Paul Harris, Jennifer A Whitty, Elizabeth Kendall, Julie Ratcliffe, Andrew Wilson,Peter Littlejohns, Paul A Scuffham.
BMJ Open 2015;5:e006820 doi:10.1136/bmjopen-2014-006820
Objectives The current study seeks to quantify the Australian public's preferences for emergency care alternatives and determine if preferences differ depending on presenting circumstances.
Setting Increasing presentations to emergency departments have led to overcrowding, long waiting times and suboptimal health system performance. Accordingly, new service models involving the provision of care in alternative settings and delivered by other practitioners continue to be developed.
Objective: To examine the prescribing of lipid-lowering medications during general practitioner encounters with Indigenous and non-Indigenous Australians from 2001 to 2013.
Design, setting and participants: Observational time trend study, using data from the Bettering the Evaluation and Care of Health (BEACH) survey, of 9594 primary care encounters with Indigenous patients and 750 079 encounters with non-Indigenous patients aged 30 years or over.
Main outcome measure: Prescription of at least one lipid-lowering medication.
Results: The ageesex standardised proportion of encounters that resulted in at least one lipid-lowering medication being prescribed was 5.5% (95% CI, 4.7%e6.3%) for Indigenous patients and 4.6% (95% CI, 4.5%e4.7%) for non-Indigenous patients. The proportion of encounters with Indigenous patients at which a lipid-lowering medication was prescribed increased significantly from 4.1% during 2001e2005 to 6.4% during 2009e2013 (P ¼ 0.013 for trend). For encounters with non-Indigenous patients, the proportion increased significantly from 3.8% during 2001e2005 to 5.2% during 2009e2013 (P < 0.01). For encounters during which GPs managed diabetes, hypertension or ischaemic heart disease, the proportion of Indigenous encounters during which lipid-lowering medication was prescribed was similar to that for non-Indigenous patients. For encounters in which GPs managed a lipid disorder, however, the ageesex standardised proportion was significantly greater for Indigenous (78.4%; 95% CI, 72.6%e84.2%) than for non-Indigenous patients (65.2%; 95% CI, 64.5%e65.8%).
Conclusion: We detected substantial increases in the prescribing of lipid-lowering medications from 2001 to 2013 for both Indigenous and non-Indigenous patients seen in Australian general practice. Providers were more likely to prescribe lipid-lowering medications for Indigenous than for non-Indigenous patients, suggesting somemeasure of success in expanding access to medications and reducing cardiovascular risk among Indigenous people.
Jordan, Zoe PhD; Munn, Zachary PhD; Aromataris, Edoardo PhD; Lockwood, Craig PhD
International Journal of Evidence-Based Healthcare:September 2015 - Volume 13 - Issue 3 - p 117–120 doi: 10.1097/XEB.0000000000000053
Our new Corporate Member, the Joanna Briggs Institute, is celebrating its 20th anniversary. 10 years ago the Institute published the JBI model of evidence-based healthcare, outlining a developmental framework of evidence-based practice that attempted to situate healthcare evidence and its role and use within the complexity of practice settings globally. Guidance on how to conduct reviews of different evidence types was limited at that time and has come a long way in the last decade. With a focus on both the scientific and pragmatic elements of the translational cycle, this article explores the history of methodological development of the Institute and postures where to from here.
The latest edition of the Australian Journal of Primary Health provides perspectives on commissioning from Australia, the United Kingdom, New Zealand and China. It covers conceptual frameworks for commissioning, the history of commissioning and the experience of commissioning in particular jurisdictions and settings. Specific applications of commissioning for general practice, capacity building and community services are also included.
Commissioning is a means to an end, not an end in itself. It may have potential as a mechanism for improving the quality and efficiency of health and community services, but there are many pitfalls and risks. The choices made in how commissioning is developed and implemented in Australia will determine just how many of these are avoided. It is worth learning from past experience.
It includes articles from a number of HSRAANZ members.