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Medical Journal of Australia

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https://www.readbyqxmd.com/read/27852200/health-care-variation-time-to-act
#1
Heather A Buchan, Anne Duggan, Jenny Hargreaves, Ian A Scott, Luke Slawomirski
Geographic variation in health care use has been demonstrated in many countries over many years. Such variation can be warranted - in response to patient need or preference for care - or unwarranted. Unwarranted variation raises concerns about equity and appropriateness of care. Recent analyses of health care provision in the Australian atlas of healthcare variation show that when routinely available Australian data are mapped by residence of patient, there are wide variations in rates of use of diagnostic tests, dispensing of prescriptions for a range of indications, surgical procedures and hospital admission rates...
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852199/paying-hospitals-for-quality-can-we-buy-better-care
#2
Jane P Hall, Kees C van Gool
Economic theory predicts that changing financial rewards will change behaviour. This is valid in terms of service use; higher costs reduce health care use. It should follow that paying more for quality should improve quality; however, the research evidence thus far is equivocal, particularly in terms of better health outcomes. One reason is that "financial incentives" encompass a range of payment types and sizes of reward. The design of financial incentives should take into account the desired change and the context of existing payment structures, as well as other strategies for improving quality; further, financial incentives should be fair in rewarding effort...
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852198/clinical-quality-registries-have-the-potential-to-drive-improvements-in-the-appropriateness-of-care
#3
Nick Wilcox, John J McNeil
The provision of timely, relevant and reliable information on patient care to clinicians has been shown to drive improvements in health care quality. Well constructed clinical quality registries collect and report information on both the appropriateness of care (process) in keeping with clinical practice guidelines and the effectiveness of care (outcomes). Notwithstanding the successful establishment of several new registries and improvements in established registries, barriers persist for clinical groups wishing to improve the quality of information and level of participation in registries in Australia...
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852197/antimicrobial-use-in-australian-hospitals-how-much-and-how-appropriate
#4
John D Turnidge, Karin Thursky, Caroline S Chen, Vicki R McNeil, Irene J Wilkinson
Antimicrobial agents play a central role in modern health care, especially in the hospital setting. This article describes the currently available information on the volumes of antimicrobial use in Australian hospitals, the appropriateness of that use, and the levels of compliance with nationally or locally endorsed prescribing guidelines. The data presented here come from the 2014 National Antimicrobial Utilisation Surveillance Program report and the 2013 and 2014 National Antimicrobial Prescribing Survey reports and are based on voluntary participation in the two programs...
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852196/appropriate-care-for-older-people-with-cognitive-impairment-in-hospital
#5
Gideon A Caplan, Susan E Kurrle, Anne Cumming
More than half of the patients in adult hospitals are over 65 years of age. Although not a normal part of ageing, many older people will present to hospital with cognitive impairment (dementia or delirium) along with other complex comorbidities. Older people, and particularly those with dementia, are also at increased risk of developing delirium during their hospital stay. Delirium has serious short and long term consequences, such as increased mortality, falls, accelerated functional and cognitive decline, and earlier entry to residential care...
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852195/clinical-care-standards-appropriate-care-everywhere-acute-coronary-syndromes-as-an-example
#6
Derek P Chew, Robert Herkes, Meredith A Page
Audit data show that despite clinical practice guidelines, some patients miss out on evidence-based care, which is not explained by individual needs or preferences. Clinical care standards are small sets of concise recommendations that focus on known gaps in evidence-based care for a particular clinical condition. They aim to ensure that all patients with the same clinical condition are offered appropriate care, regardless of their location. Clinical care standards are nationally agreed standards and are developed to maximise engagement of consumers, clinicians, health services, and state and territory health departments and agencies...
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852194/english-lessons-can-publishing-an-atlas-of-variation-stimulate-the-discussion-on-appropriateness-of-care
#7
Philip DaSilva, J A Muir Gray
NHS England has published series of atlases to highlight variation in costs, outcomes and intervention rates as part of a large scale transformational program to increase value and close the quality gap in health care. The NHS Atlas of Variation series has stimulated the search for unwarranted variation, an important step in the quest to improve quality and reduce harm. This article describes how the series was conceived, shares some of the lessons of preparing and publishing an atlas of variation, and considers how it can stimulate the discussion on appropriate care...
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852193/clinical-variation-why-it-matters
#8
Anne Duggan, Elizabeth Koff, Villis Marshall
No abstract text is available yet for this article.
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852192/bunbury-to-bundaberg-darwin-to-dover-establishing-a-successful-regional-participation-program-for-the-endia-type-1-diabetes-cohort-study
#9
Megan Ann Sabine Penno, Rebecca Louise Thomson, Jennifer J Couper
No abstract text is available yet for this article.
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852191/a-decade-of-australian-methotrexate-dosing-errors
#10
Rose Cairns, Jared A Brown, Nicholas A Buckley
No abstract text is available yet for this article.
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852190/a-decade-of-australian-methotrexate-dosing-errors
#11
Betty Sh Chan, Nicholas A Buckley
No abstract text is available yet for this article.
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852189/a-decade-of-australian-methotrexate-dosing-errors
#12
Monisha Gupta, Marius Rademaker, John R Sullivan, Peter Foley
No abstract text is available yet for this article.
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852188/a-review-of-maturity-onset-diabetes-of-the-young-mody-and-challenges-in-the-management-of-glucokinase-mody
#13
Ramy H Bishay, Jerry R Greenfield
Maturity onset diabetes of the young (MODY), the most common monogenic form of diabetes, accounts for 1-2% of all diabetes diagnoses. Glucokinase (GCK)-MODY (also referred to as MODY2) constitutes 10-60% of all MODY cases and is inherited as an autosomal dominant heterozygous mutation, resulting in loss of function of the GCK gene. Patients with GCK-MODY generally have mild, fasting hyperglycaemia that is present from birth, are commonly leaner and diagnosed at a younger age than patients with type 2 diabetes, and rarely develop complications from diabetes...
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852187/prevention-of-breast-cancer
#14
Ian N Olver
Modifiable lifestyle factors may reduce the risk of developing breast cancer. Obesity is associated particularly with post-menopausal breast cancer. Diet is important, and exercise equivalent to running for up to 8 hours each week reduces the risk of breast cancer, both in its own right and through reducing obesity. Alcohol consumption may be responsible for 5.8% of breast cancers in Australia and it is recommended to reduce this to two standard drinks per day. Drinking alcohol and smoking increases the risk for breast cancer and, therefore, it is important to quit tobacco smoking...
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852186/supportive-care-of-women-with-breast-cancer-key-concerns-and-practical-solutions
#15
Nicholas Zdenkowski, Stephanie Tesson, Janine Lombard, Melanie Lovell, Sandra Hayes, Prudence A Francis, Haryana M Dhillon, Frances M Boyle
Patients diagnosed with breast cancer may have supportive care needs for many years after diagnosis. High quality multidisciplinary care can help address these needs and reduce the physical and psychological effects of breast cancer and its treatment. Ovarian suppression and extended endocrine therapy benefits are associated with vasomotor, musculoskeletal, sexual and bone density-related side effects. Aromatase inhibitor musculoskeletal syndrome is a common reason for treatment discontinuation. Treatment strategies include education, exercise, simple analgesia and a change to tamoxifen or another aromatase inhibitor...
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852185/young-onset-colorectal-cancer-in-new-south-wales-a-population-based-study
#16
Stephen Boyce, Natasha Nassar, Cathy Yuen Yi Lee, Michael Kl Suen, Saleh Al Zahrani, Marc A Gladman
OBJECTIVE: Australia has the highest incidence of colorectal cancer (CRC) in the world. The incidence of young-onset CRC (yCRC) is increasing in developed nations. Our aim was to determine the incidence of yCRC in New South Wales, the demographic and clinico-pathological characteristics of these patients, and their survival. DESIGN, SETTING, PARTICIPANTS: A population-based cohort study of all cases of CRC diagnosed in NSW during 2001-2008. Data on newly diagnosed cases of CRC were obtained from the NSW Central Cancer Registry; mortality data were obtained from the NSW Registry of Births Deaths and Marriages (to 2012)...
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852184/factors-associated-with-quality-of-care-for-patients-with-pancreatic-cancer-in-australia
#17
Elizabeth A Burmeister, Dianne L O'Connell, Susan J Jordan, David Goldstein, Neil Merrett, David K Wyld, Vanessa L Beesley, Helen M Gooden, Monika Janda, Rachel E Neale
OBJECTIVES: To develop a composite score for the quality of care for patients with pancreatic cancer in Australia; to determine whether it was affected by patient and health service-related factors; to assess whether the score and survival were correlated. DESIGN, PARTICIPANTS AND SETTING: We reviewed medical records of patients diagnosed with pancreatic cancer during July 2009 - June 2011 and notified to the Queensland and New South Wales cancer registries. DESIGN AND MAIN OUTCOME MEASURES: Participants were allocated proportional quality of care scores based on indicators derived from a Delphi process, ranging from 0 (lowest) to 1 (highest quality care)...
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852183/trends-in-cancer-incidence-and-survival-for-indigenous-and-non-indigenous-people-in-the-northern-territory
#18
John R Condon, Xiaohua Zhang, Karen Dempsey, Lindy Garling, Steven Guthridge
OBJECTIVE: To assess trends in cancer incidence and survival for Indigenous and non-Indigenous Australians in the Northern Territory. DESIGN: Retrospective analysis of population-based cancer registration data. SETTING: New cancer diagnoses in the NT, 1991-2012. MAIN OUTCOME MEASURES: Age-adjusted incidence rates; rate ratios comparing incidence in NT Indigenous and non-Indigenous populations with that for other Australians; 5-year survival; multivariable Poisson regression of excess mortality...
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852182/appropriateness-of-care-why-so-much-variation
#19
Richard C Madden, Andrew Wilson, Philip Hoyle
No abstract text is available yet for this article.
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27852181/high-quality-data-are-the-key-to-understanding-inequalities-in-cancer-outcomes-for-aboriginal-and-torres-strait-islander-australians
#20
David M Roder, Elizabeth Buckley
No abstract text is available yet for this article.
November 21, 2016: Medical Journal of Australia
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