Older People Leaving Hospital

"Older people leaving hospital: a statistical overview of the Transition Care Program in 2008-09" presents key statistics on the characteristics and services provided to older people who are eligible for residential aged care directly after discharge from hospital. The program aims to improve recipients' independence and functioning. At 30 June 2009 there were 2,228 places providing transitional care to older people leaving hospital. During 2008-09, around 12,600 individuals received just over 14,000 episodes of transition care.

Injecting Drug Use and Associated Harms Among Aboriginal Australians

The Australian National Council on Drugs (ANCD) commissioned Anex and the National Aboriginal Community Controlled Health Organisation (NACCHO) Inc. to conduct a project entitled "Injecting Drug Use and Associated Harms among Aboriginal Australians". The project is based on recommendations made by the National Indigenous Drug and Alcohol Committee (NIDAC), which reports to the ANCD on drug and alcohol problems and associated harms in Aboriginal communities nationally. Providing choice and improving options for individuals must be the ultimate goals in a functioning health system. Barriers to choice and options for access to health services can increase dependence on a person’s level of disadvantage and vulnerability.

The findings of this project support this premise and outline a range of issues that impact on the ability of Aboriginal people who inject drugs to access quality and timely prevention, treatment and harm reduction services, when and where they need them. This report highlights the need for greater investment in the prevention, treatment and harm reduction sector so that those most disadvantaged in our community are not further disadvantaged by an ineffective system. The findings from this project tell a similar story to many other research projects undertaken in this area. The next steps must be to move from analysis and consideration to action - that is, a structured and detailed approach to planning and delivering services that encompasses the complexity inherent among Aboriginal people who inject drugs, but is practical enough to make a difference.

Safety and Quality in General Practice Clinical Software

Electronic prescribing (e-prescribing) offers an opportunity to improve the quality, safety and efficiency of health care and is now the norm in many countries. There is evidence to show that e-prescribing (often with clinical decision support) is associated with a reduction in medication errors and incomplete or unclear orders, improved drug allergy detection and greater adherence with clinical practice guidelines. There are, however, also reports of unintended negative consequences of e-prescribing, for example, unfavourable effects on workflow and the introduction of new types of errors.

In Australia, general practitioners (GPs) have been using clinical software systems that include e-prescribing for more than 15 years, with rapid uptake encouraged by government incentives in the 1990s. This report, "Evaluation of features to support safety and quality in general practice clinical software", attempts to find out if current systems include features that facilitate improved patient safety and care, with a focus on quality use of medicines. Quality use of medicines is the judicious, effective and safe use of medicines, and in terms of clinical software functionality it encompasses the entire medication management process.

A Guide to Understanding and Working with General Practice in NSW

This resource provides an outline of general practice. It considers its uniformity and diversity; its funding arrangements, service delivery, workforce, training, capacity and supporting structures. It provides recommendations for identifying and acting on opportunities for collaboration. The Guide draws on published literature as well as the experience of an expert group.

It is important that the complex and essential role of general practice is fully understood by those wishing to work within and across the different components of the health care system in NSW. A better understanding of the particular ways of working and ethos of general practice will support sustainable partnerships, improve health care integration and eliminate misperceptions about general practice and general practice service delivery. The Guide is not intended to be exhaustive. It attempts to consolidate in one document key information about general practice. Web links to further information and resources are provided throughout this guide to support a more detailed understanding of the range of areas covered.

Preventive Care in Indigenous Community Health Centres in Australia

Early onset and high prevalence of chronic disease among Indigenous Australians calls for action on prevention. However, there is deficiency of information on the extent to which preventive services are delivered in Indigenous communities. This study, 'Variation in quality of preventive care for well adults in Indigenous community health centres in Australia', examined the variation in quality of preventive care for well adults attending Indigenous community health centres in Australia.

Aboriginal Injury Prevention Projects

The NSW Department of Health is establishing a four year program to provide grants to fund and evaluate demonstration projects that aim to prevent injury among Aboriginal people, as part of the NSW implementation plan for the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes. NSW Health has engaged the Sax Institute to assist in designing and implementing this project. The Sax Institute will consult with a Reference Group and Aboriginal communities to set priorities, with the following decisions to be made:
This, 'Aboriginal Injury Prevention Projects', is one of three reviews subsequently commissioned to inform the program. It reviews peer-review and grey literature evaluations of the effectiveness of Australian Indigenous initiatives published 1995-2010 to answer the following questions with specific terms of reference provided:
• What are the most effective strategies/projects/programs that have been implemented for the prevention of injury amongst Aboriginal populations?
• What types and causes of injury have successfully been addressed by these strategies?
• What types and causes of injury have not been successfully addressed (or addressed at all) by these strategies?
• What are elements that contribute to success or failure in such strategies?
(June 2011)

Chronic Disease Guidelines

The rise in the burden of chronic diseases has important implications for health systems in Australia and around the world. Chronic disease is estimated to be responsible for more than 80% of the burden of disease and injury suffered by Australians. Integral to the effective management of chronic disease is the availability of appropriate, quality services and tools. The evidence suggests an approach that includes primary health care health service re-orientation to chronic disease management, use of patient information recall systems, as well as evidence based guidelines and protocols.

To this end the Chronic Disease Guidelines 3rd edition 2010 have been developed to guide health practitioners in providing best practice prevention, early detection and management of chronic disease with a standardised set of tools and information. This 3rd edition is a synthesis of contemporary evidence-based principles and practices and has been developed collaboratively with input from a range of clinical experts and clinical networks from Queensland Health, the Royal Flying Doctor Service and Apunipima – Cape York Health Council.

End Stage Kidney Disease in Australia

The Australian Institute of Health and Welfare (AIHW) has released a report - "End-stage kidney disease in Australia: total incidence, 2003-2007". The incidence of end-stage kidney disease is an important indicator of the health of the Australian population and valuable for healthcare planning. In the past we have been limited to counting only individuals treated with dialysis or transplant. However, it is recognised that many people with end-stage kidney disease might not receive these treatments for a variety of reasons. This report presents a new method for counting the total incidence of end-stage kidney disease which also includes those not treated with dialysis or transplant. This method indicates that for every new case treated with dialysis or transplant there is one that is not, although the vast majority of these are elderly. (AIHW catalogue number (PHE143))

Proceedings : 11th National Rural Health Conference

The 11th National Rural Health Conference was held at the Perth Convention Centre, 13-16 March 2011. The plenary and concurrent papers are available at the conference website. The theme of the conference was 'Rural and Remote Australia: the heart of a healthy nation'. The speakers included Tom Calma speaking about the health and wellbeing of Australia’s first peoples; Colleen Hayward talking about the importance of the social determinants of good health, and Sam Prince reporting on his aspirations for improving rural and remote health by eradicating one disease at a time – beginning with scabies. Delegates from overseas include: Amanda Sheedy from the People’s Food Project Canada speaking on Engaging Citizens in Policy Development; speakers from Papua New Guinea and Timor L’Este on health in the Pacific Region. Other issues of importance include recurring natural disasters, the ongoing closure of rural hospitals, the long term sustainability of rural communities, the sorry state of oral health and the lack of aged care and mental health facilities in the Bush.

Student Opinions on a Rural Placement Program for Dental Undergraduates

The value of undergraduate rural medical placements is now funded and established as a rural workforce strategy. Will the same strategy improve the distribution of dentists to Australian rural areas? This study from New South Wales, "Student opinions on a rural placement program in New South Wales, Australia", published in the journal 'Rural and Remote Health' reviews local and international evidence to date, and adds to it with information from a 2009 study of dental undergraduates. (From NRHA eforum 6 June 2011)

Priority Setting in Primary Health Care

In rural health, priority setting is frequently an interdisciplinary, interagency collaborative process. This review "Priority setting in primary health care: a framework for local catchments" puts into words what many have experienced - that primary care partnership program negotiations can be a complex process, often burdened by the policy shifts of political cycles, and competing values, objectives and priorities among participating agencies. The model presented by these authors captures the range of factors to be considered in such an environment, providing a valuable resource for those in primary health care alliances responsible for doing the work of setting regional priorities. It is published in Rural and Remote Health (NRHA eforum 20 June 2011)

Review of efficiency measurement methodologies to inform hosptial resource allocations in NSW

The Centre for Efficiency and Productivity Analysis conducted this review to identify efficiency modelling methodologies and data considerations relevant to Australia and of use to NSW Health and the Independent Hospital Pricing Authority in driving decisions about hospital resource allocation.
Download the review here.

45 and up study

The 45 and Up Study is the largest study of healthy ageing ever undertaken in the Southern Hemisphere. Over 265,000 men and women aged 45 and over across NSW have been recruited – about 10% of this age group – and will have their health followed over the coming decades.
Information collected through the 45 and Up Study will be used by policy agencies and by researchers to help gain a better understanding of how to prevent and provide the best possible health care for common health conditions such as cancer, cardiovascular disease, arthritis, depression, Alzheimer’s disease and diabetes.

Working with Indigenous children, families, and communities: lessons from practice

Many Indigenous families and communities in contemporary Australia face immense challenges. These issues contribute to the high levels of poverty, unemployment, violence, and substance abuse seen in many Indigenous communities. Social problems are often deeply entrenched, and need to be approached with consideration of historical, social, community, family and individual factors. Furthermore, as Australian Indigenous cultures are not homogenous, Indigenous communities can differ considerably.
Rhys Price-Robertson and Myfanwy McDonald from the Communites and Families Clearinghouse address these issues in this CAFCA Practice Sheet.

Autism Living Guideline Work

The New Zealand Guidelines Group has produced two new papers related to autism. The first provides supplementary evidence-based guidance on the use of aripiprazole, citalopram and melatonin.
The second is a review of diagnostic instruments.
Both papers have been converted into electronic booklets and are available on the NZ ASD Guidelines website . A short version of the diagnostic instruments review is also available at this website.

Parenting and mental illness: the early years

How do Australians with a mental illness fare when they become parents? How well are they supported during pregnancy and the early years – by maternal and child health services and by mental health services – and what action is needed to improve care?
For parents with a pre-existing mental illness, the challenges can be daunting, as they worry about the impact of their mental illness on the pregnancy and child rearing and vice versa. This study by SANE asks these parents about their experience, and what they think would help.
Download Research Bulletin 13 here.

Prevalence of Type 1 diabetes in Australian children

Type 1 diabetes is a serious, life-long disease which causes a major health, social and economic burden for individuals with the disease, their families and the community. Prevalence of Type 1 diabetes in Australian children, 2008 presents for the first time estimates of the prevalence of Type 1 diabetes in children aged 0-14 years in 2008, based on Australia's National Diabetes Register data. In 2008, it is estimated that over 5,700 children aged 0-14 years had Type 1 diabetes in Australia. The prevalence rate increased with age and varied by state and territory. Assuming that new cases of Type 1 diabetes in 0-14 year old children continue increasing at the rate observed between 2000 and 2008, it is estimated that the prevalence rate will increase by 10% between 2008 and 2013.

Key indicators of progress for chronic disease and associated determinants

With preventive health now a major focus of health reform in Australia, this report published by AIHW, provides information about the prevalence of those chronic diseases for which behavioural changes, or increased screening practices, can reduce onset, assist in management, or prevent death. The report contains current prevalence rates, and where possible, shows trends in chronic conditions over time. Statistics about the determinants of chronic disease assist in planning of prevention programs and strategies. When monitored over time, they may also help explain and predict any changes in chronic disease trends.
Click on the link to view the media release and report.

It's My Health - new consumer website

It's My Health : empowering Australians to manage their health, is published by Reed Business Information and Elsevier, who publish many scholarly journals including Australian Doctor and New Scientist.  The publisher describes the resources on their website as: Australian, evidence-based and easy to access and understand. The information is divided into the following sections: Conditions, Medicines, Symptoms Checker, Healthy Living and Recipes.

The site also has feature articles and sections on men's health, digestive disorders and sexual health, with referenced summary information.

Young Australians : their health and wellbeing 2011

Young Australians: their health and wellbeing 2011, is the fourth in a series of national statistical reports on young people aged 12-24 years, produced by the AIHW. It provides the latest available information on how Australia's young people are faring according to a set of national indicators of health and wellbeing. Death rates have fallen considerably among young people, mainly due to declines in injury deaths. Most young people are achieving national minimum standards for reading, writing and numeracy, are fully engaged in study or work, and have strong support networks. There are some favourable trends in risk and protective factors, such as declines in smoking and illicit substance use. But it is not all good news. There is a high rate of mental disorders among young people, and road transport accidents, although continuing to decline, are still a major cause of death among young males. Too many young people are overweight or obese, are not doing sufficient physical activity or eating enough fruit and vegetables, and are drinking alcohol at risky levels. Aboriginal and Torres Strait Islander young people are far more likely to be disadvantaged across a broad range of indicators.

Using social media to improve healthcare quality

The Change Foundation in Canada has launched a project with the Innovation Cell to examine where the social media environment (Twitter, Facebook, LinkedIn and so on) intersects with healthcare and how healthcare providers can use this media to improve the quality of their service.

Part 1 of the project has been completed:  Introduction and Key Issues in the Current Landscape: a guide to current practice and future promise.  A series of systematic scans of the social media environment was conducted in order to describe current leading practices, challenges, lessons, opportunities and limitations related to the use of social media in healthcare. Here the researchers introduce the idea that healthcare organisations can use social media as a tool for quality improvement by tapping into the growing presence and power of online conversations. Through numerous examples from across North America – and by presenting the first open and user-editable Canadian directory of healthcare organisations using social media - the guide provides a snapshot of where we are now in this fast-changing world. It also explores important ethical issues, particularly around privacy and data control, that healthcare organisations must understand as they begin to navigate this new territory.

Interview with Cathy Fooks of the Change Foundation

Health of Australia's Males report

Drawing on a wide range of data sources, The health of Australian males is the latest report from the AIHW.  In June 2010, there were 11.1 million males living in Australia and the report made some detailed findings, including: males born between 2007-2009 can expect to live 24 years longer than males born between 1901-1910; around two-thirds of adult males and one-quarter of boys are overweight or obese; nearly half have had a mental health condition at some time; nearly one-quarter have a disability and nearly one-third have a chronic health condition; 16% of males do not use any Medicare services in a year. 

Men visit GPs less often than women, but have a higher proportion of emergency department admissions.

Australian Family Physician special mental health issue

This month's issue of AFP is devoted to mental health, and the articles are available freely online.  Included are studies on:

• Antidepressant use
• Mental health risk assessment – a guide for GPs
• Anxiety disorders – assessment and management in general practice
• Managing borderline personality disorder and substance use – an integrated approach
• Anxiety and depression – online resources and management tools
• Patient initiated aggression

Please contact your library if you have problems downloading any journal articles.

The Digital divide as a health issue

"The digital divide: a profound public health issue that needs work" is a recent article in the Croakey health issues blog. Don Perlgut, CEO of the Rural Health Education Foundation, is concerned that with the introduction of the National Broadband Network, over 3 million Australians will be disadvantaged by their lack of information technology skills in regards to public health. "If you are poor, Indigenous, old or disabled and live in outer regional/remote areas of Australia, your chances of being “online ready” are pretty low. And who are the people who will most need the chronic disease monitoring systems the Government is starting to put in place? The poor, the elderly, the disabled and the residents of outer regional and remote Australia.


The Croakey blog is a forum for debate and discussion about health issues and policy. It is moderated by journalist Melissa Sweet, with regular contributions from a panel of medical experts.  It is related to the online social commentary publication, crikey.com.

National Health Reform - latest report

National Health Reform : delivering outcomes for Australians provides a summary of the Commonwealth's assessment of progress towards key National Health Reform milestones as at 1 June 2011.

If you want to to know more about what the National Health Reform promises, go to the Department of Health and Ageing website where there is a detailed description.

International Men's Health Week

This will be celebrated from 13-19 June.  If you would like any resources for the event, go to the Andrology Australia website to order booklets, fact sheets, posters and guides.  The site also contains patient information leaflets, as well as a section for health professionals with links to recent articles on men's health, clinical guidelines and professional education modules.

Global Health Observatory (WHO)

The Global Health Observatory data repository provides access to over 50 datasets on priority health topics including mortality and burden of diseases, the Millennium Development Goals (child nutrition, child health, maternal and reproductive health, immunization, HIV/AIDS, tuberculosis, malaria, neglected diseases, water and sanitation), non communicable diseases and risk factors, epidemic-prone diseases, health systems, environmental health, violence and injuries, equity among others. In addition, the GHO provides on-line access to WHO's annual summary of health-related data for its 193 Member states: the World Health Statistics 2011.

Post-diagnosis support for children with Autism

Post-diagnosis support for children with Autism Spectrum Disorder, their families and carers consists of two reports by Kylie Valentine and Marianne Rajkovic from the Department of Families, Housing, Community Services and Indigenous Affairs.  The first report concentrates on younger children and the second on older children.

The authors conducted literature reviews to address the experiences of diagnosis, treatment and support for families with children who are diagnosed with Autism Spectrum Disorder. They focus on the impact of Autism Spectrum Disorder on families and on their perceptions of the benefits of the treatment received and support models provided, as well as intervention studies and programs that assist transitions from school.  Parents and Autism Spectrum Disorder service providers across Australia were also interviewed.

A Picture of NSW Children - website

A Picture of NSW Children is a data book website which provides demographic information on the children and young people of NSW aged 0-17 years and their families.  It includes information about child care and education, health and well-being, economic well-being, harm and injury, crime, and information about the communities in which children live.
It is produced by the NSW Commission for Children and Young People in collaboration with the Social Policy Research Centre (SPRC) at UNSW.

Older People Leaving Hospital: a Statistical Overview of the Transition Care Program in 2008-09

The report "Older people leaving hospital: a statistical overview of the Transition Care Program in 2008-09" presents key statistics on the characteristics and services provided to older people who are eligible for residential aged care directly after discharge from hospital. The program aims to improve recipients' independence and functioning. At 30 June 2009 there were 2,228 places providing transitional care to older people leaving hospital. During 2008-09, around 12,600 individuals received just over 14,000 episodes of transition care. This report was released 2nd June 2011. (AIHW catalogue number (AGE64))