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

{"title":"Funding of digital health care for the management of chronic conditions in Australia.","authors":"Amandine Barnett, Jaimon T Kelly, Paul Scuffham","doi":"10.1071/AH24310","DOIUrl":"https://doi.org/10.1071/AH24310","url":null,"abstract":"<p><p>Digitally delivered health care, such as telehealth, mobile apps and remote monitoring via apps or devices, can result in improved outcomes for chronic conditions. However, Australia is struggling to maximise the potential of digital health for chronic conditions, due in part to funding arrangements that lack incentives for providers and end users. The aim of this article is to examine the current landscape of digital health funding for chronic conditions and considers potential funding arrangements for the future. Current funding arrangements for digital health in Australia lack sufficient incentives for both providers and end users, limiting the reach and effectiveness of digital health for managing chronic conditions. Alternative funding approaches, such as value-based models, are used internationally which include funding avenues for mobile apps and remote patient monitoring via apps or devices as well as for those operating digital health services. The development of sustainable value-based funding mechanisms that support stakeholder involvement and national adoption are recommended. For Australia to fully leverage the benefits of digital health in managing chronic conditions, funding reforms are one critical area to assist with the implementation of patient-centred and outcome-driven funding models. Effective and sustainable funding structures are essential to ensure long-term benefits of digital health for chronic disease management. Further research will be essential to identify effective funding avenues for digital health services, including mobile apps and remote patient monitoring.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384366","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}

{"title":"Mandatory and statutory compliance screening for undergraduate nursing students in Australia: a review of compliance requirements.","authors":"Alycia Jacob, Paula Ince, Carolyn Ross, Susan Hua, Bill Swannie, Lara Demetrios, Darren Falconer","doi":"10.1071/AH24235","DOIUrl":"https://doi.org/10.1071/AH24235","url":null,"abstract":"<p><p>ObjectiveStatutory checking requirements for nursing students vary across Australian states and territories. In Australia, predictions of a shortfall of 123,000 full-time equivalent nurses will occur by 2030, emphasising the necessity for standardised policies that enhance processes and address inconsistencies to ensure a qualified and accessible nursing workforce. The objective of this study was to understand the requirements for nursing students' statutory checking across Australian jurisdictions.MethodsThe study investigated compliance requirements through in-depth pragmatic case study analysis utilising publicly available data from official government sources.ResultsThe study found that nursing students in Australia are mandated by the federal government to undergo statutory checks that are regulated by state and territory laws. All have similarities while varying in cost, processes, and timeframes. Costs varied widely between A$19.90 and A$254 over the course of a 3-year degree.ConclusionThis study highlights the inconsistencies regarding nursing students' statutory checking requirements in different jurisdictions in Australia. Various financial and logistical challenges negatively impact nursing students as they prepare for clinical placements. Further examination and potential reforms in healthcare policy to facilitate a smoother transition for nurses entering health care are required.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384377","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}

{"title":"Trends in retention and attrition in nine regulated health professions in Australia.","authors":"Jade Tan, Rechu Divakar, Lee Barclay, Sunita Bayyavarapu Bapuji, Sarah Anderson, Eva Saar","doi":"10.1071/AH24268","DOIUrl":"https://doi.org/10.1071/AH24268","url":null,"abstract":"<p><p>ObjectiveTo identify factors associated with the retention and attrition of regulated health practitioners in Australia across nine health professions.MethodsAn online survey of practitioners and an analysis of 10years of Australian Health Practitioner Regulation Agency (Ahpra) registration data were carried out.ResultsAmong surveyed health practitioners, 20,449 (79.4%) intended to stay, 1368 (5.3%) intended to leave, and 1759 (6.8%) were unsure. Most intending to leave planned to do so immediately or within 1-year (72.8%). Top reasons for leaving included mental burnout (32.9%), retirement (30.5%), feeling undervalued/unrecognised (28.5%), lack of professional satisfaction (27.9%), and work no longer being fulfilling (25.1%). Men, older practitioners, those working fewer than 20h per week, and non-self-employed practitioners were more likely to consider not renewing or to be unsure. Analysis of Ahpra registration data from 2014 to 2023 showed that the number of registered practitioners per 100,000 population increased by 29.6%, but the replacement rate showed notable fluctuations over the observed period. Females consistently exhibited higher replacement rates compared to males, with exits from the workforce highest in those aged under 35 pre-2020 and highest in those aged 35-60 post-2020.ConclusionsAlthough the overall number of health practitioners increased from 2014 to 2023, replacement rates have been fluctuating, highlighting concerns about workforce stability, particularly among males, older practitioners, those working fewer or greater than full-time hours, and non-self-employed practitioners. Addressing intrinsic and workplace factors such as mental burnout, lack of recognition, and job satisfaction may improve retention.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384380","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}

{"title":"Consumer involvement; the system says 'No.'","authors":"Kylie Hill, Sarah Hug, Vinicius Cavalheri, Ben Horgan","doi":"10.1071/AH24207","DOIUrl":"https://doi.org/10.1071/AH24207","url":null,"abstract":"<p><p>The importance of authentic consumer engagement to shape decisions in health care is now well recognised. Both the National Health and Medical Research Council and Cancer Council conceptualise consumer involvement as a process that requires consumer capability and organisational capacity and emphasise that organisations should commit to acting on outcomes that have involved consumers. In this perspective piece, we share our experience of working with consumers to develop strategies that aimed to optimise referrals to an evidence-based and cost-effective intervention; a pulmonary rehabilitation program. Although we were successful at implementing some of the co-design strategies and were able to demonstrate an increase in referrals, we were surprised that many of the strategies, which were seemingly simple, could not be implemented due to bureaucratic barriers. Based on our experience, given their ability to navigate bureaucratic barriers within the system, future health researchers should consider actively recruiting senior hospital staff to be part of the co-design process from project inception.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124153","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}

{"title":"Lived Experience Advisor Program initiative: harnessing consumer leadership for best care.","authors":"Rebecca Barbara, Jodie Lydeker, Alex Potter, Debra Kerr","doi":"10.1071/AH24311","DOIUrl":"10.1071/AH24311","url":null,"abstract":"<p><p>The Lived Experience Advisor Program (LEAP), introduced at Western Health in January 2023, is an innovative approach to consumer engagement in mainstream health care, integrating lived experience perspectives into organisational decision-making, research, and quality improvement. As health care has increasingly embraced consumer involvement at both direct care and governance levels, the LEAP was implemented to expand the role of health consumers beyond traditional volunteer positions, recognising lived experience as a valuable form of expertise. Through employment of Lived Experience Advisors (LEAs) across a range of clinical and operational projects, this program has enhanced service planning and health literacy for diverse communities. This case study details the development, implementation, and outcomes of the LEAP, focusing on how LEAs have contributed to areas such as youth health services, carer support, emergency care, and consumer engagement strategies. With support from a Community of Practice, LEAs receive ongoing mentorship and training, fostering skill development and promoting sustainable career pathways. The program has also driven shifts in staff perspectives, supporting a patient-centred culture where consumer voices are prioritised. Challenges in program funding, role clarity, and matching lived experience to project needs, underscore the need for thoughtful recruitment, executive sponsorship, and adaptable role design. The impact of the LEAP has extended beyond individual projects, influencing organisational culture, and enhancing staff capabilities in consumer partnership. The case study offers practical insights for other healthcare organisations aiming to integrate lived experience roles, emphasising the potential for consumer-led initiatives to drive transformative change in healthcare delivery and policy.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082414","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}

{"title":"Mapping essential oral healthcare for the Australian context.","authors":"Tan Minh Nguyen, Clare Lin, Martin Hall, Hanny Calache","doi":"10.1071/AH24298","DOIUrl":"10.1071/AH24298","url":null,"abstract":"<p><p>Australia's universal healthcare scheme, Medicare, has largely excluded oral healthcare resulting in inequitable access to affordable, essential oral healthcare. To achieve inclusion of oral health within Australia's universal healthcare scheme, it is necessary to identify and define the dental services that constitute essential oral healthcare. This perspective paper explores how essential oral healthcare should be considered for the Australian context and to align with the World Health Organization's approach to universal health coverage that includes oral health.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973768","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}

{"title":"Value-based health care for Aboriginal peoples with chronic conditions in the Northern Territory: a cohort study.","authors":"Maya Cherian, Yuejen Zhao, Antonio Ahumada-Canale, Peter Nihill, Maja VanBruggen, Deborah Butler, Paul Burgess","doi":"10.1071/AH24241","DOIUrl":"10.1071/AH24241","url":null,"abstract":"<p><p>Objective This study aimed to investigate associations between patient activation, healthcare use and clinical outcomes for Aboriginal peoples living with a chronic condition in remote Northern Territory (NT) communities. Methods A retrospective cohort study was undertaken between 2 April 2020 and 1 April 2022 to measure activation and its associations with chronic conditions secondary prevention treatment targets and healthcare usage: hospitalisations, potentially preventable hospitalisations and patient travel. All Aboriginal peoples enrolled at NT Government health services, who had one or more preventable chronic conditions and were prescribed one or more oral chronic condition medications identified in the Primary Care Information System, were included in the study. Patient activation was defined as a 90-day medicine possession ratio ≥80%. An activated patient has the belief, knowledge, skills and behaviours to manage their chronic conditions. Results A total of 5356 patients met the inclusion criteria; 9% of these patients were activated. Activated patients were older and sicker but were significantly more likely to achieve treatment targets for glycosylated haemoglobin, blood pressure and total and low-density lipoprotein cholesterol. Activated patients used more primary healthcare and outpatient resources and had a non-significant trend for less acute care use. Conclusions The remote NT Government primary healthcare system is providing low-value chronic conditions care for patients. As identified by Aboriginal peoples, strengthening culturally appropriate self-management support could lead to more patients becoming activated, better health outcomes and decreased acute care demand.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973771","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}

{"title":"The impact of COVID-19 on public and private emergency departments in Queensland, Australia.","authors":"Amy L Sweeny, Emma Hall, Anthony Padowitz, Ben Walters, Ping Zhang, Kylie Alcorn, Gerben Keijzers, Andrea P Marshall, Jamie Ranse, Julia Crilly","doi":"10.1071/AH24182","DOIUrl":"10.1071/AH24182","url":null,"abstract":"<p><p>Objective COVID-19 affected health care globally. The aim of this study was to investigate the impact of COVID-19 on both public and private emergency departments (EDs). Methods This was a retrospective cohort study of ED presentations made to three private and two public hospital EDs located in one region in Queensland. Presentation rates per 1000 population and incident rate ratios (IRR) for three time periods: T1: pre-pandemic (March-June 2018/2019), T2: initial restrictions (March-June 2020), and T3: restrictions easing (March-June 2021) were calculated. Linear trends were produced to describe pre- and post-pandemic changes. Additional outcomes reported for public EDs included ED length of stay (LoS) and cost. Results In T2, both public and private ED presentation rates decreased by 12% (overall IRR 0.88; 95% confidence interval (CI): 0.87-0.89). Private EDs experienced a quicker and greater return of patient volumes in T3, exceeding T1 levels. The median ED length of stay decreased and then increased above pre-pandemic levels (T1: 159 min, T2: 151 min, T3: 201 min). Total costs were higher during T2 but then decreased during T3, below that of T1 (T1: A$652, T2: A$791, T3: A$566). Between February 2020 and June 2021, 269 people tested positive for SARS-CoV-2, 19 of whom (7.1%) interfaced with the ED. Conclusions During initial COVID-19 restrictions, a shift towards fewer ED presentations was observed. Private ED presentations rebounded more quickly than public. Few COVID-19 patients interfaced with an ED. Systems and public-private agreements made during this time appeared to protect EDs and soften the impact of reduced volumes for the private sector.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054482","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}

{"title":"Oral health services provided for Aboriginal and Torres Strait Islander peoples in Australia: a scoping review.","authors":"Lisa Hai My Do, Yvonne Dimitropoulos, John Skinner, Woosung Sohn","doi":"10.1071/AH24281","DOIUrl":"10.1071/AH24281","url":null,"abstract":"<p><p>Objective The shortage of oral health professionals in rural and remote regions of Australia directly impacts the access to oral health services for people who live in these regions, including Aboriginal and Torres Strait Islander peoples. This scoping review aims to explore where and how these services are provided for Aboriginal and Torres Strait Islander peoples and the relevant workforce model used. Methods Electronic databases, including MEDLINE, EMBASE, Cochrane, and CINAHL, were searched. Grey literature searches included the Australian Indigenous HealthInfoNet webpage, Australian Institute of Health and Welfare, and Advanced Google search. Results Oral health services were classified into the following categories: (1) clinical oral health services, (2) oral health promotion to improve oral health awareness, knowledge, attitudes, behaviours, or skills at patient/community level, and (3) oral health promotion including the use of single clinical interventions (e.g. fluoride varnish). Services were delivered in a variety of settings including community health clinics and schools or using mobile dental equipment. Both the dental and non-dental workforce were utilised to provide these services. Limited data were found on the experiences and challenges faced by the workforce that provide these services. Conclusion Oral health services provided for Aboriginal and Torres Strait Islander peoples in rural and remote regions of Australia vary in service type, location, and workforce involved. Future research is required to explore the experiences and support of this workforce. This can enhance delivery of culturally and clinically safe oral health services for Aboriginal and Torres Strait Islander peoples, particularly in rural and remote regions.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973769","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}

{"title":"Translational research in Australian mental health policy: a scoping review.","authors":"Caroline Robertson, Justin J Chapman, Vicky Stewart, Calista Castles, Victoria J Palmer, Harry Lovelock, Kerry Hawkins, Michelle Banfield, The Alive National Centre For Mental Health Research Translation Investigator Group, The Alive National Centre Intersectoral Policy And Practice Committee, Amanda J Wheeler","doi":"10.1071/AH24259","DOIUrl":"10.1071/AH24259","url":null,"abstract":"<p><p>Objectives The role of translational research in improving mental health care has been highlighted in federal policy; however, an examination of how and to what extent it has been articulated at this level has not been undertaken. The aim of this scoping review was to characterise translational research concepts in federal mental health policy. Methods Australian Government websites were searched for federal policy documents that made recommendations for mental health services in primary care and/or community settings. Thirty eligible documents were identified, corresponding with 25 policies. Data extraction was informed by a conceptual model of translational research involving: (1) barriers and enablers and (2) recommendations and priorities codes; each had evidence generation and evidence translation subcodes. Coded text excerpts were further categorised into topics based on content. Results In total, 1951 references were coded, about three-quarters of which were 'recommendations and priorities'. More were related to evidence generation (total = 1163, 59.6%) than evidence translation (total = 788, 40.3%). Most were generic without specific recommendations for how translational research should be supported. Specific recommendations for evidence generation included the use of routine databases, lived experience involvement (e.g. co-design) and strategic responsibilities (e.g. funding, policy). Specific recommendations for evidence translation mostly referred to lived experience, quality improvement and strategic responsibilities. Conclusion While the value of translational research is broadly acknowledged, recommendations and priorities in federal policy should emphasise evidence translation with greater specificity about how translational research should be supported. This may further influence state policy and drive improvements in practice to improve mental health care.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980552","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}