Use of medical services by older Australian women with dementia : a longitudinal cohort study
- Authors: Byles, Julie , Cavenagh, Dominica , Bryant, Jamie , Mazza, Danielle , Browning, Colette , O'Loughlin,Sally
- Date: 2021
- Type: Text , Journal article
- Relation: Australian and New Zealand Journal of Public Health Vol. 45, no. 5 (2021), p. 497-503
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- Description: Objective: To assess the use of Medicare-subsidised health services by women with and without dementia. Methods: Data from women of the 1921–26 birth cohort of the Australian Longitudinal Study on Women's Health were linked to various administrative datasets to ascertain dementia diagnosis. The use of subsidised general practitioner (GP) services (75+ health assessments [HAs], chronic disease management meetings [CDMs], multidisciplinary case conferences [MCCs]) and specialist and allied health services between 2000 and 2013 for these women was analysed using longitudinal GEE models. Results: A total of 9,683 women were included with 1,444 (15%) women identified as having dementia. Compared to women with no dementia indication, women with dementia had more yearly non-emergency GP attendances (short [<30 minutes] IRR=1.11 [1.07, 1.13]; long [>30 minutes] IRR=1.11 [1.04, 1.19]) and fewer specialist attendances (IRR=0.91 [0.85, 0.97]) and were more likely to have an emergency GP attendance (OR=2.29 [2.05, 2.57]). There were no significant differences in the odds of having either a HA or CDM or using allied health services for women with and without dementia indicators. Conclusions: The overall use of services designed to improve the prevention and coordination of the care of older people with chronic conditions was low. Women with dementia were no more likely to access these services. Implications for public health: There is underuse of some primary and allied healthcare services designed for people with complex chronic conditions. These could be better used by women with dementia to improve the management of complex comorbidities (e.g. CDMs), to prevent the onset of disability (e.g. physiotherapy), and enhance needs assessment and service access (e.g. HAs). © 2021 The Authors. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Colette Browning” is provided in this record**
The data deficit for asthma emergency presentations might surprise you : how RAHDaR addresses the data chasm
- Authors: Terry, Daniel , Peck, Blake , Kloot, Kate
- Date: 2020
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 20, no. 2 (2020), p. 5776
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- Description: INTRODUCTION: National and state-based minimum data sets remain inadequate in providing a complete representation of emergency presentations, especially among paediatric asthma presentations. Thus, the aim of the study was to identify if a deficit exists in current emergency paediatric asthma hospital presentation datasets and how this may inform an understanding of childhood asthma in Victoria Methods: This retrospective cross-sectional study examined emergency hospital presentation data between 1 February 2017 and 31 January 2019. All paediatric (0-14 years) emergency asthma presentation data were collected from nine hospitals in south-western Victoria, Australia, using the Rural Acute Hospital Data Register (RAHDaR), which gathers both Victorian Emergency Minimum Dataset (VEMD) data from larger government hospitals, and non-VEMD data from smaller, more rural institutions. RESULTS: Of the 854 emergency presentations identified for children with asthma aged 0-14 years, 540 (63.2%) were managed initially at larger government-reporting hospitals. A total of 314 (36.8%) emergency presentations were initially managed at emergency facilities, such as urgent care centres. Overall, it was found that a total 278 (32.5%) of all emergency presentations did not appear in current government datasets. CONCLUSION: The RAHDaR database, a complete register of data, captures all emergency presentations in south-western Victoria and highlights as much as a 33% deficit in the data currently available to inform asthma resource initiatives including policy development, funding allocation, prevention and management initiatives in Victoria. More accurate data from sources such as RAHDaR are essential to fill the now-evident data chasm.
The relationship of sport participation to provision of sports facilities and socioeconomic status : A geographical analysis
- Authors: Eime, Rochelle , Harvey, Jack , Charity, Melanie , Casey, Meghan , Westerbeek, Hans , Payne, Warren
- Date: 2017
- Type: Text , Journal article
- Relation: Australian and New Zealand Journal of Public Health Vol. 41, no. 3 (2017), p. 248-255
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- Description: OBJECTIVE: Ecological models have been applied to investigate multiple domains influencing physical activity behaviour, including individual, social, organisational, community, environmental and policy factors. With regard to the built environment, research to date has been limited to small geographical areas and/or small samples of participants. This study examined the geographical association between provision of sport facilities and participation in sport across an entire Australian state, using objective total enumerations of both, for a group of sports, with adjustment for the effect of socioeconomic status (SES). METHODS: De-identified membership registration data were obtained from state sport governing bodies of four popular team sports. Associations between participation rate, facility provision rate and SES were investigated using correlation and regression methods. RESULTS: Participation rate was positively associated with provision of facilities, although this was complicated by SES and region effects. The non-metropolitan region generally had higher participation rates and better provision of facilities than the metropolitan region. CONCLUSIONS: Better provision of sports facilities is generally associated with increased sport participation, but SES and region are also contributing factors. Implications for public health: Community-level analysis of the population, sport participation and provision of facilities should be used to inform decisions of investments in sports facilities.
Community assets and capabilities to recruit and retain GPs : the community apgar questionnaire in rural Victoria
- Authors: Terry, Daniel , Baker, Ed , Schmitz, David
- Date: 2016
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 16, no. 4 (2016), p.
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- Description: Introduction: Rural communities continue to experience significant challenges recruiting and retaining physicians. The Community Apgar Questionnaire (CAQ) was developed in Idaho in the USA to comprehensively assess the characteristics associated with successful recruitment and retention of rural physicians. The CAQ has been utilised and validated across the USA; however, its value in rural Australia has not been examined. The objective of this study was to use the CAQ in rural Australia to examine its utility and develop a greater understanding of the community factors that impact general practitioner (GP) recruitment and retention. Method: The project conducted structured face-to-face interviews with hospital chief executive officers (CEOs) and directors of clinical services (DCSs) from 14 of the 21 (76%) health services that agreed to participate in rural north-eastern Victoria, Australia. The interviews were undertaken to complete the CAQ, which contains 50 questions centred on factors that influence physician recruitment and retention. Once completed, CAQs were scored by assigning quantitative values to a community's strengths and challenges including the level of importance placed on each factor. As such, the most important factors in physician recruitment, whether they are advantages or challenges for that community, were then weighed for their relative importance. Scores were then combined to create a CAQ score. To ensure reliability and validity of the results, three additional CAQs were purposefully administered to key general practices within the region. Results: The 14 rural communities exhibited cumulative CAQ scores ranging from a high of 387 to a low score of 61. This suggests the tool was sensitive enough to differentiate between communities that were high and low performers in terms of physician recruitment. The groups of factors that had the greatest impact on recruitment and retention were ranked highest to lowest and included medical support, hospital/community support, economic, scope of practice and geographic factors. Overall, the highest individual factors to impact recruitment and retention were perception of quality, hospital leadership, nursing workforce and transfer arrangements. Conversely, the lowest factors and challenges to recruitment and retention were family related, specifically spousal satisfaction and access to schools. Conclusions: Hume, in rural Victoria, was the first international site to implement the CAQ to differentially diagnose a community's relative strengths and challenges in recruiting and retaining GPs, while supporting health facilities to prioritise achievable goals to improve long-term retention strategies. It provided each community with a tailored gap analysis, while confidentially sharing best practices of other health facilities. Within Hume, open communication and trust between GPs and health facility leadership and nursing staff ensures that GPs can feel valued and supported. Possible solutions for GP recruitment and retention must consider the social, employment and educational opportunities that are available for spouses and children. Participation in the program was useful as it helped health facilities ascertain how they were performing while highlighting areas for improvement. © James Cook University 2016.
Quantitative exploration of the barriers and facilitators to nurse-patient communication in Saudia Arabia
- Authors: Albagawi, Bander , Jones, Linda
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Hospital Administration Vol. 6, no. 1 (2016), p.16-24
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- Description: Nurses with effective communication skills play a critical role in minimising the stress associated with hospitalisation for both patients and their families. Effective communication has become increasingly reported as a key component in effective health care outcomes, which is even more crucial in countries such as Saudi Arabia with a large foreign healthcare workforce. The presence of a large expatriate workforce with a different language from the host society and the ensuing complexity of sociocultural linguistic and heath beliefs systems has been poorly researched. This study aimed to investigate barriers and facilitators of nurse-patient communication in Saudi Arabia using the Nurses’ Self-Administered Communication Survey. The survey was distributed to a random sample of 291 nurses working in medical and surgical departments at five hospitals in Saudi Arabia. The results indicate that the Philippine and Saudi Arabian nurses perceived greater barriers to communication with respect to personal/social characteristics, job specifications and environmental factors then nurses of other nationalities. In addition, nurses with shorter experience in Saudi Arabia perceived greater barriers to communication with respect to the clinical situation of patient and environmental factors than the nurses with longer experience. Lastly, nurses who had not attended specialist courses on communication skills acquisition perceived greater barriers to communication with respect to personal characteristics and job specifications than nurses who had attended such courses. This study highlights the need to better prepare expatriate nurses before they enter the workforce in Saudi Arabia on cultural competence and language skills.
A model of home-based care for people with disabilities : Better practice in rural Thailand
- Authors: Wanaratwichit, Civilaiz , Hills, Danny , Cruickshank, Mary , Newman, Barbara
- Date: 2015
- Type: Text , Journal article
- Relation: Asia Pacific Journal of Health Management Vol. 10, no. 2 (2015), p. 44-51
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Background and objective: People with disabilities living in rural areas often require considerable support to meet their complex needs. This study investigated a best practice model in home-based care for people with disabilities in rural Thailand.
Design and Setting: A case study method was adopted to investigate a best practice model of home-based care for people with disabilities in Nakhonthai District, Phitsanulok Province, Thailand. Data were collected from 30 participants through in-depth interviews, focus groups, direct observation and document analysis. Content and thematic analyses were conducted for qualitative data. The Wilcoxon Signed-Rank test was used for the outcome measurement of activities of daily living (ADL) scores.
Results: This model of home-based care for people with disabilities, as an integrated network model, brings together the community, health professionals and other organisations. The role of trained community health volunteers was mainly to deliver home-based personal care for people with disabilities, while health professionals focused mainly on controlling the quality of care, managing the knowledge and skills of volunteers, and co-ordinating the network. The difference between ADL scores before and after the implementation of the model (n=20) was statistically significant (p<0.01). Conclusion: This best practice model of home-based care for people with disabilities in rural Thailand shifts responsibility in the main service decisions from professionals to the community and other stakeholders and engages and empowered all stakeholders in the provision, co-ordination and management of care.
Organisational barriers to effective pain management amongst oncology nurses in Saudi Arabia
- Authors: Alqahtani, Mohammed , Jones, Linda , Holroyd, Eleanor
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Hospital Administration Vol. 5, no. 1 (2015), p. 81-89
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- Description: Cancer pain is a multi-dimensional syndrome with a combination of acute and chronic pain that causes physical, psycho-social, behavioural, emotional and spiritual problems resulting in adverse effects on patients’ quality of life. Nurses need to be well prepared with knowledge on pain assessment and management techniques in oncology units, due to their vital role in the decision-making process regarding pain management. However, limited research has been conducted regarding nurses’ barriers regarding pain management in oncology units, especially in Saudi Arabia. The overall aim of this study was to explore the nurses’ perceived barriers that hinder the delivery of effective pain management to cancer patients. Five focus group discussions were conducted using a purposive sampling of six to eight nurses in each group, with a total of 35 oncology nurses. The results of focus group analysis revealed two main thematic categories with associated sub themes, being nurses’ workloads, and the absence of health team collaboration. This study provides an increased awareness of the barriers that may hinder the efficacy of pain management provided to cancer patients in Saudi Arabia context. Significant implications will benefit nursing practice, administration and education, in addition to identifying potential future research.
Investing in big ideas: utilisation and cost of Medicare Allied Health services in Australia under the Chronic Disease Management initiative in primary care
- Authors: Cant, Robyn , Foster, Michele
- Date: 2011
- Type: Text , Journal article
- Relation: Australian health review : a publication of the Australian Hospital Association Vol. 35, no. 4 (2011), p. 468-474
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- Description: To critically examine utilisation of the 13 allied health services provided through Medicare Chronic Disease Management program and related general practitioner (GP) care planning initiatives.