Australian health review : a publication of the Australian Hospital Association最新文献_第9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

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

Evaluating the weighting of extracurricular involvement in standardised curriculum vitae scoring criteria for entrance into Australian medical and surgical speciality training programs. 评估课外活动在进入澳大利亚医学和外科专业培训项目的标准化简历评分标准中的权重。

IF 1.4

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-07-01 DOI: 10.1071/AH24348

Matthew Robertson, Thomas Muecke, Stephen Bacchi, Robert Casson, Weng Onn Chan

{"title":"Evaluating the weighting of extracurricular involvement in standardised curriculum vitae scoring criteria for entrance into Australian medical and surgical speciality training programs.","authors":"Matthew Robertson, Thomas Muecke, Stephen Bacchi, Robert Casson, Weng Onn Chan","doi":"10.1071/AH24348","DOIUrl":"10.1071/AH24348","url":null,"abstract":"Objective This study aims to evaluate how extracurricular involvement, such as sports, music, volunteering and teaching, are weighted within standardised curriculum vitae (CV) scoring criteria for medical officers applying to medical and surgical specialty training programs in Australia. Methods A cross-sectional observational analysis of point allocations for extracurricular involvement was performed, as detailed by publicly available standardised CV scoring criteria for medical and surgical training programs. The analysis includes all specialty training programs in Australian and New Zealand listed by the Australian Health Practitioner Regulation Agency that publish these criteria for the 2023 intake. Results Of the 47 reviewed specialty training programs, 14 publish publicly available standardised CV scoring criteria, and 8 of these allocate points for extracurricular involvement. The mean weighting for extracurricular involvement was 11.5% (range 4.5-20%), compared with 42.5% for research. The allocation of points varies by training program and subdomain. Conclusion The weighting of extracurricular involvement within standardised CV scoring criteria is limited and varied among specialty training programs, despite alignment with non-cognitive competencies emphasised by training frameworks. Current emphasis on academic achievements may disadvantage applicants with limited access to research opportunities. Greater clarity and consistency in evaluating non-academic attributes may support fairer, more holistic selection processes.","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":"144735996","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

Improving inpatient mental health nurses practice through the use of a standardised instrument. 通过使用标准化仪器改善住院精神卫生护士的实践。

IF 1.4

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-07-01 DOI: 10.1071/AH25037

V K Drinkwater, M Giles, A P O'Brien, C Harmon, R J Tynan

{"title":"Improving inpatient mental health nurses practice through the use of a standardised instrument.","authors":"V K Drinkwater, M Giles, A P O'Brien, C Harmon, R J Tynan","doi":"10.1071/AH25037","DOIUrl":"10.1071/AH25037","url":null,"abstract":"Objective The role of mental health nurses (MHNs) working in inpatient units involves providing care to patients with complex needs and challenging behaviours, with reporting and documenting findings from brief interactions a critical part of their duties. Despite this, there is no agreed-upon instrument to document a patient's mental state or recognise signs of progress or deterioration. The aim of this study was to assess the impact of implementing a standardised instrument known as the SMART card on MHNs documentation, knowledge, and self-efficacy in assessing and reporting a patient's mental state. Methods The SMART card was implemented across eight mental health inpatient units. Completion rates of the SMART card and quality of assessments were measured using a file/chart audit before and 3months post-implementation. A pre/post-implementation survey measured changes in MHNs' perceived knowledge and self-efficacy, with the post survey evaluating attitudes towards training and SMART card acceptability. Results Clinical file audits showed significant improvement in completion rates in documentation of key clinical/symptom domains. Survey results showed a positive attitude towards the SMART card, with training having increased MHNs' understanding of psychiatric terminology and significantly improved confidence and self-efficacy. Conclusions This study demonstrates how the implementation of a standardised instrument significantly improved MHNs' reporting of patient mental health status.","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":"144735997","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

Data linkage for healthcare research: basics and important considerations. 医疗保健研究的数据链接：基础知识和重要考虑因素。

IF 1.4

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-06-30 DOI: 10.1071/AH25051

Maria C Inacio, Olivia Ryan

引用次数: 0

Artificial intelligence medical scribes in allied health: a solution in search of evidence? 联合医疗中的人工智能医疗记录员：寻找证据的解决方案？

IF 1.4

Australian health review : a publication of the Australian Hospital Association Pub Date : 2025-06-01 DOI: 10.1071/AH25064

Laura Ryan, Laetitia Hattingh

引用次数: 0