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

{"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":"10.1071/AH24268","url":null,"abstract":"<p><p>Objective To identify factors associated with the retention and attrition of regulated health practitioners in Australia across nine health professions. Methods An online survey of practitioners and an analysis of 10years of Australian Health Practitioner Regulation Agency (Ahpra) registration data were carried out. Results Among 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. Conclusions Although 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":"2025-02-01","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":"Health research governance of data access: a black-box challenge.","authors":"Paula McDonald, Robyn Mayes, Peter Frederiksen, Christina Malatzky, Alicia Feldman, Janet M Davies, Diana Leon-Espinoza","doi":"10.1071/AH24341","DOIUrl":"10.1071/AH24341","url":null,"abstract":"<p><p>This article addresses organisational governance, including perceived reputational concerns, by health data custodians as the principal barrier to timely and transparent research. Although existing literature primarily addresses ethics reviews and site-specific research approvals, our experience with a Local Hospital Network uncovered additional active barriers within this complex health system. We position these experiences in relation to literature that has documented inefficiencies in health research governance processes that lead to lost knowledge capital and opportunities for significant advancements in health systems research.</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":"143495012","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":"Comprehensive day-to-day care and support needs of older Australians requiring government-funded home-based aged care: a scoping review.","authors":"Rachel McKittrick, Elizabeth Manias, Martin Hensher, James Meroiti, Alison M Hutchinson","doi":"10.1071/AH24234","DOIUrl":"10.1071/AH24234","url":null,"abstract":"<p><p>Objective This study aimed to locate and describe research studies in which the comprehensive day-to-day care and support needs of older Australians requiring home-based aged care have been measured and reported in detail. Methods A scoping review was conducted according to Joanna Briggs Institute guidance. A systematic search of peer-reviewed and grey literature was undertaken. Results Screening identified 2/866 eligible records. Researchers studying the 'service needs' of older people (n =50) residing in a rural/remote Aboriginal and Torres Strait Islander community found a high need for home care (86%), transport (59%), and allied health (46%) services. In the second study, older people (n =55) from a regional community had 38/79 'underlying care needs' including for washing/bathing, managing urinary incontinence, and arranging/keeping appointments. The authors of each study took a different perspective of 'needs' - that is, their participants' need for specific service types (e.g. transport) versus their fundamental underlying needs (e.g. arranging/keeping appointments) which give rise to service needs. Conclusions The findings suggest Australian aged care providers and policy-makers lack a strong evidence base about the comprehensive underlying day-to-day care and support needs experienced by older Australians, to optimally inform both the design of home-based aged care programs and services, and workforce skill and skill mix requirements for the sector. Future studies about the population's underlying day-to-day care and support needs, with larger and more representative study populations (e.g. making use of routinely collected aged care datasets), would be beneficial. Such studies would provide important information to support the development of a government-funded home-based aged care system optimised to effectively and efficiently meet the needs of the population it is seeking to support.</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":"143434587","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":"Environmental, Social and Governance principles in Australian publicly funded healthcare: an extension of value-based care.","authors":"Aletha Ward, Mark E Holmes, Isabella Ward, Zerina Lokmic-Tomkins, Leah East, Tracy Levett-Jones","doi":"10.1071/AH24296","DOIUrl":"10.1071/AH24296","url":null,"abstract":"<p><p>Australia's publicly funded healthcare system is financed through a complex mix of Commonwealth, State, Territory and private sources, which include activity-based funding, fee for service and block funding. These models may be insufficient to meet future budgetary constraints, and healthcare systems in Australia and worldwide are increasingly adopting value-based healthcare (VBHC), which is defined as 'health outcomes that matter to patients relative to the resources or costs required, over a full cycle of care'. There is no national Australian strategy for the adoption of VBHC, and examining other industries or policies may provide solutions to enhance implementation. For example, as of January 2025, the Australian Securities Exchange will mandate climate-related disclosures for listed companies. This change reflects a growing societal and shareholder emphasis on environmental accountability. Our paper argues that universally applying Environmental, Social and Governance principles across all healthcare sectors represents a strategic evolution of VBHC to ensure fiscally responsible climate change mitigation and adaptation strategies.</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":"143495004","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}

{"title":"The incidence of cardiac surgery in adults with treated kidney failure in Australia: a retrospective cohort study.","authors":"Dominic Keuskamp, Christopher E Davies, Robert A Baker, Kevan R Polkinghorne, Christopher M Reid, Julian A Smith, Lavinia Tran, Jenni Williams-Spence, Rory Wolfe, Stephen P Mcdonald","doi":"10.1071/AH24188","DOIUrl":"https://doi.org/10.1071/AH24188","url":null,"abstract":"<p><p>Objective Kidney failure increases people's risk of cardiovascular disease, sometimes requiring cardiac surgery. The aim of this study was to estimate the risk of cardiac surgery for adults with treated kidney failure in comparison with the general population in Australia. Methods We performed a population-based retrospective cohort study by linking data between the Australia and New Zealand Dialysis and Transplant Registry and the Australian and New Zealand Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database, for 2010-2019. Age-sex-standardised surgery risk relative to the general population was estimated for adults receiving long-term dialysis and kidney transplant recipients, and subpopulations defined by procedure type, comorbidity, clinical status and dialysis-related factors. Results Among 1541 adults receiving treatment for kidney failure at the time of cardiac surgery in 2010-2019, the prevalence of comorbidity and risk factors was usually highest in those receiving dialysis, followed by transplant recipients and the general population (n =113,126). For all major cardiac surgical procedure types, the incidence of surgery for adults receiving dialysis and transplant recipients exceeded that for the general population (e.g. isolated coronary artery bypass grafting relative rates 15.3 [95% CI 13.7-17.0] and 2.0 [1.6-2.6] respectively). Relative incidence was especially high for the dialysis cohorts with insulin-treated diabetes and those with body mass index <25kg/m2 . Conclusions Adults with treated kidney failure had a higher risk of cardiac surgery than the general population in Australia in 2010-2019, especially when associated with diabetes. Data linkage between clinical quality registries enabled estimation of the extent of cardiac surgical burden.</p>","PeriodicalId":93891,"journal":{"name":"Australian health review : a publication of the Australian Hospital Association","volume":"49 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257549","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}