June Policy and Research Update No Images? Click here Research & Policy UpdateWelcome to the July Research and Policy Unit update. This month the team has been: developing the protocol and risk management documents for the national telehealth research trial; progressing the research paper on cardiovascular health; working with Palliative Care Australia on an end of life research project; continuing to develop the strategic planning and operation tool (SPOT); and developing research protocol documents for the Clinical and Health Services Research Committee. Lara, Andy and Cresley Peer reviewed researchEmergency aeromedical services in Ireland: A single-centre study in 2014 This study found that American College of Surgeons (ACS) criteria for predicting hospital admission rates can be applied to patients transported by the Irish Helicopter Emergency Management Service (HEMS). The ACS criteria may be a potential alternative to currently used dispatch criteria by HEMS. Cultural competency training in emergency medicine Given diversity in emergency department (ED) presentations, an assessment of residency and faculty staff exposure to formal cultural competency programs was conducted in the United States. 94% of 4-year programs and 61% of 3-year programs included cultural competency in the curriculum. This commentary provides both an overview of Indigenous SEWB and MH and some of the promising initiatives for restoring wellbeing. Solutions for Indigenous mental health issues require an approach which acknowledges the impact of social and cultural determinants on Aboriginal and Torres Strait Islander wellbeing. Where to next for rural general practice policy and research in Australia? This article suggests there is an urgent need for targeted research-informed policy on vocational rural generalist training, advanced skills practice, migration, sustainable practice models, and specific interventions that target greatest need. Special Indigenous health issue of the Medical Journal of Australia (MJA) This issue of the MJA focuses on Indigenous health issues. It includes two articles co-authored by Martin Laverty. Embedding cultural safety in Australia’s main health care standards In Australia, the existing health safety and quality standards are insufficient to ensure culturally safe care for Indigenous patients in order to achieve optimum care outcomes. Researchers have suggested that accreditation with nationally consistent standards for culturally safe clinical care will improve Indigenous health outcomes. Improving preventive health care in Aboriginal and Torres Strait Islander primary care settings Researchers used clinical audit data to create a framework of the priority evidence-practice gaps, strategies to address them, and drivers to support these strategies in the delivery of recommended preventive care to improve health for Indigenous Australians. Beyond the medical model: Future directions for suicide intervention services This paper outlines criticisms of current approaches to the care of persons who are suicidal and offers examples of alternative models of care that challenge the medical model framework. It describes features of alternative service models that are more culturally appropriate and effective interventions. Cardiac care for Indigenous Australians: Practical considerations from a clinical perspective Care of Indigenous Australians with chronic cardiovascular disease (CVD) is challenging. It requires well supported health care systems, a holistic approach to care, and multidisciplinary care, involving an empowered and supported primary care team working together with specialists, especially in remote areas. Australian general practitioners (GPs) reportedly over prescribe antibiotics, but the extent has not previously been quantified. Antibiotic prescription rates for ARIs are 4 to 9 times higher than recommended rates. This research supports setting absolute targets for reducing antibiotic prescribing in Australian general practice. The research found that positive professional, personal, and socially responsive learning experiences, and pre-placement cultural training in understanding the local Aboriginal community, assisted in providing a positive experience for allied health students. This pilot study sought to ascertain what funding would be required to ensure equitable access to sustainable high quality PHC, regardless of geographic location. The findings provide empirical evidence based on real costs to guide funding for remote PHC services that takes into account the safety and equity requirements for a minimum viable service. A review of HF presentations to Alice Springs Hospital from 2008 to 2011 was undertaken to identify the differences between Indigenous and non-Indigenous outcomes. The pattern of HF among Indigenous Australians was characterised by a younger population with more clinically complex cases and greater health care utilisation. A 2-year, retrospective study of NT respiratory patients referred for specialist treatment, found higher rates of respiratory disease in Indigenous compared with non-Indigenous Australians. Bronchiectasis was also more common among Indigenous patients. Assessment of Australian Aboriginal children (aged 7 to 9 years), living in the Fitzroy Valley, identified that one-third had a neurodevelopmental disorder whether or not they were prenatally exposed to alcohol. Children diagnosed on the FASD spectrum had impairment in a number of central nervous system domains associated with prenatal alcohol exposure. Behavior in children with FASDs in remote Australia: A population-based study This study of children aged 7.5 to 9.6 years, residing in remote Western Australian communities, found that children with FASD demonstrated higher rates of problematic behaviour than children without FASD. Education is required to further inform ACS patients of the Heart Foundation's Australian warning sign campaign. A large proportion of ACS patients did not use emergency medical services transport because they thought using other transport would be faster. Implementation of oral health initiatives by Australian rural communities: Factors for success Researchers identified five factors significant in the success of community participation in the implementation of new oral health services, including: community motivation to participate in oral health initiatives, having the "right" people involved, continuing involvement of sponsors and/or significant people, trusting working relationships between participants; and perceiving benefits from participation. The rural pipeline to longer-term rural practice: GPs and specialists Researchers found that for specialists and GPs, rural background and rural clinical school attendance were independent, duration-dependent, and additive, predictors of longer-term rural practice. Metropolitan-based medical schools can enhance both specialist and GP rural medical workforce by enrolling rural background medical students and providing them with long-term rural undergraduate clinical training.
Recent policy proposals & reformConference strengthens Indigenous suicide prevention Leading Indigenous Australians involved in tackling suicide recently attended the national suicide prevention conference which aimed to increase the profile of Indigenous suicide prevention, with a focus on learning from programs featured in the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project. Program evaluation and monitoring - Tackling Indigenous Smoking (TIS) program A preliminary evaluation report of the TIS program found that the program is operating effectively, using proven approaches to change smoking behaviours, and is delivering evidence-based local tobacco health promotion activities. Public consultation to help inform care at home reforms The Turnbull Government has released a public discussion paper to help inform future care at home reforms. Consultation has commenced and will be open until 21 August 2017. The discussion paper can be accessed through the Department of Health’s consultation hub. Innovation Grants Support Dementia and Aged Care Choices The Australian Government has released $34 million in funding grants to support innovation in dementia care and other aged care services. 42 projects will receive grants, with the focus on six priority areas. For grant details see the Department of Health tenders and grants webpage. $3.7m in additional support to improve Indigenous aged care services Aboriginal and Torres Strait Islander people living in aged care in regional, rural and remote communities will benefit from more than $3.7 million in one-off grants. Central Research a Hub of Hope for Indigenous Health A consortium bringing together Aboriginal community controlled health services and leading medical researchers will spearhead efforts to close the health gap in Central Australia. The 11 organisations partnering in the new Central Australia Academic Health Science Centre will be led by the Aboriginal community controlled health service sector. Coalition Government grants to boost training in general practice More doctors, nurses and other health professionals will complete their training in regional Australia as a result of new grant funding to eligible general practices in regional Australia. Grants of up to $300,000 have been offered to successful applicants to upgrade facilities and encourage more GP training in country areas. More jobs and clinical training opportunities for young doctors Twenty-six new regional training hubs will create more opportunities for doctors to stay, study, work and live in rural and regional Australia for all of their postgraduate training. Three new university departments of rural health will also be established. New drug to help over 200,000 Australians The Australian Government will commence subsidising a new drug (Epclusa®) - which can treat all forms of Hepatitis C, with an expected success rate of 90%. Epclusa® will be listed on the Pharmaceutical Benefits Scheme (PBS) from 1 August. New treatment for lung and kidney cancer on PBS From 1 August, more than 4,500 Australians will benefit each year from the PBS listing of Nivolumab (sold as Opdivo®) - which is used to treat both locally advanced and metastatic stages of non-small cell lung cancer and Stage IV clear cell variant renal cell carcinoma. National approach to prescription drug misuse The Australian Government will invest over $16 million for a national roll-out of real time prescription monitoring for medicines prone to misuse. The real time prescription monitoring system will provide an instant alert to pharmacists and doctors if patients received multiple supplies of prescription-only medicines. More youth mental health support ReachOut - the online mental health organisation for young people - has unveiled a new digital platform, dubbed ReachOut Next Generation. The platform deals with issues such as bullying and exam stress, sexuality, relationship difficulties, alcohol and drugs and mental health problems. Health funding to protect Australians The Australian Government will provide $27 million to strengthen the planning and response to a national health emergency, should one be triggered by bioterrorist attack or contagious disease outbreak. 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. Australian Institute of Health and Welfare (AIHW) releases The AIHW released several reports and web updates in July, including:
Australian Bureau of Statistics (ABS) releases The ABS released the following in July:
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