September Policy and Research Update No Images? Click here Research & Policy UpdateWelcome to the October research and policy update. This update includes some great research articles on aeromedicine, mental health, heart health, chronic disease, Indigenous health and much more. HAPPY READING! In the Research and Policy Unit this month we:
Lara, Andy and Cresley Peer reviewed researchIn by helicopter out by cab: The financial cost of aeromedical overtriage of trauma patients This study demonstrated that the use of a complex trauma algorithm lead to significant aeromedical overtriage at substantial cost. Predictors of over-triage included age, injury severity score, head abbreviated injury score, nonoperative treatment, and lower tier activation criteria. Revision of trauma activation protocols may result in more judicious air transport use and cost reductions. Researchers found that non-technical skills performance of critical care air ambulance clinicians was significantly better when they were rested, and was degraded when they were fatigued. This has implications for patient safety. Data from six clinical trials (1822 cases) was analysed to identify whether AO reduced the incidence of hypoxemia during endotracheal intubation in the ED and during retrievals. The study found a significant reduction in the incidence of desaturation and critical desaturation when AO was implemented. There was also a significant improvement in first pass intubation success rate. Factors influencing suicide in older rural males: A review of Australian studies Mental health in rural Australia Mental health services do not match need in rural Australia. The most frequent reason for visits to general practitioners (GPs) is for psychological care, but access to rural GPs is limited. Development of digital health technologies may enhance access to services. New national rural pathways will also improve GP access. Using suicide mortality statistics and hospitalisation data, researchers employed geographical information system techniques to detect suicide clusters occurring between 2005 and 2014 for those aged over 5 years. Identifying areas with high suicide rates enables interventions to be targeted to key problem areas. Chronic disease and health risk behaviours among rural agricultural workforce in Queensland (Qld) Data on lifestyle risk factors and prevalence of diabetes and cardiovascular diseases were collected from 700 participants in rural Qld. A high proportion reported concerning levels of psychological distress. Fewer people reported smoking, and they reported being more active than average Australians. A greater proportion had risky alcohol consumption and were found to be hypertensive. Chronic obstructive pulmonary disease (COPD) was the most common respiratory condition among patients presenting to a specialist respiratory outreach service, followed by sleep apnoea, bronchiectasis and asthma. Smoking status was correlated with these conditions and was highest for Indigenous Australians. Patients with CHF experience poor survival (30%-50% at 5 years) with high episodes of hospitalisation. This paper describes the protocol for a study that seeks to identify if ITEC-CHF improves patient compliance with daily weight monitoring, which is recommended for the management of CHF to help maintain fluid balance. Research has demonstrated that stroke care for the NT Aboriginal population is at least as cost-effective as for the non-Aboriginal population. Stroke care presents worthwhile and equitable survival benefits for Aboriginal patients in remote communities, notwithstanding their higher level burden of disease. Researchers reviewed four randomised controlled trials (RCTs) to identify the effectiveness of SDM in the context of developing asthma management plans for children and adults. Substantial differences between the four RCTs precluded the researchers from identifying meaningful overall conclusions. A Cochrane review examined the success of professional, organisational, and structural interventions in primary care to reduce preventable medication errors that resulted in hospital admissions, emergency department visits, and mortality. They found that interventions probably make little or no difference to these outcomes. A “touch-capable” technology was developed that enables a patient’s hands to serve as remote surrogates for the physician’s in the screening of acute abdominal pain, leveraging only a smartphone. 81% of tested patients were able to match a physician abdominal palpation curve with <20% error after 6 attempts. Family effects on the rurality of GP's work location: A longitudinal panel study This systematic, national-level longitudinal study showed that GP work location is related to key family needs which differ according to GP gender and educational stages of children. Such non-professional factors are likely to be dynamic across the GP’s lifespan and should be regularly reviewed as part of GP retention planning. Recent policy proposals & reformAnnouncement of Australia’s first National Rural Health Commissioner Emeritus Professor Paul Worley will become Australia’s first National Rural Health Commissioner. He is a GP and was Dean of Medicine at Flinders University for 10 years. He has also held senior leadership roles with the Rural Doctors Association of South Australia and the Australian College of Rural and Remote Medicine. This framework sets out a comprehensive and culturally appropriate guide for use by Aboriginal and Torres Strait Islander Peoples who experience higher levels of mental health issues than other Australians. Fifth National Mental Health and Suicide Prevention Plan released This Plan was endorsed in August by all health ministers, and is aimed at improving support and treatment for those with mental health challenges. It proposes a more coordinated approach to mental health by both government and stakeholders. This Plan provides an additional focus on suicide prevention. From 1 November 2017, the Better Access initiative will be expanded to include new Medicare items to allow patients in Modified Monash Model regions four to seven to access services through video conferencing. More information about the Better Access telehealth psychological services for people in rural areas is available here. Port Macquarie-Hastings, Manning and Macleay communities are receiving one of 40 new Local Drug Action Teams. The first 40 Local Drug Action Teams rolled out in April this year, and this second round brings the total to 80. Interested groups can apply for the next round which opens in late 2017. Better safety and security for remote health workers Funding was announced to boost investment in training and professional support for health professionals working in the bush. More than $250,000 is being provided to develop training which improves personal safety and security. Quality review released: Aged care assessment visits to be unannounced Announced accreditation visits will be replaced with unannounced audits across Australia’s residential aged care facilities, to help ensure safe, quality care standards are maintained at all centres at all times. New provider to bring better access to hearing services across Australia Free healthy food app dials up good tucker for remote Indigenous communities A new app promises to help Aboriginal and Torres Strait Islander people in remote areas make healthy food choices. The rating system is based on the Government’s Health Star Rating system and the Australian Dietary Guidelines. Once the app is downloaded, it is independent of internet service. Evaluation of Indigenous Australians’ health program (IAHP) Independent consultants have been engaged to conduct evaluations of the IAHP. A longer term evaluation of primary health care will be co-designed with stakeholders. This project will consider the relative costs of providing primary health care to Indigenous Australians. New report outlines residential aged care funding reform options The release of a new report into aged care funding highlights a range of options to modify Australia’s residential care funding instrument. The report is available on the Department of Health’s website. More than $60 million for end-of-life care projects The Australian Government is providing more than $60 million for new projects that will help improve quality and access to palliative care. Providing affordable access to new treatment for leukaemia and lymphoma Improved access to medicine for leukemia and lymphoma patients is expected to benefit 920 Australians per year. A new vaccine to strengthen the health of young Australians From the start of 2018, young Australians will have free access to the new Human Papillomavirus (HPV) vaccine, protecting against more strains of HPV infections. Only two doses are required (instead of three) to be fully protected. The expanded schedule means Australians up to the age of 19 are eligible. $200 million research boost to improve the lives of Australian patients Increased funding to address cancers, mental illnesses and chronic disease such as cardiovascular disease, diabetes and obesity research has been announced. More than 1,400 medicines more affordable Tamoxifen, Leflunomide, Telmisartan, Quetiapine, and Capecitabine Brexpiprazole (Rexulti®) will provide patients with an alternative treatment to oral antipsychotics, and will be available through the Pharmaceutical Benefits Scheme at reduced cost. Public consultationFramework for Improving Aboriginal and Torres Strait Islander health The National Health and Medical Research Council has released the draft Road Map 3: A Strategic Framework for Improving Aboriginal and Torres Strait Islander Health through Research (Road Map 3) for public consultation. It is open for public consultation until 10 December 2017. What's new?Australian Indigenous HealthInfoNet publishes a peer-reviewed electronic journal, called HealthBulletin, which provides new information about research of relevance to the health of Aboriginal and Torres Strait Islander peoples. This is a comprehensive resource that may be of interest to RFDS staff. The AIHW released the following updates in October:
The ABS released the following updates in October:
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