Australian health review : a publication of the Australian Hospital Association最新文献

Advance care planning: empowering older frail people to document their end of life wishes.

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-04-09 DOI: 10.1071/AH25060

Peter Gonski, Melissa Chan, Ken Hillman

{"title":"Advance care planning: empowering older frail people to document their end of life wishes.","authors":"Peter Gonski, Melissa Chan, Ken Hillman","doi":"10.1071/AH25060","DOIUrl":"https://doi.org/10.1071/AH25060","url":null,"abstract":"ObjectiveTo determine the features that are required to increase uptake of advance care directives (ACDs).MethodsWe conducted a study involving older patients attending aged care outpatient clinics and/or receiving outreach services between March 2021 and December 2022. Patients were assessed using tools related to frailty, end of life and empowerment. If the person agreed to complete an ACD, they were guided through it, and it was subsequently uploaded on the electronic medical record.ResultsOf 170 patients referred to complete an ACD, 47% completed it. These patients had lower Rockwood Clinical Frailty Scale and SPICT (Supportive and Palliative Care Indicators Tool) scores. The Frailty and SPICT tools were easier to use, the PAM (Patient Activation Measure) was difficult to use and assess. Patients did, however, show satisfaction in the process.ConclusionsPatients completing an ACD tended to be a little less frail and less likely to die in the following 12months. Increased uptake of ACD is more likely if the less frail are targeted, and assisted through the process by a health professional at a time and place that suits the person.","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A 'True North Statement for Care': charting the course to better care for all Australians.

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-04-09 DOI: 10.1071/AH25063

Rebecca K Golley, Georgia Middleton, Michael T Lawless, Lucy Anastasi, Alison L Kitson, Raymond J Chan

{"title":"A 'True North Statement for Care': charting the course to better care for all Australians.","authors":"Rebecca K Golley, Georgia Middleton, Michael T Lawless, Lucy Anastasi, Alison L Kitson, Raymond J Chan","doi":"10.1071/AH25063","DOIUrl":"https://doi.org/10.1071/AH25063","url":null,"abstract":"ObjectiveTo shift the narrative from 'deficit dialogues' in health and social care in Australia, we aimed to generate a series of consensus 'ambition' statements representing what peak care stakeholders in Australia want health and social care to look like in the future.MethodsA multiphase co-design study with Australian 'care' stakeholders was undertaken. This consisted of a desk-based audit of Australian health and social care organisations (n=9) and a pre-forum survey (n=21 responses) (activity 1), the findings of which informed the national forum activities (activity 2, n=31 organisations), which became the content for the Delphi survey (activity 3, n=28 organisations).ResultsThrough this process we distilled five ambition statements and 39 descriptors. These statements are our True North Statement for Better Care, providing a starting point to guide individual, organisation and system redesign across the life span. The statements require action at individual consumer, workforce and system level.ConclusionsCreating the True North Statement for Better Care provides a united direction for heterogeneous groups to work together to improve care for consumers, their workforce and the systems they work in. This is an important initiative to change the way we value, talk about, do, own and research care. Further user testing is required to ensure the statements can be translated into action.","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Accuracy of medication allergy documentation in My Health Record after severe adverse drug reactions.

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-04-09 DOI: 10.1071/AH25005

Juliana Yang, William Lay, Linda V Graudins, Melissa Walker, Celia Zubrinich, Ar Kar Aung

{"title":"Accuracy of medication allergy documentation in My Health Record after severe adverse drug reactions.","authors":"Juliana Yang, William Lay, Linda V Graudins, Melissa Walker, Celia Zubrinich, Ar Kar Aung","doi":"10.1071/AH25005","DOIUrl":"https://doi.org/10.1071/AH25005","url":null,"abstract":"BackgroundInaccurate or incomplete documentation of severe medication allergies, such as anaphylaxis and severe cutaneous adverse drug reactions (SCAR), may lead to harm from inadvertent re-exposure to implicated medications. My Health Record (MHR) is a national patient-controlled electronic health record in Australia linking hospital, general practitioner and community pharmacy records. The medication allergy/adverse reaction section should contain accurate information to aid prescribing.ObjectiveTo investigate the accuracy of documentation in MHR of confirmed medication-related anaphylaxis and SCAR and to determine barriers and facilitators to documentation.MethodsA retrospective cohort study of patients with medication-related anaphylaxis and SCAR, validated between January 2019 and June 2023. Medication allergy documentation in MHR was reviewed after patient consent to determine accuracy with medication and reaction type, against the assessment made by the hospital Adverse Drug Reaction Review Committee and/or allergy clinic consultation.ResultsForty-eight patients with anaphylaxis and 40 patients with SCAR (total 88) were included, involving 134 medications. Fourteen (15.9%) patients had their reactions documented accurately in MHR. When analysed per medication, 21 medications (15.7%) were documented accurately. Anaphylaxis, allergy clinic follow-up and life-threatening severity were factors significantly associated with a higher frequency of accurate allergy documentation in the MHR.ConclusionThe accuracy of medication allergy documentation for severe allergies in the MHR is low, representing a risk of harm from inadvertent re-exposure. This study identifies several system level issues and makes recommendations to improve patient safety.","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sociodemographic and clinical factors affecting advance care planning: results from a large community cohort in New South Wales, Australia.

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-04-08 DOI: 10.1071/AH24327

E Yang, A Kabir, J Rhee, C O'Callaghan, M Barr

{"title":"Sociodemographic and clinical factors affecting advance care planning: results from a large community cohort in New South Wales, Australia.","authors":"E Yang, A Kabir, J Rhee, C O'Callaghan, M Barr","doi":"10.1071/AH24327","DOIUrl":"https://doi.org/10.1071/AH24327","url":null,"abstract":"ObjectivesThe ageing population and increasing chronic illness pose significant healthcare challenges, including care late in life. Advance care planning (ACP) is an ongoing process of making decisions regarding future health care for patients. This process can include formal completion of an advance care directive (ACD), which is a legally binding document. ACP can improve patient outcomes and satisfaction, but rates are low across Australia. This study assessed the sociodemographic and clinical predictors of individuals engaging with ACP and ACDs using data from the 45 and Up Study cohort in New South Wales.MethodsA cross-sectional cohort study of 28,626 people responded to ACP-related questions in the wave 2 questionnaire of the Sax Institute's 45 and Up Study. ACP completion was recorded if people responded 'yes' to any of the three ACP questions, and ACD was recorded if they responded 'yes' to the ACD question. Poisson regression modelling was used to estimate the prevalence ratio and the 95%CI.ResultsA total of 28,626 people completed the ACP- and/or ACD-related questions, of whom 17,458 (61%) completed ACP and 3744 (13.1%) completed ACD. The predictors associated with an increased likelihood of ACP and ACD completion included having a will, advancing age, being female, having private health insurance, not currently working, and having one or more self-reported medical conditions. Predictors unique to increased overall ACP completion included having a university degree or higher, being married and having a health care concession card (Health Care Card). Being a carer increased ACD rates, whereas being married or in a de facto relationship decreased ACD completion.ConclusionsThese findings could inform interventions aimed at improving ACP uptake by identifying groups that engage less in ACP and provide a basis for future research.","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Monitoring cross-setting care and outcomes among older people in aged care: a national framework is needed.

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-04-01 DOI: 10.1071/AH24294

Maria C Inacio, Olivia Ryan, Leonard C Gray, Gillian E Caughey, On Behalf Of The Acac-Qmet Research Collaborators

{"title":"Monitoring cross-setting care and outcomes among older people in aged care: a national framework is needed.","authors":"Maria C Inacio, Olivia Ryan, Leonard C Gray, Gillian E Caughey, On Behalf Of The Acac-Qmet Research Collaborators","doi":"10.1071/AH24294","DOIUrl":"10.1071/AH24294","url":null,"abstract":"Establishing an evidence-based framework to monitor and evaluate quality and safety of care for older people is critical. Despite progress in health system performance monitoring in Australia, slower progress has occurred for the older population accessing aged care services. With an aging population and increasing demands on aged care and healthcare systems, there is growing recognition of the need for more coordinated and integrated care across settings. It is not uncommon for older people accessing aged care to require a range of services administered by different organisations simultaneously (e.g. primary care, home care) and sequentially (e.g. hospitals, residential care). Aged care also represents an increasingly regulated sector, with significant investment in and growing recognition of the value of quality measurement. Accountability for care quality and safety is often shared among providers, with consequent challenges in attributing responsibility. Therefore, the development of a pragmatic national framework to support high-quality, person-centred care for the older population accessing aged care services across care settings is one opportunity for shared responsibility, care monitoring, and quality improvement activities that could lead to better outcomes for this population. The strategy for framework development proposed in this perspective has implications for aged care and healthcare providers, consumers, policy makers, regulators, and academics. Once implemented, this framework has the potential to drive consistent high-quality care to improve health outcomes and wellbeing among older people accessing aged care services.","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":"49 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The trend of once-off versus follow-up Medicare-reimbursed psychiatric consultations and increased telehealth availability: an interrupted time series analysis.

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-04-01 DOI: 10.1071/AH25011

Luke Sy-Cherng Woon, Tarun Bastiampillai, Jeffrey C L Looi

{"title":"The trend of once-off versus follow-up Medicare-reimbursed psychiatric consultations and increased telehealth availability: an interrupted time series analysis.","authors":"Luke Sy-Cherng Woon, Tarun Bastiampillai, Jeffrey C L Looi","doi":"10.1071/AH25011","DOIUrl":"10.1071/AH25011","url":null,"abstract":"Objective The Australian Medicare Benefits Schedule (MBS) telehealth items were expanded in March 2020 and consolidated in January 2022. We aim to describe the trend of the ratio of MBS psychiatric video items for once-off assessments to follow-up sessions and examine the effect of telehealth consolidation. Methods Psychiatric once-off item to follow-up item ratios in face-to-face (F2F) and video modes were computed from state and territory-level monthly Medicare data (January 2016-December 2023). We performed a multilevel interrupted times series analysis (ITSA) of once-off video consultations with telehealth consolidation as the intervention, followed by subgroup analyses by age groups. Finally, in the young adult group (25-44years), we performed a multiple-group ITSA comparing video once-off to follow-up ratios between genders. Results The once-off to follow-up ratio for video items after telehealth consolidation greatly increased compared with F2F items, with rapid growth in once-off assessments. Sustained high video once-off assessment usage occurred in the youth (15-24years) and young adult (25-44years) groups, while other age groups showed declines following the initial rise. The male group showed a greater initial increase in the video once-off to follow-up ratio among young adults but the ratio continued to rise only in the female group. Conclusions The evolving trends of reimbursed telepsychiatry consultations require further examination given their potential implications concerning service quality, health equity, health attitudes and behaviours, and healthcare costs.","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Value-based health care definition and characteristics: an evidence-based approach. 以价值为基础的医疗保健定义和特点：循证方法。

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-03-01 DOI: 10.1071/AH24279

H Khalil, M Ameen, C Davies, R Arunkumar, C Liu

{"title":"Value-based health care definition and characteristics: an evidence-based approach.","authors":"H Khalil, M Ameen, C Davies, R Arunkumar, C Liu","doi":"10.1071/AH24279","DOIUrl":"10.1071/AH24279","url":null,"abstract":"Objective The aim of this study was to develop a concise, accessible definition of value-based health care (VBHC) and identify its main characteristics through a comprehensive analysis of existing literature. Methods A scoping review methodology was employed to map definitions and characteristics of VBHC from nine databases, including JBI EBP Database, Cochrane Reviews, Embase, Ovid MEDLINE(R), APA PsycINFO, and others, from inception until November 2023. The scoping review aimed to clarify existing concepts and identify gaps in VBHC definitions and frameworks across various geographical contexts. Additionally, qualitative data on VBHC were analysed from the included studies using a word cloud generated via an online tool and a word frequency table generated from Excel. This dual analysis informed the creation of a simplified, data-driven definition of VBHC along with its key characteristics. Results The word frequency analysis highlighted common themes, including 'care,' 'outcomes,' 'quality,' 'efficiency,' and 'cost.' Based on these frequently mentioned terms, a simplified definition of VBHC was formulated, focusing on patient-centred care that aims to improve health outcomes relative to costs. Comparisons with existing literature revealed that while the derived definition is more accessible and concise, it lacks the depth of the academic definitions, which emphasise strategic implementation, interdisciplinary collaboration, and nuanced measurement of outcomes. Conclusion This study provides a simplified, data-driven definition of VBHC that can facilitate understanding and implementation among practitioners and stakeholders. Integrating this accessible definition can bridge the gap between theory and practice, ultimately supporting better health outcomes and system sustainability.","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cardiac arrest in Australia: a call to action. 澳大利亚的心脏骤停：行动呼吁。

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-03-01 DOI: 10.1071/AH25034

Elizabeth D Paratz, Garry Jennings, Susan Timbs, Janet E Bray, Jodie Ingles, Greg Page, Jamie Vandenberg, Andre La Gerche

引用次数: 0

Beyond social determinants of health.

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-03-01 DOI: 10.1071/AH25014

Alicia E Veasey

引用次数: 0

Exploring the unique value of clinician scientist roles to the health services in which they are employed: a scoping review. 探索临床科学家角色对其所在医疗服务机构的独特价值：范围界定综述。

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-03-01 DOI: 10.1071/AH24231

Peter Buttrum, Prudence Butler, Adrienne Young, Diann Eley, Shaun O'Leary

{"title":"Exploring the unique value of clinician scientist roles to the health services in which they are employed: a scoping review.","authors":"Peter Buttrum, Prudence Butler, Adrienne Young, Diann Eley, Shaun O'Leary","doi":"10.1071/AH24231","DOIUrl":"10.1071/AH24231","url":null,"abstract":"Objective This scoping review explored the unique value or impacts of clinician scientists (CSs) to the health services in which they work and metrics used to identify and measure this value. Methods Five databases, grey literature, and the internet were searched in April 2024 to identify articles that described and measured the value or impact of CSs within clinical health services. CSs were defined as having dual clinical and research qualifications and work duties. Articles were screened at title, abstract, and full text level against inclusion and exclusion criteria, before extracting data and analysing the included articles. Results The search identified 5368 articles, with six eligible for inclusion. Articles were qualitative in nature (structured interviews or multiple case study reports) and had relatively few participants. The reported value or impacts included educating colleagues on research skills and processes, promoting evidence-based practice, fostering inter-institutional collaboration, and conducting clinically relevant research. No articles recommended a detailed suite of metrics as to how this value or impact could be measured. Conclusions There is limited literature describing the unique value or impact of CSs to the health services in which they work. While some articles described aspects of CS value, no articles provided metrics for how specific CS value could be measured.","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0