Australian health review : a publication of the Australian Hospital Association最新文献_第3页

Emergency care requirements in alcohol-related presentations: a multi-site observational study. 酒精相关症状的急诊护理需求：一项多地点观察性研究

IF 1.4

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-08-01 DOI: 10.1071/AH25100

Josea Arneli Polong Brown, Katie East, Ping Zhang, Josh Byrnes, Jill Duncan, Leonie Jones, Nathan J Brown, David Rosengren, Jeremy Furyk, David Green, Sean Rothwell, Julia Crilly

{"title":"Emergency care requirements in alcohol-related presentations: a multi-site observational study.","authors":"Josea Arneli Polong Brown, Katie East, Ping Zhang, Josh Byrnes, Jill Duncan, Leonie Jones, Nathan J Brown, David Rosengren, Jeremy Furyk, David Green, Sean Rothwell, Julia Crilly","doi":"10.1071/AH25100","DOIUrl":"10.1071/AH25100","url":null,"abstract":"Objective Globally, the social and economic costs of alcohol-related disorders are considerable. The aim of this study was to determine the characteristics, clinical care requirements and outcomes of alcohol-related presentations (ARPs) to emergency departments (EDs). Methods A multi-site observational study was undertaken in Queensland, Australia. We selected a random sample of 2720 presentations to four public hospital EDs between April 2016 and August 2017, in which the treating clinician perceived that alcohol contributed to the presentation. Routinely collected demographic, clinical, outcomes and costings data were analysed. Additional data about clinical care delivery in the ED (bedside tests, radiology, pathology and referrals) were extracted by manual medical record review. Results The ARPs predominantly involved young men: 62% arrived by ambulance and 61% arrived between 6pm and 6am. Most (>83%) ARPs had at least one vital observation (i.e. heart rate, blood pressure, respiratory rate) recorded, 46% had pathology, and 41% had radiology. Some form of medication (e.g. paracetamol, diazepam, thiamine) was ordered in 65% of ARPs and 20% involved intravenous fluid treatment. Referrals to a specialist team (e.g. mental health, alcohol and other drug services) were documented for 42% of patients. The median ED length of stay was 194min (IQR: 122-292 min); the admission rate was 38%; and the median cost of ED episodes of care (in Australian dollars) was A$651 (IQR: A$422-961). Conclusions The ED resource utilisation and costs due to the use of alcohol are considerable. Public health measures that reduce alcohol-related harm have the potential to reduce ED occupancy, workloads and costs.","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818641","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

Trends in endometriosis interventions: an interrupted time series analysis following the Australian National Action Plan for Endometriosis (NAPE) 2018. 子宫内膜异位症干预的趋势：2018年澳大利亚子宫内膜异位症国家行动计划（NAPE）后的中断时间序列分析。

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-07-08 DOI: 10.1071/AH25047

Chiemeka C Chinaka, Brenda Gannon, Jenny Doust

{"title":"Trends in endometriosis interventions: an interrupted time series analysis following the Australian National Action Plan for Endometriosis (NAPE) 2018.","authors":"Chiemeka C Chinaka, Brenda Gannon, Jenny Doust","doi":"10.1071/AH25047","DOIUrl":"https://doi.org/10.1071/AH25047","url":null,"abstract":"ObjectiveThis study aimed to highlight trends in the utilisation of selected endometriosis treatments before and after the launch of the National Action Plan for Endometriosis and observe the impact of the action plan on the utilisation of these interventions.MethodsMonthly Medicare and Pharmaceutical Benefits Scheme claims were used to represent the utilisation of laparoscopic resection and nafarelin for endometriosis. Time series analysis using autoregressive integrated moving average models was used to establish the trend in the utilisation of these treatments. An interruption was then applied at the launch of the plan, and a counterfactual prediction was modelled based on the claims made before the interruption. Factual values and counterfactual predictions were compared to evaluate the impact of the plan.ResultsThe action plan was associated with an immediate increase of 3.94 Medicare Benefits Schedule claims per month (95% CI -44.61 to 52.50) and an estimated change in slope of 1.30 claims per month (95% confidence interval (CI) -3.80 to 6.30) for laparoscopic resection. Nafarelin dispensing after the launch of the action plan had an immediate increase of 68.30 dispensing claims per month (95% CI -4.34 to 141.03), with a slope change of -2.84 claims per month (95% CI -10.975 to 5.293).ConclusionsThe results suggest that although the action plan was linked with a marked immediate spike in the utilisation of nafarelin, it did not make any difference in the long term. However, it may have contributed to a small but steady increase in the utilisation of laparoscopic resection, used in severe cases of the condition.","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585822","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

Physiotherapy-led lung ultrasound in acute cardiorespiratory physiotherapy. 物理治疗引导肺超声在急性心肺物理治疗中的应用。

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-07-07 DOI: 10.1071/AH25117

Jane Lockstone, George Ntoumenopoulos

引用次数: 0

Experiences of allied health clinicians and tertiary educators working in and teaching palliative care - a qualitative study. 联合健康临床医生和高等教育工作者在姑息治疗工作和教学中的经验-一项定性研究。

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-07-07 DOI: 10.1071/AH25061

Zhi Wen Ewee Yeo, Jennifer Tieman, Stacey George, Olivia Farrer

{"title":"Experiences of allied health clinicians and tertiary educators working in and teaching palliative care - a qualitative study.","authors":"Zhi Wen Ewee Yeo, Jennifer Tieman, Stacey George, Olivia Farrer","doi":"10.1071/AH25061","DOIUrl":"https://doi.org/10.1071/AH25061","url":null,"abstract":"ObjectivePalliative and end-of-life care should be considered core business for aged care and healthcare teams in these settings. With a growing ageing population, the primary care workforce faces growing demand to deliver palliative care. This study aimed to explore the experiences of allied health clinicians and tertiary educators working in, and teaching, palliative care with an ageing focus in Australia.MethodsWe undertook a qualitative study using semi-structured interviews with clinicians experienced in aged and palliative care and tertiary educators delivering aged and palliative care curriculum content from four allied health disciplines (dietetics, occupational therapy, physiotherapy, speech pathology). Guided by critical realism ontology and a constructivist epistemology, reflexive thematic analysis was used for data analysis.ResultsEleven participants were interviewed. Thematic analysis yielded two key themes and five subthemes. The two key themes were: (i) Barriers to best practice (n=4 subthemes) and (ii) Enablers of palliative care best practice (n=2 subthemes). Key barriers were that curriculum content is lacking and the medical model limits the volume and quality of care delivered. Enablers to quality care were self-directed learning and clinical experience.ConclusionPalliative and end-of-life care in aged care should foster reablement to support continuing agency and dignity through person-centred care. Allied health professionals are well-positioned to support this approach. However, facilitating allied health best practice will require addressing the reported barriers, including clinician preparedness and funding sufficient to meet demand and need.","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577187","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 effect of dietitian universal nutrition assessment and malnutrition documentation on patient nutritional care and revenue in an acute care hospital. 营养学家普遍营养评估和营养不良记录对急症护理医院患者营养护理和收入的影响。

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-07-03 DOI: 10.1071/AH25090

Gail Whitelock, Michael Millward

{"title":"The effect of dietitian universal nutrition assessment and malnutrition documentation on patient nutritional care and revenue in an acute care hospital.","authors":"Gail Whitelock, Michael Millward","doi":"10.1071/AH25090","DOIUrl":"https://doi.org/10.1071/AH25090","url":null,"abstract":"This case study sought to determine if a dietitian universal nutrition assessment (DUNA) with initial nutrition care plan and high-quality documentation was a cost-effective way of delivering nutrition care within the cancer service of a tertiary hospital. A 2-week pilot project of universal nutrition assessment by dietitians for admitted patients demonstrated a high prevalence of cancer-related malnutrition (57%, n=39). The episodes for malnourished patients not identified through usual referral processes (18%, n=7) were examined to determine the National Weighted Activity Unit (NWAU) with and without the malnutrition diagnosis. The additional malnutrition diagnoses were responsible for an NWAU uplift of 8.1. A larger 10-month project was undertaken where patients underwent DUNA on admission with an initial nutrition care plan and high-quality documentation of malnutrition. Fifty-one percent of patients were malnourished with an increase in the number of coded malnutrition diagnoses as compared to baseline. Financial modelling from the pilot project indicated an NWAU uplift of 66.96. With a National Efficient Price (NEP) of AUD$6032 (2023/24), this equated to an uplift of AUD$403,902.72 in 10 months. Universal nutrition assessment and high-quality documentation of malnutrition by dietitians enabled a greater number of patients with cancer-related malnutrition to receive nutrition care while generating improved revenue through clinical coding complexity. This revenue was used to fund an additional dietitian position. Areas of high prevalence of malnutrition may be better served by DUNA rather than nutrition risk screening followed by dietetic referral for nutrition assessment.","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556161","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

Reflections on 15years of National Health Practitioner Regulation in Australia. 澳大利亚《国家卫生从业人员条例》15年的反思。

IF 1.4

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-07-01 DOI: 10.1071/AH25131

Martin Fletcher

引用次数: 0

Challenges with involving persons with lived experience in suicide prevention programs. 在自杀预防项目中涉及有生活经验的人的挑战。

IF 1.4

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-07-01 DOI: 10.1071/AH25140

Samantha McIntosh, Anton N Isaacs

引用次数: 0

Effect and illustrative costs of downscheduling on government subsidised dispensings of triptans in Australia: a 10-year analysis. 在澳大利亚，政府补贴的曲坦类药物分配的降低调度的影响和说明性成本：一个10年的分析。

IF 1.4

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-07-01 DOI: 10.1071/AH25050

Jack Janetzki, Jacinta Johnson, Lisa Kalisch Ellett, Jun Ni Ho, Kelly Hall, Michael Ward, Nicole Pratt

{"title":"Effect and illustrative costs of downscheduling on government subsidised dispensings of triptans in Australia: a 10-year analysis.","authors":"Jack Janetzki, Jacinta Johnson, Lisa Kalisch Ellett, Jun Ni Ho, Kelly Hall, Michael Ward, Nicole Pratt","doi":"10.1071/AH25050","DOIUrl":"10.1071/AH25050","url":null,"abstract":"Objective Acute migraine episodes affect >18% of Australians. Triptans are most effective when taken early in migraine attacks, making timely access critical. Before February 2021, triptans were prescription-only, but a downscheduling policy change enabled over-the-counter (OTC) purchase with pharmacist advice. This study examined the effect on subsidised Pharmaceutical Benefits Scheme (PBS) dispensing rates and illustrative patient costs. Methods Aggregated PBS dispensing data were used to estimate monthly triptan dispensing rates per 1000 people using population data from the Australian Bureau of Statistics. As PBS data excludes OTC supply, we projected dispensings, and illustrate potential costs based on pre-downscheduling trends to estimate the potential shift to OTC. PBS beneficiaries include concessional (social security recipients/low-income earners) and general (those ineligible for concessions). Prescription costs were based on a four-tablet PBS pack of sumatriptan 50mg (A$7.70 concessional; up to A$24.60 general). OTC costs were estimated using a two-tablet pack (A$10.00 standard pharmacy, A$7.00 discount pharmacy). Results Before downscheduling, triptan dispensings grew 1.4% monthly, slowing to 0.6% post-downscheduling. By illustration, we estimate that shift to OTC access would have led to a cost saving of up to A$2million for general patients, but an increased cost of A$2.3-5.8million for concessional patients, depending on pharmacy pricing models. Conclusion Downscheduling slowed PBS dispensing growth. If reduced PBS dispensing was offset by OTC access, the policy may have improved timely migraine treatment, although PBS use remains high. Cost benefits depend on patient concession status and potential offsets, such as reduced doctor visits, which should be considered in further policy evaluations.","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735995","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

Preparing healthcare organisations for using artificial intelligence effectively. 为医疗机构有效使用人工智能做好准备。

IF 1.4

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-07-01 DOI: 10.1071/AH25102

Ian A Scott, Anton van der Vegt, Stephen Canaris, Paul Nolan, Keren Pointon

{"title":"Preparing healthcare organisations for using artificial intelligence effectively.","authors":"Ian A Scott, Anton van der Vegt, Stephen Canaris, Paul Nolan, Keren Pointon","doi":"10.1071/AH25102","DOIUrl":"10.1071/AH25102","url":null,"abstract":"Healthcare organisations (HCOs) must prepare for large-scale implementation of artificial intelligence (AI)-enabled tools that can demonstrably achieve one or more aims of better care, improved efficiency, enhanced professional and patient experience, and greater equity. Failure to do so may disadvantage patients, staff, and the organisation itself. We outline key strategies Australian HCOs should enact in maximising successful AI implementations: (1) establish transparent and accountable governance structures tasked to ensure responsible use of AI, including shifting organisational culture towards AI; (2) invest in delivering the human talent, technical infrastructure, and organisational change management that underpin a sustainable AI ecosystem; (3) gain staff and patient trust in using AI tools by virtue of their value to real world care and minimal threats to patient safety and privacy, existence of reliable governance, provision of appropriate training and opportunity for user co-design, transparency in AI tool use and consent, and retention of user agency in responding to AI generated advice; (4) establish risk assessment and mitigation processes that delineate unacceptable, high, medium, and low risk AI tools, based on task criticality and rigour of performance evaluations, and monitor and respond to any adverse impacts on patient outcomes; and (5) determine when and how liability for patient harm associated with a specific AI tool rests with, or is shared between, staff, developers, and the deploying HCO itself. In realising the benefits of AI, HCOs must build the necessary AI infrastructure, literacy, and cultural adaptation with foresighted planning and procurement of resources.","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735998","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

Conceptualising urgent care: taxonomy, terminology, and relationships with primary and emergency care. 急诊护理的概念：分类、术语以及与初级和急诊护理的关系。

IF 1.4

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-07-01 DOI: 10.1071/AH25028

Nicole W Carter, Shelley Gower, Christopher Helms, Janie A Brown

{"title":"Conceptualising urgent care: taxonomy, terminology, and relationships with primary and emergency care.","authors":"Nicole W Carter, Shelley Gower, Christopher Helms, Janie A Brown","doi":"10.1071/AH25028","DOIUrl":"10.1071/AH25028","url":null,"abstract":"Objective The aim of this study was to develop a taxonomy of urgent care service models and their relationships within healthcare systems through concept mapping, and by addressing inconsistent terminology and service classifications. Methods This descriptive study used an iterative mapping methodology to analyse and categorise urgent care services. Data collection involved literature describing urgent care models across international healthcare systems, focusing on terminology, operational characteristics, and integration points with primary and emergency care. This was complemented by an Australian urgent care model analysis, that is, a comparative review of publicly declared service characteristics and clinical scopes across Australian urgent care models, coded to ICD-10 (International Classification of Diseases, 10th Revision) and presented in tabular form. Results The concept map presents a taxonomy of healthcare services across three distinct care pathways based on condition acuity: primary care for non-urgent needs, urgent care for non-life-threatening conditions requiring prompt, non-scheduled treatment, and emergency care for acute emergencies. The map establishes standardised nomenclature, including intersectoral areas such as co-located facilities and nurse practitioner walk-in services. Supplementary analysis highlights scope variation between models, particularly differences in procedural capability, diagnostics access and mental health response. These findings inform current Australian policy directions, particularly the Medicare Urgent Care Clinics rollout. Conclusions This concept map provides a framework for examining urgent care services within the broader healthcare landscape. Alongside a comparative analysis of Australian models, it supports systematic investigation, highlights variation in service scope and design, and informs planning, integration and policy development across diverse urgent care settings.","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736047","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