Health expenditure Australia 2007-08 (AIHW)

Health expenditure in Australia in 2007-08 reached $104 billion. As a percentage of GDP it was 9.1%, the same level as in 2006-07. The area of health expenditure showing the highest growth was public health expenditure which grew by 21% in real terms, mostly due to extra spending on immunisation. This report examines expenditure on different types of health goods and services in the decade to 2007-08. It describes funding by the Australian and State governments, private health insurance and individuals; compares health expenditures in the different states and territories and compares Australia's spending with other countries.

Media release

Achieving quality use of medicines in the community for palliative and end-of-life care

Deprescribing, opioid-phobia and disposal of unused medicines have been identified as significant issues in palliative care in a report prepared by the National Prescribing Service (NPS) and Palliative Care Australia. Achieving quality use of medicines in the community for palliative and end-of-life care, released last week at the 10th Australian Palliative Care Conference, is the first to document a shared understanding of the barriers to the best use of medicines during the end stages of life. Informed by submissions from more than 70 healthcare organisations and individuals, the report describes medicines use issues in palliative care and documents ways in which it can be improved.

Primary health care research discussion

Researchers examining better ways to provide primary health care to rural and remote communities today gathered in Alice Springs to showcase and share the results of their work.

Delivering the opening speech at the Primary Health Care Research, Evaluation and Development Tri-State Conference, the Minister for Indigenous Health, Rural and Regional Health and Regional Services Delivery, Warren Snowdon, said research and reform go hand in hand, and at this critical juncture for Australia’s health service delivery, the collaboration of universities and researchers is essential.

Sydney centre to tackle youth mental illness

Researchers hope to be a step closer to working out why 75 per cent of major mental illnesses strike Australians before they turn 25. The University of Sydney and the New South Wales Government are opening a $16 million youth mental health centre in Sydney for people aged between 12 and 25.

Towards national indicators of safety and quality in health care (AIHW)

This report sets out recommendations for a set of 55 national indicators of safety and quality in health care. The report concludes the National Indicators Project, a major project funded by the Australian Commission on Safety and Quality in Health Care (the Commission).

$5.67 million in support for Central West families (media release)

Minister for Community Services Linda Burney today announced continued funding of more than $5.67 million over three years for early intervention services in the Central West. Ms Burney said this funding is part of a $20.8 million investment by the NSW Government in its early intervention program, Brighter Futures, for Western NSW.

“Brighter Futures helps struggling families by intervening before problems escalate or turn into a crisis,” Ms Burney said.

National Indigenous Eye Health Survey

A national report into Indigenous eye health shows adult Indigenous Australians suffer higher rates of blindness and other eye related health problems than non-Indigenous Australians.

The National Indigenous Eye Health Survey found that 1.9 per cent of Indigenous adults were blind, over six times the rate of non-Indigenous adults. The major cause of blindness in Australia is blinding cataracts, and this is 12 times more common in Indigenous Australians than non-Indigenous.

The survey found that 94% of vision loss is preventable or treatable, but 35 per cent of Indigenous adults have never had an eye examination. The report however also made positive findings for Indigenous children, as vision loss in Indigenous children was found to be five times less common than non-Indigenous children.

Media Release

Injury deaths, Australia 2004-05 (AIHW)

Accidental falls, suicide and transport-related injuries are common causes of death in the Australian community. This report finds that overall, rates of injury death in Australia during 2004-05 increased with the remoteness of the injured person's residence, with those who resided in very remote areas having a rate more than double that of the national rate. When considering only deaths resulting from motor vehicle transport accidents, the mortality rate for those who resided in very remote areas was 4 times the national rate. When considering state and territory of residence, those who resided in the Northern Territory, where much of the population lives in remote and very remote areas, had mortality rates almost 3 times the national rate for motor vehicle transport-related deaths, more than double the national rate for suicides, and more than 4 times the national rate for homicides.

Media release

Paediatric Emergency Guidelines e-learning package (NSW Health)

A statewide, web-based, Paediatric Clinical Practice Guidelines e-learning package, based on the 12 current guidelines, has been launched. The interactive modules promote as well as test understanding of the key clinical principles behind the CPGs and also facilitates monitoring of the clinician engagement across the health system. The package is available online and enables access from anywhere in the state by internet or local intranet. It is free to register.

This is the latest course available from the NSW Health Online Training portal. Also available :
* Open disclosure training
* Incident Information Management System Training

A healthier future for rural and remote Australians

National Rural Health Alliance response to the Final Report of the National Health and Hospitals Reform Commission

More Than 35 Million People Have Alzheimer's And Dementia Worldwide (World Alzheimer's report)

More than 35 million people worldwide will have dementia in 2010, according to the 2009 World Alzheimer's Report from Alzheimer's Disease International (ADI). The new report was released on September 21st, which is World Alzheimer's Day. This is a 10 percent increase over previous global dementia prevalence reported in 2005 in The Lancet. According to the new report, dementia prevalence will nearly double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050.

"The information in the 2009 World Alzheimer's Report makes it clear that the crisis of dementia and Alzheimer's cannot be ignored," said Marc Wortmann, ADI's Executive Director. "Unchecked, Alzheimer's will impose enormous burdens on individuals, families, health care infrastructures, and global economy. There is hope in taking action by improving and funding dementia care and services, and increasing investment in research. Australia, France, Korea and the UK have developed national Alzheimer's action plans, and several more are currently in development. We strongly encourage other countries to follow their example and make Alzheimer's a priority."

Chapter 2 of the report focuses on the impact of dementia. Dementia has physical, psychological and economic impact not only the person with the disease, but also caregiver(s), the person's family and friends, healthcare system(s), and society. For example, statistics cited in the new report suggest that 40-75% of carers have significant psychological illness as a result of their caregiving, and 15-32% have depression.

The report also outlines challenges faced by governments and healthcare systems worldwide and offers eight global recommendations based on report findings.

Women's Health Resources (Website)

A new website has been launched on the US National Library of Medicine site as part of the Specialized Information Services Website. It lists Women's Health Resources - covering the following Women's Health Topics :
General topics; Alcohol, Tobacco and Substance Abuse; Autoimmune Diseases; Bone and Joint Health; Cancer; Complementary and Alternative Medicine (CAM); Diabetes; Exercise and Fitness; Heart Disease; HIV/AIDS; Menopausal Hormone Therapy; Mental Health; Nutrition; Reproductive Health; Safety and Wellness; Sexually Transmitted Diseases (STD); Violence and Abuse (From NLM Weekly Announcements)

WHO Issues Guidelines for Antiviral Treatment of H1N1 and Other Influenza

WHO Guidelines for Pharmacological Management of Pandemic (H1N1) 2009 Influenza and other Influenza Viruses were published on 20 August. The purpose of the new recommendations is to provide a basis for advice to clinicians regarding the use of the currently available antivirals for patients presenting with illness caused by influenza virus infection, as well as considerations regarding potential use of these antiviral medications for chemoprophylaxis. (From: Medscape News CME dated 19th September 2009)

Australian Institute for Population Ageing Research

Treasurer Wayne Swan launched the Australian Institute for Population Ageing Research (AIPAR) at the University of New South Wales. The AIPAR will help to inform debate about the challenges of our ageing population. It will also help to develop policy options for adapting to our changing population and take advantage of the opportunities this will bring. The AIPAR has been developed within the University of New South Wales and has brought together researchers, government and industry. The AIPAR will also launch its new Longevity Index which will track the ability of an individual to maintain their living standards over their lifetime. Population ageing is among Australia's most important long-term economic and social challenges.

Ed-Can learning resources on Cancer Learning

The EdCaN learning resources on the Cancer Learning website were developed to support the EdCaN National Education Framework for Cancer Nursing. The resources are designed to be:

*delivered flexibly in terms of time, place, and mode (ie, in web, data stick or text-based forms)
* tailored to the needs of particular courses used as whole or in part
* Case-based learning resources

The EdCaN project developed 11 case-based learning resources.

Educator resources are available on-line to assist educators to increase capacity amongst students and staff in cancer control. These include: workshop outlines and presentations for specific cancer types, assessment fact sheets, competency assessment tools and implementation tools to assist educators in their use of the EdCaN learning resources.

Cancer Learning provides access to over 400 resources to help professionals learn about cancer, palliative care and related topics. Career planning pathways and cancer resources for allied health professions are also included.

T2DM Guideline Series (Free on DVD)

Diabetes is the fastest growing chronic disease globally and currently affects 246 million people worldwide. This is expected to rise to 380 million by 2025. type 2 diabetes mellitus (T2DM) accounts for 85% of this figure. In Australia, 275 people are diagnosed with T2DM daily. That’s over 100,000 people annually or an MCG of people each year. However, up to 60% of this disease is preventable by adopting a healthy diet and increasing physical activity.

The Rural Health Education Foundation is presenting a series of four professional development programs through simultaneous live satellite broadcast and interactive webcast surrounding the new NHMRC endorsed Type 2 Diabetes Mellitus Clinical Guidelines. The Foundation’s programs focus on the key practice points and goals for management of T2DM presented in the Guidelines to assist clinicians, health services and policy makers.

The simultaneous satellite broadcasts and webcasts include live panel discussions with leading clinicians in the area of diabetes and are chaired by Dr Norman Swan. Case studies, filmed on location, showcase innovative approaches to best practice prevention, diagnosis and management of T2DM. The fourth program specifically focuses on type 2 diabetes and Indigenous Australians.

The programs that make up the series are:

913b T2DM Guideline Series: Blood Glucose Control, Patient Education in Type 2 Diabetes (8th September)
913c T2DM Guideline Series: Diabetic Retinopathy, Chronic Kidney Disease (22nd September)
913a T2DM Guideline Series: Primary Prevention, Case Detection and Diagnosis (13th October)
913d T2DM Guideline Series: Diabetes and Indigenous Australians (10th November)

Clinicians will have the opportunity to contribute to the discussions via the Foundation’s live simultaneous webcast and broadcast facilities.

This series will be released on DVD in early December 2009 and may be ordered free as a DVD set of four programs on four discs.

The wellbeing of Australians: gambling, chocolate and swine flu

The Australian Unity Wellbeing Index monitors the subjective wellbeing of the Australian population. The 21st 6-monthly survey, was undertaken in May 2009. This six month period was marked by an increasing appreciation that the international financial situation was worsening and that Australia would be adversely affected to some degree. However, few people had lost their jobs as a direct consequence of the economic environment and, for those people with jobs, many were better-off financially due to cuts in interest rates, and so, in mortgage repayments.

Each survey involves a telephone interview with a new geographically representative sample of 2,000 Australians.. These surveys comprise the Personal Wellbeing Index, which measures people's satisfaction with their own lives, and the National Wellbeing Index, which measures how satisfied people are with life in Australia. Other items include a standard set of demographic questions and other survey-specific questions. The specific topics for Survey 21 are Swine Flu, Chocolate Eating, and Gambling.

"Conclusion:
Eating chocolate daily and feeling contented with this behaviour is good for wellbeing.
Eating chocolate daily and wishing to change this behaviour is bad for wellbeing."

Be happy!

Diabetes Type 2 Guidelines

The NHMRC has recently released four new guidelines for Type 2 Diabetes:
* National Evidence Based Guideline for Diagnosis, Prevention and Management of Chronic Kidney Disease in Type 2 Diabetes
* National Evidence Based Guideline for Case Detection and Diagnosis of Type 2 Diabetes
* National Evidence Based Guideline for Patient Education in Type 2 Diabetes
* National Evidence Based Guideline for Blood Glucose Control in Type 2 Diabetes

The Diabetes Australia website has several more best practice guidelines for health professionals.

Reposted from NCAHS Library Clippings

Mental health first aid for Indigenous Australians

In 2007, the Mental Health First Aid (MHFA) program implemented a cultural adaptation of its first aid course to improve the capacity of Indigenous Australians to recognise and respond to mental health issues within their own communities. It became apparent that the content of this training would be improved by the development of best practice guidelines. This research aimed to develop culturally appropriate guidelines for providing first aid to an Australian Aboriginal or Torres Strait Islander person who is experiencing a mental health crisis or developing a mental illness.

Hart LM, Jorm AF, Kanowski LG, Kelly CM, Langlands RL. (2009). Mental health first aid for Indigenous Australians: using Delphi consensus studies to develop guidelines for culturally appropriate responses to mental health problems. BMC Psychiatry. 2009 Aug 3;9:47.

An investigation of medication information transfer and application in aged care facilities in an Australian rural setting

Medication error is very common and can be life threatening for frail aged patients transferred within Australia's increasingly complex healthcare system. This rural pilot study identifies some of the issues and also importantly offers solutions that are unique to the rural context.

Health Care Expenditure On Chronic Kidney Disease In Australia 2004-05 (AIHW)

Chronic kidney disease is a common and serious problem in Australia. Those with the most severe form, end-stage kidney disease, usually require dialysis or a kidney transplant to survive. It is with these resource intensive and technologically advanced treatments that much of the health costs for chronic kidney disease are incurred, with regular dialysis the most common reason for hospitalisation in Australia.

Chronic kidney disease contributes substantially to health care expenditure in Australia and is increasing much faster than expenditure on total health care. In 2004-05 it accounted for 1.7% of total expenditure ($898.7 million), an increase of 33% since 2000-01 ($573.6 million).

A home for rural health professionals (Centre for Remote Health- NT)

The Centre for Remote Health is setting up a home in Katherine to help attract health professionals to the Northern Territory, thanks to the Rudd Government.

“The Centre for Remote Health brings together the Flinders and Charles Darwin Universities to provide quality tertiary education, training and research, specifically focused on remote health services,” Mr Snowdon said.

Childhood bullying associated with later psychiatric hospitalisation, treatment

Childhood bullying and victimisation appear to predict future psychiatric problems in both males and females although females appear more likely to be affected regardless of pre-existing psychiatric problems, according to a report in the September issue of Archives of General Psychiatry.

Andre Sourander, MD, PhD, of Turku University Hospital, Turku, Finland, and colleagues studied associations between bullying and victimisation in childhood (at age 8) and later psychiatric hospitalization and treatment with antipsychotic medication (from ages 13 to 24) in 5,038 Finnish children who participated in the nationwide Finnish 1981 Birth Cohort Study.

eGenetics

eGenetics is a single access point for human genetics resources and information in Australia.

eGenetics facilitates the sharing of knowledge on human genetics, improving access to high quality, current human genetic resources for health professionals, students and the Australian community.

Information on eGenetics has been provided by various national, state and territory agencies involved in human genetics. Organisations may submit their information with an application form to eGenetics via Submit information to eGenetics.

The Point of Care : improving patients' experience (The King's Fund)

The Point of Care programme from The King's Fund aims to transform patients' experience of care in hospital. The goal of the programme is to enable health care staff in hospitals to deliver the quality of care they would want for themselves and their own families.The program works with patients and their families, staff and hospital boards to research, test and share new approaches to improving patients' experience.

The Point of Care starts with a focus on the hospital as a whole, and on the experience of staff. Everyone, at all levels, can influence patients' experience of care, whether as a board member or administrator, a health care assistant, a clinician, or support staff.Every action, bed management, communication between caregivers, staffing levels, financial investment etc has an impact on patients and families who use hospital services.

Keeping Dementia Front of Mind: Incidence and Prevalence 2009-2050

A new report has found that the number of Australians with dementia is expected to quadruple to more than 1.1 million people by 2050.

In the report, Access Economics has warned that future growth in the number of people with dementia will have substantial consequences for the already pressured Australian health care system and the quality of life of Australians.

Media release

Remote and Rural Transition Toolkit (for allied health professionals) (SARRAH)

Remote and rural practice provides so many opportunities for professional and personal development. Personally, it provides the chance to experience a different lifestyle, to meet new people and to move beyond comfort zones. Professionally, the diversity and variety inherent to remote and rural practice fosters the development of high levels of professional competence, independence, resourcefulness and flexibility.

While the experience is well worth the effort, making the transition to remote and rural practice and life can be challenging.This toolkit will be useful for a range of Allied Health Professionals entering the remote and rural context, including students on clinical placement, graduates commencing work, or experienced practitioners commencing work in a remote or rural area for the first time.

The toolkit includes a whole host of information, resources and support pathways around the:

Remote & Rural Context
Remote & Rural Practice
Skills & Competencies
Orientation, Development & Support.

We have included some Links and Resources that may be useful, as well as some Clinician Stories from others working in remote and rural settings. For a full topic listing please see the Site Map.

There are also five Learning Modules that focus on key issues for remote and rural practice :

Self Care
Confidentiality & Professional Boundaries
Cultural Safety
Translating Evidence Based Practice
Introduction to Primary Health Care.

Arthritis clinical guidelines (RACGP)

A lack of evidence-based clinical musculoskeletal guidelines has prompted the Royal Australian College of General Practitioners (RACGP) to develop guidelines for GPs and other primary health care professionals covering musculoskeletal prevention and early treatment. The first three of four guidelines cover osteoarthritis, rheumatoid arthritis and juvenile idiopathic arthritis. Other guidelines on osteoporosis will be available in the near future.

"The guidelines focus strongly on the early diagnosis and management because there is an opportunity within the first few months of disease onset to provide treatment that effectively limits structural damage and
improves health outcomes."

These guidelines are one of the first to use the NHMRC Evidence based Matrix (NHMRC additional levels of evidence and gradings of recommendations for developers of guidelines), which greatly assisted the grading of the recommendations.

Health expenditure for arthritis and musculoskeletal conditions, 2004-05 (AIHW)

Arthritis and musculoskeletal conditions affect more than 6 million Australians. In 2004-05, direct health expenditure on these conditions amounted to $4.0 billion or 7.5% of total allocated health expenditure in Australia. Osteoarthritis alone accounted for nearly one-third of the expenditure, mostly due to hospital costs associated with knee and hip replacements. Other major sources of expenditure included prescription pharmaceuticals for osteoporosis and rheumatoid arthritis.

This report provides detailed information on health expenditure on these diseases and conditions using estimates derived from the AIHW Disease expenditure database, supported by information from various other data sources.

Media release

Disability in Australia: multiple disabilities and need for assistance (AIHW)

The number and type of disabilities a person has is highly related to the severity of disability and need for assistance. This report examines the severity of disability and complex support needs of people with multiple disabilities in Australia. The analysis examines people with multiple disabilities in different age groups: children (0-14 years), people of working age (15-64 years) and older people (aged 65 years or over).

Media release

Burden of disease due to asthma in Australia 2003 (AIHW)

In 2003 asthma was the leading cause of burden of disease in Australian children, contributing 17.4% of total DALYs and the eleventh-leading contributor to the overall burden of disease in Australia, accounting for 2.4% of the total number of DALYs. Asthma also contributed a substantial proportion to the Indigenous health gap in the burden of non-communicable conditions. It is predicted that asthma will continue to rank as one of the major causes of disease burden in Australia for the next 2 decades, particularly among females.

Building a 21st Century Primary Health Care System: A Draft of Australia's First National Primary Health Care Strategy

The Draft Strategy sets out a road map for the future to provide Australians with a primary health care system which is among the best in the world and which is equipped to meet future challenges. Primary health care is the first point of connection with the health system and needs to be able to manage the full range of challenges that emerge, from prevention to enabling access to health services, through to managing complex chronic conditions in partnership with other health sectors.

The Australian Stroke Clinical Registry (AuSCR)

The Australian Stroke Clinical Registry (AuSCR) is collaborative national effort to monitor, promote, and improve the quality of acute stroke care.

The data collected in AuSCR will be used to guide quality improvement interventions in hospitals to ensure best practice stroke care. The data can be used to reduce variations in care delivery and, ultimately,provide evidence of reduced deaths, disability, and recurrent strokes from improvements in stroke care.

AuSCR is a free service that offers hospitals a secure, online interface which:

* stores patient data
* provides clinicians with downloadable reports summarising patient data
* allows hospitals to export their data to Microsoft Excel for local analyses; and
* provides annual performance reviews, newsletters, and publications

The AuSCR database will gather information about patients with stroke to determine the patterns of treatment, rehabilitation and recovery of patients. The data collected provides information about the severity of stroke at three months after stroke, as well as the quality of stroke treatment in hospitals, and includes questions such as:

* Whether the patient was treated in a Stroke Care Unit?
* Whether the patient and family received a care plan on discharge?
* Whether the patient received blood pressure medication on discharge?
* Whether the patient has had another stroke since discharge from hospital?

Contact admin@auscr.com.au to enquire about participating in AuSCR.

National Preventative Health Strategy

The Minister for Health and Ageing, the Hon Nicola Roxon, launched the National Preventative Health Strategy on 1 September 2009.

The Strategy provides a blueprint for tackling the burden of chronic disease currently caused by obesity, tobacco, and excessive consumption of alcohol. It is directed at primary prevention and addresses all relevant arms of policy and all available points of leverage, in both the health and non-health sectors. The Strategy comprises three parts: an overview; a roadmap for action; and technical papers focused on the three key areas - obesity, tobacco and alcohol.

AMA response

Pharmaceutical Society of Australia Response

Australian e-journal for the advancement of mental health

The Australian e-Journal for the Advancement of Mental Health, Volume 8, Issue 2 (April 2009), is now online.

* Editorial: On remembering and forgetting in prevention

* Guest Editorial: Mental wellbeing of older people: making an economic case

* Guest Editorial: Mental health promotion, Australian policy, and housing for people with mental illness

* Two way approaches to Indigenous mental health training: Brief training in brief interventions

* Social capital and mental health among Indigenous Australians, New Australians and Other Australians living in a coastal region

* The impact of traumatic brain injury on the mental health outcomes of individuals and their family carers

* Investigating the strengths and difficulties of children from families with a parental mental illness

* Fathers as informants of children’s fears and worries

* Toward an understanding of how art making can facilitate mental health recovery

* Volunteering as a community mental health educator: Positives and negatives for recovery

BreastScreen Australia monitoring report 2005-06 (AIHW)

Breast cancer is the second most common cause of death from cancer in Australian women. The BreastScreen Australia Program aims to reduce mortality and morbidity from breast cancer through detecting cancers early, with over 1.5 million women (56.9%) aged 50-69 years participating in the Program in 2005-2006. Mortality from breast cancer has decreased steadily since the Program commenced in 1991, from 66 to 47 deaths per 100,000 women.

Media release
Report