Australia and New Zealand health policy最新文献

{"title":"Evaluating health policy capacity: Learning from international and Australian experience.","authors":"Deborah H Gleeson,&nbsp;David G Legge,&nbsp;Deirdre O'Neill","doi":"10.1186/1743-8462-6-3","DOIUrl":"https://doi.org/10.1186/1743-8462-6-3","url":null,"abstract":"<p><strong>Background: </strong>The health sector in Australia faces major challenges that include an ageing population, spiralling health care costs, continuing poor Aboriginal health, and emerging threats to public health. At the same time, the environment for policy-making is becoming increasingly complex. In this context, strong policy capacity - broadly understood as the capacity of government to make \"intelligent choices\" between policy options - is essential if governments and societies are to address the continuing and emerging problems effectively.</p><p><strong>Results: </strong>This paper explores the question: \"What are the factors that contribute to policy capacity in the health sector?\" In the absence of health sector-specific research on this topic, a review of Australian and international public sector policy capacity research was undertaken. Studies from the United Kingdom, Canada, New Zealand and Australia were analysed to identify common themes in the research findings. This paper discusses these policy capacity studies in relation to context, models and methods for policy capacity research, elements of policy capacity and recommendations for building capacity.</p><p><strong>Conclusion: </strong>Based on this analysis, the paper discusses the organisational and individual factors that are likely to contribute to health policy capacity, highlights the need for further research in the health sector and points to some of the conceptual and methodological issues that need to be taken into consideration in such research.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"6 ","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2009-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-6-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28008122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regulatory axes on food advertising to children on television.","authors":"Elizabeth Handsley,&nbsp;Kaye Mehta,&nbsp;John Coveney,&nbsp;Chris Nehmy","doi":"10.1186/1743-8462-6-1","DOIUrl":"https://doi.org/10.1186/1743-8462-6-1","url":null,"abstract":"<p><p> This article describes and evaluates some of the criteria on the basis of which food advertising to children on television could be regulated, including controls that revolve around the type of television programme, the type of product, the target audience and the time of day. Each of these criteria potentially functions as a conceptual device or \"axis\" around which regulation rotates. The article considers examples from a variety of jurisdictions around the world, including Sweden and Quebec. The article argues that restrictions centring on the time of day when a substantial proportion of children are expected to be watching television are likely to be the easiest for consumers to understand, and the most effective in limiting children's exposure to advertising.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"6 ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2009-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-6-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27937828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selecting interventions to promote fruit and vegetable consumption: from policy to action, a planning framework case study in Western Australia.","authors":"Christina M Pollard,&nbsp;Janette M Lewis,&nbsp;Colin W Binns","doi":"10.1186/1743-8462-5-27","DOIUrl":"https://doi.org/10.1186/1743-8462-5-27","url":null,"abstract":"<p><strong>Background: </strong>The Department of Health in Western Australia identified access to, and daily consumption of recommended amounts of fruit and vegetables, as priority health determinants. The numerous factors that influence supply and consumption of fruit and vegetables indicated that a comprehensive approach would be required.A government and non-government sector steering group was set up to select priority interventions using the National Public Health Partnership's Framework for Implementing Public Health Strategies. This structured framework was used for developing strategies to improve fruit and vegetable consumption and supply, and to identify implementation priorities.After one year a desktop audit of progress on framework interventions was undertaken.</p><p><strong>Results: </strong>The structured framework led to a plan for defined actions, partners, costs, and performance indicators for strategies to improve fruit and vegetable consumption and supply. Lead agency custodians for management of the selected interventions were identified.After one year there was significant progress in the implementation of a number of the high-ranking interventions. The exception was interventions that provide the infrastructure support such as research and development capacity, information systems.</p><p><strong>Conclusion: </strong>A structured framework and stakeholder participation assisted in developing a fruit and vegetable implementation strategy. Engagement and commitment of influential and diverse stakeholders is needed, not just for program support, but particularly in the areas of food and nutrition policy development and providing the infrastructure support required. Further work is required to develop performance outcomes and cost effectiveness measures for many of the strategies that have been proposed to address portfolio objectives.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"5 ","pages":"27"},"PeriodicalIF":0.0,"publicationDate":"2008-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-5-27","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27922705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using performance-based regulation to reduce childhood obesity.","authors":"Stephen D Sugarman,&nbsp;Nirit Sandman","doi":"10.1186/1743-8462-5-26","DOIUrl":"https://doi.org/10.1186/1743-8462-5-26","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, the public health community has recognized the growing problem of childhood obesity. But, unlike tobacco control policy, there is little evidence about what public policies would work to substantially reduce childhood obesity. Public health leaders currently tend to support traditional \"command and control\" schemes that order private enterprises and governments to stop or start doing specific things that, is it hoped, will yield lower childhood obesity rates. These include measures such as 1) taking sweetened beverages out of schools, 2) posting calorie counts on fast-food menu boards, 3) labeling foods with a \"red light\" if they contain high levels of fat or sugar, 4) limiting the density of fast food restaurants in any neighborhood, 5) requiring chain restaurants to offer \"healthy\" alternatives, and 6) eliminating junk food ads on television shows aimed at children. Some advocates propose other regulatory interventions such as 1) influencing the relative prices of healthy and unhealthy foods through taxes and/or subsidies and 2) suing private industry for money damages as a way of blaming childhood obesity on certain practices of the food industry (such as its marketing, product composition, or portion size decisions). The food industry generally seeks to deflect blame for childhood obesity onto others, such as parents and schools.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"5 ","pages":"26"},"PeriodicalIF":0.0,"publicationDate":"2008-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-5-26","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27845345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing the options for reducing adverse events: Results from a modified Delphi technique.","authors":"Jeff Richardson,&nbsp;John McKie","doi":"10.1186/1743-8462-5-25","DOIUrl":"https://doi.org/10.1186/1743-8462-5-25","url":null,"abstract":"<p><strong>Background: </strong>The aim of this paper is to illustrate a simple method for increasing the range of possible options for reducing adverse events in Australian hospitals, which could have been, but was not, adopted in the wake of the landmark 1995 'Quality in Australian Health Care' study, and to report the suggestions and the estimated lapse time before they would impact upon mortality and morbidity.</p><p><strong>Method: </strong>The study used a modified Delphi technique that first elicited options for reducing adverse events from an invited panel selected on the basis of their knowledge of the area of adverse events and quality assurance. Initial suggestions were collated and returned to them for re-consideration and comment.</p><p><strong>Results: </strong>Completed responses from both stages were obtained from 20 of those initially approached. Forty-one options for reducing AEs were identified with an average lapse time of 3.5 years. Hospital regulation had the least delay (2.4 years) and out of hospital information the greatest (6.4 years).</p><p><strong>Conclusion: </strong>Following identification of the magnitude of the problem of adverse events in the 'Quality in Australian Health Care' study a more rapid and broad ranging response was possible than occurred. Apparently viable options for reducing adverse events and associated mortality and morbidity remain unexploited.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"5 ","pages":"25"},"PeriodicalIF":0.0,"publicationDate":"2008-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-5-25","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27843110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reforming primary health care: is New Zealand's primary health care strategy achieving its early goals?","authors":"Jacqueline Cumming,&nbsp;Nicholas Mays,&nbsp;Barry Gribben","doi":"10.1186/1743-8462-5-24","DOIUrl":"https://doi.org/10.1186/1743-8462-5-24","url":null,"abstract":"<p><strong>Background: </strong>In 2001, the New Zealand government introduced its Primary Health Care Strategy (PHCS), aimed at strengthening the role of primary health care, in order to improve health and to reduce inequalities in health. As part of the Strategy, new funding was provided to reduce the fees that patients pay when they use primary health care services in New Zealand, to improve access to services and to increase service use. In this article, we estimate the impact of the new funding on general practitioner and practice nurse visit fees paid by patients and on consultation rates. The analyses involved before-and-after monitoring of fees and consultation rates in a random sample of 99 general practices and covered the period from June 2001 (pre-Strategy) to mid-2005.</p><p><strong>Results: </strong>Fees fell particularly in Access (higher need, higher per capita funded) practices over time for doctor and nurse visits. Fees increased over time for many in Interim (lower need, lower per capita funded) practices, but they fell for patients aged 65 years and over as new funding was provided for this age group. There were increases in consultation rates across almost all age, funding model (Access or Interim), socio-demographic and ethnic groups. Increases were particularly high in Access practices.</p><p><strong>Conclusion: </strong>The Strategy has resulted in lower fees for primary health care for many New Zealanders, and consultation rates have also increased over the past few years. However, fees have not fallen by as much as expected in government policy given the amount of extra public money spent since there are limited requirements for practices to reduce patients' fees in line with increases in public funding for primary care.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"5 ","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2008-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-5-24","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27824548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"By invitation only - the case for breast cancer screening reminders for women over 69 years.","authors":"Carla Saunders, Monica Robotin, Sally Crossing","doi":"10.1186/1743-8462-5-23","DOIUrl":"10.1186/1743-8462-5-23","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is the leading cause of cancer death in women in Australia. Early detection provides the best chance of reducing mortality and morbidity from the disease. Mammographic screening is a population health strategy for the early detection of breast cancer in Australia. Recruitment strategies such as regular advertising and biannual screening invitations are exclusively targeted at women aged 50 - 69 years. Even though they can participate, women 70 years or over are not invited or actively encouraged to undertake screening. Research has found that a routine letter of invitation increases the number of women participating in breast cancer screening.</p><p><strong>Methods: </strong>Cancer data analysis and a literature and policy review was conducted to assess age specific breast cancer mortality rates and the legitimacy of rationale used to limit invitations for breast cancer screening to women younger than 70 years.</p><p><strong>Results: </strong>The proportion of women over 69 years participating in the BreastScreen program is significantly less than rate of screening in the target age range (50-69 years). Evidence and data indicate that common justifications for limiting screening reminders to the target age range including life expectancy, comorbidities, effectiveness, treatment and cost are, for many women, unreasonable.</p><p><strong>Conclusion: </strong>There is now sufficient data to support a change in the targeted upper age range for breast cancer screening to improve the existing suboptimal surveillance in women aged over 69 years.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"5 ","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"2008-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2612671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27825282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of law in the control of obesity in England: looking at the contribution of law to a healthy food culture.","authors":"Robyn Martin","doi":"10.1186/1743-8462-5-21","DOIUrl":"10.1186/1743-8462-5-21","url":null,"abstract":"<p><p> Obesity levels in England are significantly higher than in much of the rest of Europe. This article examines aspects of the physical and cultural context of food consumption in England, and the evolution of government policy on obesity, as a background to an analysis of how law might play a role in obesity prevention. Research suggests that individual food choices are associated with cultural and socio-economic circumstances and that they can be manipulated by advertising, food packaging and presentation. This suggests that there might be ways of using law to manage the influences on food choices, and of using law in support of strategies to redirect food choices towards healthy food products. Law is a particularly useful tool in the protection of the individual against the economic power of the food industry, and there is much that law can do to change the physical, economic and social environment of food consumption.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"5 ","pages":"21"},"PeriodicalIF":0.0,"publicationDate":"2008-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2615029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27727221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"I don't think general practice should be the front line: Experiences of general practitioners working with refugees in South Australia.","authors":"David R Johnson,&nbsp;Anna M Ziersch,&nbsp;Teresa Burgess","doi":"10.1186/1743-8462-5-20","DOIUrl":"https://doi.org/10.1186/1743-8462-5-20","url":null,"abstract":"<p><strong>Introduction: </strong>Many refugees arrive in Australia with complex health needs. In South Australia (SA), providing initial health care to refugees is the responsibility of General Practitioners (GPs) in private practice. Their capacity to perform this work effectively for current newly arrived refugees is uncertain. The aim of this study was to document the challenges faced by GPs in private practice in SA when providing initial care to refugees and to discuss the implications of this for policy relating to optimising health care services for refugees.</p><p><strong>Methods: </strong>Semi-structured interviews with twelve GPs in private practice and three Medical Directors of Divisions of General Practice. Using a template analysis approach the interviews were coded and analysed thematically.</p><p><strong>Results: </strong>Multiple challenges providing care to refugees were found including those related to: (1) refugee health issues; (2) the GP-refugee interaction; and (3) the structure of general practice. The Divisions also reported challenges assisting GPs to provide effective care related to a lack of funding and awareness of which GPs required support. Although respondents suggested a number of ways that GPs could be assisted to provide better initial care to refugees, strong support was voiced for the initial care of refugees to be provided via a specialist refugee health service.</p><p><strong>Conclusion: </strong>GPs in this study were under-resourced, at both an individual GP level as well as a structural level, to provide effective initial care for refugees. In SA, there are likely to be a number of challenges attempting to increase the capacity of GPs in private practice to provide initial care. An alternative model is for refugees with multiple and complex health care needs as well as those with significant resettlement challenges to receive initial health care via the existing specialist refugee health service in Adelaide.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"5 ","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2008-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-5-20","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27583881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a crisis in nursing retention in New South Wales?","authors":"Denise Doiron,&nbsp;Jane Hall,&nbsp;Glenn Jones","doi":"10.1186/1743-8462-5-19","DOIUrl":"https://doi.org/10.1186/1743-8462-5-19","url":null,"abstract":"<p><strong>Background: </strong>There is a severe shortage of nurses in Australia. Policy makers and researchers are especially concerned that retention levels of nurses in the health workforce have worsened over the last decade. There are also concerns that rapidly growing private sector hospitals are attracting qualified nurses away from the public sector. To date no systematic analysis of trends in nursing retention rates over time has been conducted due to the lack of consistent panel data.</p><p><strong>Results: </strong>A 1.4 percentage point improvement in retention has led to a 10% increase in the overall supply of nurses in NSW. There has also been a substantial aging of the workforce, due to greater retention and an increase in mature age entrants. The improvement in retention is found in all types of premises and is largest in nursing homes. There is a substantial amount of year to year movement in and out of the workforce and across premises. The shortage of nurses in public hospitals is due to a slowdown in entry rather than competition from the rapidly growing private sector hospitals.</p><p><strong>Policy implications: </strong>The finding of an improvement (rather than a worsening) in retention suggests that additional improvements may be difficult to achieve as further retention must involve individuals more and more dissatisfied with nursing relative to other opportunities. Hence policies targeting entry such as increased places in nursing programs and additional subsidies for training costs may be more effective in dealing with the workforce shortage. This is also the case for shortages in public sector hospitals as retention in nursing is found to be relatively high in this sector. However, the large amount of year to year movements across nursing jobs, especially among the younger nurses, also suggests that policies aimed at reducing job switches and increasing the number who return to nursing should also be pursued. More research is needed in understanding the relative importance of detailed working conditions and the problems associated with combining family responsibilities and nursing jobs.</p>","PeriodicalId":87170,"journal":{"name":"Australia and New Zealand health policy","volume":"5 ","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2008-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1743-8462-5-19","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27579698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}