Australian health review : a publication of the Australian Hospital Association
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Health policy making is complex, but can be informed by evidence of what works, including systematic reviews. We aimed to inform the work of the Cochrane Effective Practice and Organisation of Care (EPOC) Group by identifying systematic review topics relevant to Australian health policy makers and exploring whether existing Cochrane reviews address these topics. ⋯ This survey has identified questions for which Australian policy makers have indicated a need for systematic reviews. Further, it has confirmed that existing reviews do address issues of importance to policy makers, with the potential to inform policy processes.
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The aim of this study was to determine the patient characteristics associated with unplanned return visits, using routinely collected hospital data, to assist in developing strategies to reduce their occurrence. ⋯ Although patient characteristics associated with unplanned return visits have been identified, the reasons underpinning the unplanned return visit rate, such as patient service preference and attitudes, need to be more fully investigated.
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One of the elements of the health reform plan, as agreed to by Australian state and federal governments, is to introduce a 4-h National Access Target, to reduce emergency department (ED) waiting times. This article highlights the flawed rationale behind the 4-h rule, the UK experience of this rule and discusses the potential dangers it poses to Australian patients. An alternative solution proposed is the separation of elective and emergency surgical streams to reduce the variability in demand for inpatient services.
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To ascertain the improvements in length of stay and discharge rates following the opening of an acute medical unit (AMU). ⋯ An AMU was successful in decreasing ED length of stay and contributed to decreasing hospital length of stay. However, we suggest that local context is crucially important in tailoring an AMU to obtain maximal benefit, and that AMUs are not a 'one size fits all' solution.
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Despite the incidence of joint replacements in Australia, there is a paucity of information regarding how patients progress from their referral to their surgery. The aim of this study was to describe a patient pathway from referral to receipt of total hip replacement (THR) or total knee replacement (TKR) surgery in South Australian public hospitals. ⋯ Waiting times for THR and TKR surgery reported in this study were longer than other reports in the literature. Current Australian health policy does not consider the first (and longest) phase of the patient pathway. Excluding this initial phase could be generating an erroneous perception of the patient pathway to THR or TKR surgery, possibly leading to poorly considered health reforms.