Australian Health Review最新文献_第4页

Reverse triage in COVID surge planning: a case study of an allied health supported clinical care pathway in an acute hospital setting. COVID激增规划中的反向分类:急性医院环境中联合健康支持的临床护理途径的案例研究

IF 1.8 4区医学

Australian Health Review Pub Date : 2023-08-01 DOI: 10.1071/AH22084

Toni Dianne Withiel, Rachel Blance-Palmer, Cassandra Plant, Genevieve Juj, Carly Louise McConnell, Melissa Kate Rixon, Mark Putland, Nicola Walsham, Marlena Klaic

{"title":"Reverse triage in COVID surge planning: a case study of an allied health supported clinical care pathway in an acute hospital setting.","authors":"Toni Dianne Withiel, Rachel Blance-Palmer, Cassandra Plant, Genevieve Juj, Carly Louise McConnell, Melissa Kate Rixon, Mark Putland, Nicola Walsham, Marlena Klaic","doi":"10.1071/AH22084","DOIUrl":"https://doi.org/10.1071/AH22084","url":null,"abstract":"Objective This case study describes the development and outcomes of a new integrated and multidisciplinary care pathway. Spearheaded by allied health, the 'COVID community navigator team', applied established principles of reverse triage to create additional surge capacity. Methods A retrospective cohort study examined workflow patterns using electronic medical records of patients who received navigator input at the Royal Melbourne Hospital between 20 September 2021 and 20 December 2021. Results There were 437 eligible patient encounters identified. On average patients stayed 4.15 h in the emergency departments (ED) (s.d. = 4.31) and 9.5 h (s.d. = 10.9) in the short stay unit. Most patients were discharged into a 'low risk pathway' with community general practitioner follow up. Of discharged patients, only 38 re-presented to the ED with symptoms related to their initial COVID-19 diagnosis (34.9% of total re-admissions). Of these re-admissions, more than half did not require admission to a ward. Conclusion The findings presented here provide support for the clinical utility of a multidisciplinary reverse triage approach in surge planning for anticipated presentation peaks.","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":"47 4","pages":"456-462"},"PeriodicalIF":1.8,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10287368","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}

引用次数: 0

Corrigendum to: Out-of-pocket payments: impacts on healthcare decision-making and system and individual level measures to minimise the burden. 自付费用:对医疗决策的影响，以及减少负担的系统和个人措施的更正。

IF 1.8 4区医学

Australian Health Review Pub Date : 2023-08-01 DOI: 10.1071/AH22244_CO

Amanda L Neil

{"title":"Corrigendum to: Out-of-pocket payments: impacts on healthcare decision-making and system and individual level measures to minimise the burden.","authors":"Amanda L Neil","doi":"10.1071/AH22244_CO","DOIUrl":"https://doi.org/10.1071/AH22244_CO","url":null,"abstract":"Out-of-pocket healthcare payments are a concern for all, particularly those least able to afford them, a situation only being exacerbated by the current cost-of-living crisis. This article aims to provide an overview of out-of-pocket payments and their impacts on decision-making: whether, or not to delay care or seek care at all. The impact of average out-of-pocket payments on demand for mental healthcare services is provided as a specific example. The available data indicate a positive linear relationship between the average out-of-pocket payments for Medicare services by type of provider, and the proportion of patients who decide not to obtain care from a given type provider. This article also poses that current safety net processes are not consumer centric, the Pharmaceutical Benefits Scheme (PBS) Safety Net particularly so, and that change is required. It is recommended that a consumer-centric approach should be adopted with everyone listed on a Medicare card automatically included in the assessment of the Medicare and PBS Safety Nets and for the PBS Safety Net to be automatically assessed through Services Australia. Links to websites are provided to support individual decision-making and registering for available safety nets. Finally, supply side considerations and their implications for market equilibrium and the economy are briefly overviewed.","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":"47 4","pages":"518"},"PeriodicalIF":1.8,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10318494","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}

引用次数: 0

Optimal cancer care pathways - the ideal versus reality for patient-centric cancer care during COVID-19. 最佳癌症治疗途径——COVID-19期间以患者为中心的癌症治疗的理想与现实

IF 1.8 4区医学

Australian Health Review Pub Date : 2023-08-01 DOI: 10.1071/AH23060

Shanuka Samaranayake, Daniel Barker, Apsara Windsor

{"title":"Optimal cancer care pathways - the ideal versus reality for patient-centric cancer care during COVID-19.","authors":"Shanuka Samaranayake, Daniel Barker, Apsara Windsor","doi":"10.1071/AH23060","DOIUrl":"https://doi.org/10.1071/AH23060","url":null,"abstract":"Objectives To assess whether compliance with the nationally endorsed Optimal Care Pathways is evident in 75% of patients treated with curative intent treatment and if this compliance was impacted by the COVID-19 pandemic (hereinafter COVID-19). Methods This retrospective study included patients undergoing curative treatment with radiotherapy in head and neck (HN), breast, lung and gastrointestinal malignancies between January 2019 and June 2021 in a single NSW outer metropolitan cancer service. For care delivered within the remit of cancer services, the primary outcome measure was the proportion of patients whose treatment complied with the Optimal Care Pathways recommended time frame. Secondary outcome measures included evaluating the effect of COVID-19 on the proportion of patients being treated within the recommended time frame. Results There were n = 733 eligible patients across the five tumour streams with the majority being breast cancer patients comprising 65% (n = 479) of the cohort, followed by HN cancer patients (n = 125, 17%). None of the tumour subsites abided by the 75% compliance rate. Oesophageal cancer patients had the lowest compliance rate of 4% (P < 0.001), with a similarly low compliance rate for rectal cancer patients at 33% (P = 0.002). None of the hypothesis tests to assess for detriment in treatment time during COVID-19 were statistically significant (P > 0.05). Conclusion Despite the availability of best practice guidelines, there is limited compliance throughout all cancer subtypes, which has not been negatively influenced by COVID-19. Improved awareness of the Optimal Care Pathways, and implementation of the associated infrastructure and systems, are required to support compliance.","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":"47 4","pages":"472-479"},"PeriodicalIF":1.8,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9933732","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}

引用次数: 0

Out-of-pocket payments: impacts on healthcare decision-making and system and individual level measures to minimise the burden. 自费支付:对医疗保健决策、系统和个人层面措施的影响，以尽量减少负担。

IF 1.8 4区医学

Australian Health Review Pub Date : 2023-08-01 DOI: 10.1071/AH22244

Amanda L Neil

{"title":"Out-of-pocket payments: impacts on healthcare decision-making and system and individual level measures to minimise the burden.","authors":"Amanda L Neil","doi":"10.1071/AH22244","DOIUrl":"https://doi.org/10.1071/AH22244","url":null,"abstract":"Out-of-pocket healthcare payments are a concern for all, particularly those least able to afford them, a situation only being exacerbated by the current cost-of-living crisis. This article aims to provide an overview of out-of-pocket payments and their impacts on decision-making: whether, or not to delay care or seek care at all. The impact of average out-of-pocket payments on demand for mental healthcare services is provided as a specific example. The available data indicate a positive linear relationship between the average out-of-pocket payments for Medicare services by type of provider, and the proportion of patients who decide not to obtain care from a given type provider. This article also poses that current safety net processes are not consumer centric, the Pharmaceutical Benefits Scheme (PBS) Safety Net particularly so, and that change is required. It is recommended that a consumer-centric approach should be adopted with everyone listed on a Medicare card automatically included in the assessment of the Medicare and PBS Safety Nets and for the PBS Safety Net to be automatically assessed through Services Australia. Links to websites are provided to support individual decision-making and registering for available safety nets. Finally, supply side considerations and their implications for market equilibrium and the economy are briefly overviewed.","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":"47 4","pages":"401-409"},"PeriodicalIF":1.8,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9934260","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}

引用次数: 0

Factors associated with emergency department service outcomes for people with a mental health problem brought in by police: a retrospective cohort study. 与警察带来的精神健康问题患者急诊服务结果相关的因素:一项回顾性队列研究。

IF 1.8 4区医学

Australian Health Review Pub Date : 2023-08-01 DOI: 10.1071/AH22229

Rachel Wardrop, Jamie Ranse, Wendy Chaboyer, Jesse T Young, Stuart A Kinner, Julia Crilly Oam

{"title":"Factors associated with emergency department service outcomes for people with a mental health problem brought in by police: a retrospective cohort study.","authors":"Rachel Wardrop, Jamie Ranse, Wendy Chaboyer, Jesse T Young, Stuart A Kinner, Julia Crilly Oam","doi":"10.1071/AH22229","DOIUrl":"https://doi.org/10.1071/AH22229","url":null,"abstract":"Objective This study aimed to identify factors associated with an emergency department (ED) length of stay ≥4 hours (h) and hospital admission for people with a mental health problem brought in by police. Methods We undertook a retrospective, observational cohort study of state-wide adult ED mental health presentations brought in by police from 1 January 2012 to 31 December 2017. We used multivariable logistic regression to determine factors associated with an ED length of stay ≥4 h and hospital admission. Results In total, 9325 ED presentations with a mental health problem brought in by police to Queensland EDs were included. Factors most strongly associated with an ED length of stay ≥4 h included an Australasian Triage Score (ATS) of 1, an age of 85 years or older, night shift arrival and subsequent hospital admission. For hospital admission, an ATS of 1, an age of 85 years or older and an ED length of stay ≥4 h were the strongest factors. Conclusion Findings indicate opportunities for targeted mental health models of care to better support people brought in by police to an ED. Such models should involve ED, pre-hospital providers (police and ambulance) and mental health services to support early intervention and potentially reduce the likelihood of a long ED length of stay and subsequent hospital admission.","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":"47 4","pages":"448-455"},"PeriodicalIF":1.8,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10287367","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}

引用次数: 1

Effects of the Child Dental Benefits Schedule on dental hospitalisation rates in Australian children. 儿童牙科福利计划对澳大利亚儿童牙科住院率的影响。

IF 1.8 4区医学

Australian Health Review Pub Date : 2023-06-01 DOI: 10.1071/AH22241

Parmis Aminian, Estie Kruger, Marc Tennant

{"title":"Effects of the Child Dental Benefits Schedule on dental hospitalisation rates in Australian children.","authors":"Parmis Aminian, Estie Kruger, Marc Tennant","doi":"10.1071/AH22241","DOIUrl":"https://doi.org/10.1071/AH22241","url":null,"abstract":"Objective The Child Dental Benefits Schedule (CDBS) was introduced in 2014, and its aim was to support access to dental care for eligible children in Australia. Dental caries, and pulp and periapical diseases were the major dental reasons for children's hospitalisations. This study investigated if the availability of the CDBS had any effects on hospitalisation rates in Australian children. Methods This study was a retrospective analysis of Medicare data from the Australian Government and the hospitalisation data from The Australian Institute of Health and Welfare (AIHW) from 2008 (6 years before the commencement of the CDBS) to 2020 (6 years after the commencement of the CDBS). Results Although the hospitalisation rate trend was reducing before the CDBS started (2008-14), this reduction was not statistically significant. The reduction of hospitalisation rates was higher after the commencement of the CDBS (2014-20) and was statistically significant, but the regression model analysis showed a positive correlation between the CDBS and hospitalisation rate. The analysis without 'abnormal' year data (2019-20, COVID-19 pandemic year) supported no statistically significant decrease in hospitalisation rate after the commencement of the CDBS in 2014 until 2019. Conclusion Although the CDBS is improving access to dental care for eligible children, any possible effects the CDBS might have on hospitalisations are not yet evident.","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":"47 3","pages":"307-313"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9574922","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}

引用次数: 0

Optimising rostering patterns for Australian junior doctors. 优化澳大利亚初级医生的名册模式。

IF 1.8 4区医学

Australian Health Review Pub Date : 2023-06-01 DOI: 10.1071/AH23030

Calvin M Fletcher, Laila L Rotstein

引用次数: 0

'I thought they would do it on the spot': why do people with non-traumatic musculoskeletal pain present to emergency departments? “我以为他们会当场做”:为什么非创伤性肌肉骨骼疼痛的人会出现在急诊室?

IF 1.8 4区医学

Australian Health Review Pub Date : 2023-06-01 DOI: 10.1071/AH22274

Grace French, Karen Richards, Robert Waller, Ivan Lin

{"title":"'I thought they would do it on the spot': why do people with non-traumatic musculoskeletal pain present to emergency departments?","authors":"Grace French, Karen Richards, Robert Waller, Ivan Lin","doi":"10.1071/AH22274","DOIUrl":"https://doi.org/10.1071/AH22274","url":null,"abstract":"Objective To investigate the reasons patients with non-traumatic musculoskeletal pain (NTMSP) present to an emergency department (ED), their experience of care and perceptions about managing their condition in the future. Methods A qualitative study using semi-structured interviews with patients with NTMSP presenting to a suburban ED. A purposive sampling strategy included participants with different pain characteristics, demographics and psychological factors. Results Eleven patients with NTMSP who presented to an ED were interviewed, reaching saturation of major themes. Seven reasons for ED presentation were identified: (1) desire for pain relief, (2) inability to access other healthcare, (3) expecting comprehensive care at the ED, (4) fear of serious pathology/outcome, (5) influence of a third party, (6) desire/expecting radiological imaging for diagnosis and (7) desire for 'ED specific' interventions. Participants were influenced by a unique combination of these reasons. Some expectations were underpinned by misconceptions about health services and care. While most participants were satisfied with their ED care, they would prefer to self-manage and seek care elsewhere in the future. Conclusions The reasons for ED presentation in patients with NTMSP are varied and often influenced by misconceptions about ED care. Most participants reported that, in future, they were satisfied to access care elsewhere. Clinicians should assess patient expectations so misconceptions about ED care can be addressed.","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":"47 3","pages":"274-281"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9926390","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}

引用次数: 0

Nurse job task analysis: a profile of medical and surgical nursing activities. 护士工作任务分析:内科和外科护理活动概况。

IF 1.8 4区医学

Australian Health Review Pub Date : 2023-06-01 DOI: 10.1071/AH22283

Julie Considine, Olumuyiwa Omonaiye, Jordana Schlieff, Leanne Boyd

{"title":"Nurse job task analysis: a profile of medical and surgical nursing activities.","authors":"Julie Considine, Olumuyiwa Omonaiye, Jordana Schlieff, Leanne Boyd","doi":"10.1071/AH22283","DOIUrl":"https://doi.org/10.1071/AH22283","url":null,"abstract":"Objective We aim to examine the activities undertaken by medical and surgical ward nurses at a major health service in Victoria, Australia, to inform nursing and midwifery strategic workforce planning. Methods This descriptive, exploratory study was conducted on 17 wards from three acute care hospitals in one of Victoria's largest health services. The Work Observation Method by Activity Timing tool was used to enable participants to document the time spent in each of 10 nursing activity domains. Results Data from 70 respondents across all shifts showed nurses spent one-third of their time in direct care. Registered nurses spent a lower proportion of time than enrolled nurses in direct care and medications overall. Compared with enrolled nurses, registered nurses spent less time in direct care on morning shifts and documentation on afternoon shifts, and more time on ward-related activities on afternoon shifts. Conclusions Medical and surgical enrolled nurses and registered nurses spent comparable proportions of time engaged in specific activities. Further research is required to understand the influences on the time devoted to direct care and how time spent in direct care intersects with other activities, and the relationship with patient outcomes and quality of care indicators.","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":"47 3","pages":"354-361"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9569822","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}

引用次数: 0

Response to Raymond et al. Health policy evaluation in rural and remote Australia: a qualitative exploration and lessons from the Northern Territory. 对Raymond等人的回应。澳大利亚农村和偏远地区的卫生政策评价:质量探索和来自北领地的经验教训。

IF 1.8 4区医学

Australian Health Review Pub Date : 2023-06-01 DOI: 10.1071/AH23105

Bryce Brickley, Oliver Black, Chris Rissel, Kalinda Griffiths Yawuru, James A Smith

引用次数: 0