Australian health review : a publication of the Australian Hospital Association
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Comparative Study
Episiotomy in NSW hospitals 1993-1996: towards understanding variations between public and private hospitals.
Episiotomy rates for women experiencing childbirth in New South Wales (NSW) hospitals are another indicator that private insurance may be a risk factor for obstetric intervention. A recent comparison of episiotomy rates in NSW public and private hospitals between 1993 and 1996 revealed that episiotomy rates were 12 to 15 percentage points higher in NSW private hospitals than in public hospitals studied. ⋯ Although private hospital patients were almost twice as likely to experience forceps or vacuum delivery (often associated with episiotomy), this leaves a 6 to 8 percentage point difference unexplained. Given the potential health-related quality of life issues associated with perineal trauma during childbirth, further analysis of the clinical make-up of privately insured women may help determine the extent to which clinical explanations exist to support the differences in this childbirth intervention.
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The Australian National Sub-Acute and Non-Acute Patient (AN-SNAP) Version 1 casemix classification was completed in 1997. AN-SNAP is designed for the classification of sub-acute and non-acute care provided in both inpatient and ambulatory settings and is intended to be useful for both funding and clinical management purposes. The National Sub-Acute and Non-Acute Casemix Classification study has produced the first version of a national classification of sub-acute and non-acute care. Ongoing refinement (leading to Version 2) will be possible through further analysis of the existing data set in combination with analysis of the results of a carefully planned and phased implementation.
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Hospital managers, clinicians or their colleges, and the government departments of health are interested in a variety of information for understanding the performance of the health care system and making informed decisions. Intelligent reporting aims to provide the most relevant and reliable information to major stakeholders to facilitate evidence-based practice. ⋯ The TIME (theatre information, management and efficiency) system developed at the North Queensland Clinical School and James Cook University aims to provide intelligible reports for better theatre management. It reflects an effective amalgamation of surgical expertise and systems management principles.