateness of applying DRGs as a reimbursement method in Neonatal Intensive Care Units and pediatric ICUs. Discrepancies were observed between the actual cost of hospitalization and the reimbursement amount in all categories of ICUs. Finding the right DRG system, combined with other financing methods, would be a useful policy tool to help manage finances, contain costs, and provide quality health services.","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78086369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}