scholarly journals What has driven acute public hospital expenditure growth in South Australia? An analysis of the relative importance of major expenditure drivers between 2006–07 and 2017–18

2021 ◽  
Author(s):  
Allison Larg ◽  
John R. Moss
Keyword(s):  
Public Hospital ◽  
South Australia ◽  
Relative Importance ◽  
Hospital Expenditure ◽  
Expenditure Growth

Relative contribution of overweight and obesity to rising public hospital in-patient expenditure in South Australia

2019 ◽  
Vol 43 (2) ◽  
pp. 148 ◽  
Author(s):  
Allison Larg ◽  
John R. Moss ◽  
Nicola Spurrier
Keyword(s):  
Population Health ◽  
Obesity Prevention ◽  
Public Hospital ◽  
Financial Burden ◽  
Hospital Costs ◽  
South Australia ◽  
Overweight And Obesity ◽  
Public Healthcare ◽  
Relative Contribution ◽  
Expenditure Growth

Objective Arguments to fund obesity prevention have often focused on the growing hospital costs of associated diseases. However, the relative contribution of overweight and obesity to public hospital expenditure growth is not well understood. This paper examines the effect of overweight and obesity on acute public hospital in-patient expenditure in South Australia over time compared with other expenditure drivers. Methods Annual inflation-adjusted acute public admitted expenditure attributable to a high body mass index was estimated for 2007–08 and 2011–12 and compared with other expenditure drivers. Results Expenditure attributable to overweight and obesity increased by A$45million, from 4.7% to 5.4% of total acute public in-patient expenditure. This increase accounted for 7.8% of the A$583million total expenditure growth, whereas the largest component of total growth (62.4%) was a real increase in the average cost per separation. Conclusions The relatively minor contribution of overweight and obesity to expenditure growth over the time period examined invites reflection on arguments to boost preventive spending that centre upon reducing hospital costs. These arguments may inadvertently detract attention from the considerable health and social burdens of overweight and obesity and from unrelated sources of expenditure growth that reduce opportunities for state governments to fund obesity prevention programs despite their comparative benefits to population health. What is known about the topic? Stand-alone estimates suggest that overweight and obesity are placing a considerable financial burden on the Australian public healthcare system. What does this paper add? Our findings challenge common perceptions about the relative importance of overweight and obesity in the context of rising public in-patient expenditure in Australia. What are the implications for practitioners? Consistent serial estimates of overweight- and obesity-attributable expenditure enable its tracking and comparison with other potentially controllable expenditure drivers that may also warrant attention. Explicit consideration of population health trade-offs in expenditure-related decisions, including in enterprise bargaining, would enhance transparency in priority setting.

Preliminary investigations into the life cycle of Ventruia inaequalis (Cooke) WINT. in South Australia.

1953 ◽  
Vol 4 (4) ◽  
pp. 415 ◽  
Author(s):  
MW Jeffery
Keyword(s):  
Life Cycle ◽  
Primary Infection ◽  
South Australia ◽  
Late Summer ◽  
Relative Importance ◽  
New Information ◽  
One Year

Investigation into the possible sources of primary infection by the fungus Ventruia inaequalis (Cooke) Wint. in spring has been carried out. The results present new information on the life cycle of the pathogen under South Australian conditions. Sources of primary infection, such 'as lesions on one-year-old wood or overwintering superficial conidia on the trees, do not appear important. Bud-scale infection of dormant buds has been shown, and its relative importance is discussed. Ascospores are the most important source of primary infection. Their period of discharge extends to a later date than previously reported for South Australia and is considered in relation to leader shoot and late summer spot infection.

scholarly journals Recognising potential for preventing hospitalisation

2010 ◽  
Vol 34 (1) ◽  
pp. 116 ◽  
Author(s):  
David Banham ◽  
Tony Woollacott ◽  
John Gray ◽  
Brett Humphrys ◽  
Angel Mihnev ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Public Hospital ◽  
Hospital Admissions ◽  
South Australia ◽  
Local Area ◽  
Care Plan ◽  
Older Individuals ◽  
Preventable Hospitalisation ◽  
Access To Primary Care

To identify the incidence and distribution of public hospital admissions in South Australia that could potentially be prevented with appropriate use of primary care services, analysis was completed of all public hospital separations from July 2006 to June 2008 in SA. This included those classified as potentially preventable using the Australian Institute of Health and Welfare criteria for selected potentially preventable hospitalisations (SPPH), by events and by individual, with statistical local area geocoding and allocation of relative socioeconomic disadvantage quintile. A total of 744 723 public hospital separations were recorded, of which 79 424 (10.7%) were classified as potentially preventable. Of these, 59% were for chronic conditions, and 29% were derived from the bottom socioeconomic status (SES) quintile. Individuals in the lowest SES quintile were 2.5 times more likely to be admitted for a potentially preventable condition than those from the top SES quintile. Older individuals, males, those in the most disadvantaged quintiles, non-metropolitan areas and Indigenous people were more likely to have more than one preventable admission. People living in more disadvantaged areas in SA appear to have poorer utilisation of effective primary care, resulting in preventable hospital admissions, than those in higher SES groups. The SA Health Care Plan, 2007–2016 is aimed at investing in improved access to primary care in those areas of most disadvantage. The inclusion of SPPHs in future routine reporting should identify if this has occurred. What is known about the topic?Ambulatory care sensitive conditions, or selected potentially preventable hospitalisation separations (SPPH), are an indicator of the availability and effectiveness of primary health care. SPPHs are increasingly reported by area level disadvantage. What does this paper add?This paper offers analysis by individuals. It shows around three-quarters of individuals had one potentially preventable public hospital separation. The rate among those living in the most disadvantaged areas was more than twice that of lowest disadvantage areas. What are the implications for practitioners?Realising the potential for preventing potentially avoidable hospitalisation may involve focus on particular target areas and subpopulations. Potentially preventable separations by area of disadvantage can assist with monitoring performance and evaluating policy and program initiatives. Analysis by numbers of individuals will enhance this further.

scholarly journals Acute Transition Allliance: rehabilitation at the acute/aged care interface

2004 ◽  
Vol 28 (3) ◽  
pp. 266 ◽  
Author(s):  
Dawn J Kroemer ◽  
Geoffrey Bloor ◽  
Jeff Fiebig
Keyword(s):  
Residential Care ◽  
Public Hospital ◽  
Community Care ◽  
South Australia ◽  
Integrated Approach ◽  
Aged Care ◽  
Residential Aged Care ◽  
Acute Admissions ◽  
Made In

The acute/aged care interface has presented many challenges to funders, providers and planners in the health and aged care sectors. Concerns have long been expressed in the aged care sector about the changing needs of clients admitted permanently into residential aged care from hospitals where the decision for placement would often have been made in a crisis situation, without the opportunity to explore appropriate options. This article describes the process and outcomes to date of a collaborative effort between the acute care and aged care sectors in South Australia to develop a more integrated approach to discharge opportunities for older people. The program involves both residential and community care elements and seeks to provide rehabilitation, to restore function and to avoid inappropriate permanent residential care for older Australians following acute admissions to a public hospital. Interim outcomes are promising and show only 17% of those admitted to the program are discharged to long-term residential care.

Hospital admissions from residential aged care facilities to a major public hospital in South Australia (1999-2005)

2010 ◽  
Vol 30 (4) ◽  
pp. 202-207 ◽  
Author(s):  
Jodie B Hillen ◽  
Richard L Reed ◽  
Richard J Woodman ◽  
Deborah Law ◽  
Paul H Hakendorf ◽  
...  
Keyword(s):  
Public Hospital ◽  
Hospital Admissions ◽  
South Australia ◽  
Aged Care ◽  
Residential Aged Care ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Residential Aged Care Facilities

Public Hospital Expenditure: How Is It Divided between Lower, Middle and Upper Income Groups?

2000 ◽  
Vol 33 (4) ◽  
pp. 303-316 ◽  
Author(s):  
Deborah Schofield
Keyword(s):  
Public Hospital ◽  
Hospital Expenditure ◽  
Income Groups

Relative importance of gulf and shelf waters for spawning and recruitment of Australian anchovy, Engraulis australis, in South Australia

2004 ◽  
Vol 13 (5) ◽  
pp. 310-323 ◽  
Author(s):  
W. F. Dimmlich ◽  
W. G. Breed ◽  
M. Geddes ◽  
T. M. Ward
Keyword(s):  
South Australia ◽  
Relative Importance

scholarly journals How much emergency department use by vulnerable populations is potentially preventable?: A period prevalence study of linked public hospital data in South Australia

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e022845 ◽  
Author(s):  
David Banham ◽  
Jonathan Karnon ◽  
Kirsten Densley ◽  
John W Lynch
Keyword(s):  
Emergency Department ◽  
Vulnerable Populations ◽  
Public Hospital ◽  
South Australia ◽  
Public Hospitals ◽  
Prevalence Study ◽  
Excess Cost ◽  
Hospital System ◽  
Period Prevalence ◽  
Excess Costs

ObjectivesTo quantify emergency department (ED) presentations by individuals within vulnerable populations compared with other adults and the extent to which these are potentially preventable.DesignPeriod prevalence study from 2005-2006 to 2010–2011.SettingPerson-linked, ED administrative records for public hospitals in South Australia.ParticipantsAdults aged 20 or more in South Australia’s metropolitan area presenting to ED and categorised as Refugee and Asylum Seeker Countries of birth (RASC); Aboriginal; those aged 75 years or more; or All others.Main outcome measuresUnadjusted rates of ambulatory care sensitive condition (ACSC), general practitioner (GP)–type presentations and associated direct ED costs among mutually exclusive groups of individuals.ResultsDisparity between RASC and All others was greatest for GP-type presentations (423.7 and 240.1 persons per 1000 population, respectively) with excess costs of $A106 573 (95% CI $A98 775 to $A114 371) per 1000 population. Aboriginal had highest acute ACSC presenter rates (125.8 against 51.6 per 1000 population) with twice the risk of multiple presentations and $A108 701 (95% CI $A374 to $A123 029) per 1000 excess costs. Those aged 75 or more had highest chronic ACSC presenter rates (119.7vs21.1 per 1000), threefold risk of further presentations (incidence rate ratio 3.20, 95% CI 3.14 to 3.26) and excess cost of $A385 (95% CI $A178 160 to $A184 609) per 1000 population.ConclusionsVulnerable groups had excess ED presentations for a range of issues potentially better addressed through primary and community healthcare. The observed differences suggest inequities in the uptake of effective primary and community care and represent a source of excess cost to the public hospital system.

Patients ' preference on selecting a medical institution

2013 ◽  
Vol 26 (4) ◽  
pp. 341-352 ◽  
Author(s):  
Makoto Kobayashi ◽  
Toshiki Mano ◽  
Kazunobu Yamauchi
Keyword(s):  
Conjoint Analysis ◽  
Patient Selection ◽  
Public Hospital ◽  
Private Hospital ◽  
Organizational Form ◽  
Medical Institution ◽  
Relative Importance ◽  
Content Type ◽  
Selection Of

Purpose – The purpose of this paper is to evaluate the relative importance of attributes for patient selection of a medical institution and to quantitatively evaluate the impact of different types of organizational forms upon the patient ' s selection of a medical institution. Design/methodology/approach – By using a conjoint analysis, evaluation criteria in patient selection of a medical institution were examined. The paper assumed the selection of a medical institution under the situation of “being given a diagnosis of suspected diabetes with a physical examination and then visiting a medical institution”. The attributes included in the questionnaire were: quality of the medical institution, distance to the hospital, amount paid at the initial visit, amount paid at hospitalization for examinations, and organizational form of the hospital. Relative importance of the attributes and relative importance of organizational form were assessed. A total of 140 people were requested to respond to the questionnaire by way of researchers who have a connection with the authors. Completed responses were obtained from 111 subjects (79 per cent). Findings – The results of the conjoint analysis revealed that the most important attribute was quality of the medical institution. Organizational form was the attribute with the lowest importance. The utility value of being a public hospital was the highest within the organizational form attribute for all respondents and being a private hospital was the lowest. The quality of the medical institution was considered the most important factor in selecting a medical institution and the type of organizational form was considered least important. Regarding organizational form, being a public hospital was most preferred and being a hospital managed by a company and a private hospital were least preferred respectively among healthcare professionals and other occupations. Originality/value – The paper provides a relative evaluation of the factors thought to be important for patients in Japan when selecting a medical institution.

Potentially preventable hospitalisations in children: a comparison of definitions

2019 ◽  
Vol 105 (4) ◽  
pp. 375-381
Author(s):  
Alexandra M Procter ◽  
Rhiannon M Pilkington ◽  
John W Lynch ◽  
Lisa G Smithers ◽  
Catherine R Chittleborough
Keyword(s):  
Cumulative Incidence ◽  
Public Hospital ◽  
South Australia ◽  
Admission Rate ◽  
Admission Rates ◽  
Perinatal Data ◽  
Social Distribution ◽  
The Difference ◽  
Hospital Births ◽  
Respiratory Conditions

ObjectiveTo compare admission rate, cumulative incidence and social distribution of potentially preventable hospitalisations (PPHs) among children according to the current Australian adult definition, and the child definition developed in New Zealand.Design, setting, participantsDeidentified, linked public hospital, births registry and perinatal data of children aged 0–10 years born 2002–2012 in South Australia (n=1 91 742).Main outcome measuresPPH admission rates among 0–10 year olds and cumulative incidence by age 5 under the adult and child definitions. Cumulative incidence was assessed across indicators of social and health disadvantage.ResultsPPH admission rates among 0–10 year olds were 25.6 (95% CI 25.3 to 25.9) and 59.9 (95% CI 59.5 to 60.4) per 1000 person-years for the adult and child definitions, respectively. Greater absolute differences in admission rates between definitions were observed at younger ages (age <1 difference: 75.6 per 1000 person-years; age 10 difference: 1.4 per 1000 person-years). Cumulative incidence of PPHs among 0–5 year olds was higher under the child (25.0%, 95% CI 24.7 to 25.2) than the adult definition (12.8%, 95% CI 12.6 to 13.0). Higher PPH incidence was associated with social and health disadvantage. Approximately 80% of the difference in admission rate between definitions was due to five conditions.ConclusionsRespiratory conditions and gastroenteritis were key contributors to the higher PPH admission rate and cumulative incidence among children when calculated under the child definition compared to the adult definition. Irrespective of definition, higher PPH cumulative incidence was associated with social and health disadvantage at birth.

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