Rural-urban variation in injury-related hospitalisation, health outcomes and treatment cost in New South Wales

Objective. Assault is a global public health issue that affects individuals of all ages. This study describes the epidemiological profile of assault-related hospitalization and health outcomes across different age groups in New South Wales, Australia. Methods. Population-based linked hospitalization and mortality data from January 1, 2010, to June 30, 2014, were used to identify assault-related hospitalizations. Age-standardized rates were calculated and health outcomes were examined by age group. Results. There were 22 579 hospitalizations due to assault, with an age-standardized rate of 55.9 per 100 000 population (95% confidence interval = 55.2 to 56.70). Assault by bodily force (63.1%) and by sharp or blunt objects (21.6%) were the most common injury mechanisms. Individuals above 60 years had the highest mean hospital length of stay at 7.3 days, 30- and 90-day mortality, and average hospitalization costs at $9757. Conclusion. The findings have important implications in informing the development and strategies to reduce assault-related incidents in the community.

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Improvements in the quality of care and health outcomes with new stroke care units following implementation of a clinician-led, health system redesign programme in New South Wales, Australia

BMJ Quality & Safety ◽

10.1136/qshc.2007.024604 ◽

2008 ◽

Vol 17 (5) ◽

pp. 329-333 ◽

Cited By ~ 39

Author(s):

D A Cadilhac ◽

D C Pearce ◽

C R Levi ◽

G A Donnan ◽

Keyword(s):

Quality Of Care ◽

Health Outcomes ◽

Health System ◽

New South ◽

New South Wales ◽

Stroke Care ◽

South Wales ◽

Health System Redesign

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A Clean Air Plan for Sydney: An Overview of the Special Issue on Air Quality in New South Wales

Atmosphere ◽

10.3390/atmos10120774 ◽

2019 ◽

Vol 10 (12) ◽

pp. 774 ◽

Cited By ~ 8

Author(s):

Clare Paton-Walsh ◽

Peter Rayner ◽

Jack Simmons ◽

Sonya L. Fiddes ◽

Robyn Schofield ◽

...

Keyword(s):

Air Pollution ◽

Air Quality ◽

Health Outcomes ◽

New South ◽

New South Wales ◽

Dust Storms ◽

Pollution Level ◽

Special Issue ◽

South Wales ◽

Clean Air

This paper presents a summary of the key findings of the special issue of Atmosphere on Air Quality in New South Wales and discusses the implications of the work for policy makers and individuals. This special edition presents new air quality research in Australia undertaken by (or in association with) the Clean Air and Urban Landscapes hub, which is funded by the National Environmental Science Program on behalf of the Australian Government’s Department of the Environment and Energy. Air pollution in Australian cities is generally low, with typical concentrations of key pollutants at much lower levels than experienced in comparable cities in many other parts of the world. Australian cities do experience occasional exceedances in ozone and PM2.5 (above air pollution guidelines), as well as extreme pollution events, often as a result of bushfires, dust storms, or heatwaves. Even in the absence of extreme events, natural emissions play a significant role in influencing the Australian urban environment, due to the remoteness from large regional anthropogenic emission sources. By studying air quality in Australia, we can gain a greater understanding of the underlying atmospheric chemistry and health risks in less polluted atmospheric environments, and the health benefits of continued reduction in air pollution. These conditions may be representative of future air quality scenarios for parts of the Northern Hemisphere, as legislation and cleaner technologies reduce anthropogenic air pollution in European, American, and Asian cities. However, in many instances, current legislation regarding emissions in Australia is significantly more lax than in other developed countries, making Australia vulnerable to worsening air pollution in association with future population growth. The need to avoid complacency is highlighted by recent epidemiological research, reporting associations between air pollution and adverse health outcomes even at air pollutant concentrations that are lower than Australia’s national air quality standards. Improving air quality is expected to improve health outcomes at any pollution level, with specific benefits projected for reductions in long-term exposure to average PM2.5 concentrations.

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Health outcomes of a subsidised fruit and vegetable program for Aboriginal children in northern New South Wales

The Medical Journal of Australia ◽

10.5694/mja13.10445 ◽

2013 ◽

Vol 199 (1) ◽

pp. 46-50 ◽

Cited By ~ 17

Author(s):

Andrew P Black ◽

Hassan Vally ◽

Peter S Morris ◽

Mark Daniel ◽

Adrian J Esterman ◽

...

Keyword(s):

Health Outcomes ◽

New South ◽

New South Wales ◽

Fruit And Vegetable ◽

South Wales ◽

Aboriginal Children

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A Communitarian Correction for Health Outcomes in New South Wales?

Australian Journal of Primary Health ◽

10.1071/py96027 ◽

1996 ◽

Vol 2 (2) ◽

pp. 36 ◽

Cited By ~ 2

Author(s):

Chris Rissel

Keyword(s):

Health Services ◽

Health Outcomes ◽

New South ◽

Theoretical Perspective ◽

New South Wales ◽

State Level ◽

Health Department ◽

Australian Health ◽

South Wales ◽

Catchment Areas

For over a decade, there has been a growing focus on health outcomes in the Australian health care system at a national and state level. Designed to improve population health, health outcomes programs are an attempt to re-orient health services. In Australia, New South Wales (NSW) is probably the most advanced state in implementing a health outcomes approach. What is the role of communities in the model of health outcomes proposed by the NSW Health Department? A theoretical perspective of 'community' is presented, which is then used to analyse major policy documents and publications from the NSW Department of Health that advance a health outcomes approach. The interface between health services and communities is particularly important from the perspective of NSW Health Areas and Districts which must implement programs to improve the health outcomes of the communities in their catchment areas. The contribution to improved health outcomes that is possible by working with communities should not be lost in any re-orientation of health services.

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Impact of chronic health conditions and injury on school performance and health outcomes in New South Wales, Australia: a retrospective record linkage study protocol

BMJ Paediatrics Open ◽

10.1136/bmjpo-2019-000530 ◽

2019 ◽

Vol 3 (1) ◽

pp. e000530

Author(s):

Rebecca Mitchell ◽

Cate M Cameron ◽

Reidar P Lystad ◽

Olav Nielssen ◽

Anne McMaugh ◽

...

Keyword(s):

Health Outcomes ◽

School Performance ◽

New South ◽

New South Wales ◽

Chronic Health Condition ◽

Health Condition ◽

Health Conditions ◽

Chronic Health ◽

South Wales ◽

Education Performance

IntroductionChildren who have sustained a serious injury or who have a chronic health condition, such as diabetes or epilepsy, may have their school performance adversely impacted by the condition, treatment of the condition and/or time away from school. Examining the potential adverse impact requires the identification of children most likely to be affected and the use of objective measures of education performance. This may highlight educational disparities that could be addressed with learning support. This study aims to examine education performance, school completion and health outcomes of children in New South Wales (NSW), Australia, who were hospitalised with an injury or a chronic health condition compared with children who have not been hospitalised for these conditions.Method and analysisThis research will be a retrospective population-level case-comparison study of hospitalised injured or chronically ill children (ie, diabetes, epilepsy, asthma or mental health conditions) aged ≤18 years in NSW, Australia, using linked health and education administrative data collections. It will examine the education performance, school completion and health outcomes of children who have been hospitalised in NSW with an injury or a chronic health condition compared with children randomly drawn from the NSW population (matched on gender, age and residential postcode) who have not been hospitalised for these conditions.Ethics and disseminationThe study received ethics approval from the NSW Population Health Services Research Ethics Committee (2018HRE0904). Findings from the research will be published in peer-reviewed journals and presented at scientific conferences.

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Association between continuity of provider-adjusted regularity of general practitioner contact and unplanned diabetes-related hospitalisation: a data linkage study in New South Wales, Australia, using the 45 and Up Study cohort

BMJ Open ◽

10.1136/bmjopen-2018-027158 ◽

2019 ◽

Vol 9 (6) ◽

pp. e027158 ◽

Cited By ~ 2

Author(s):

Rachael E Moorin ◽

David Youens ◽

David B Preen ◽

Mark Harris ◽

Cameron M Wright

Keyword(s):

General Practitioner ◽

New South ◽

New South Wales ◽

Self Report ◽

Lower Probability ◽

Study Cohort ◽

Inverse Association ◽

South Wales ◽

Related Hospitalisation ◽

Bed Days

ObjectiveTo assess the association between continuity of provider-adjusted regularity of general practitioner (GP) contact and unplanned diabetes-related hospitalisation or emergency department (ED) presentation.DesignCross-sectional study.SettingIndividual-level linked self-report and administrative health service data from New South Wales, Australia.Participants27 409 survey respondents aged ≥45 years with a prior history of diabetes and at least three GP contacts between 1 July 2009 and 30 June 2015.Main outcome measuresUnplanned diabetes-related hospitalisations or ED presentations, associated costs and bed days.ResultsTwenty-one per cent of respondents had an unplanned diabetes-related hospitalisation or ED presentation. Increasing regularity of GP contact was associated with a lower probability of hospitalisation or ED presentation (19.9% for highest quintile, 23.5% for the lowest quintile). Conditional on having an event, there was a small decrease in the number of hospitalisations or ED presentations for the low (−6%) and moderate regularity quintiles (−8%), a reduction in bed days (ranging from −30 to −44%) and a reduction in average cost of between −23% and −41%, all relative to the lowest quintile. When probability of diabetes-related hospitalisation or ED presentation was included, only the inverse association with cost remained significant (mean of $A3798 to $A6350 less per individual, compared with the lowest regularity quintile). Importantly, continuity of provider did not significantly modify the effect of GP regularity for any outcome.ConclusionsHigher regularity of GP contact—that is more evenly dispersed, not necessarily more frequent care—has the potential to reduce secondary healthcare costs and, conditional on having an event, the time spent in hospital, irrespective of continuity of provider. These findings argue for the advocacy of regular care, as distinct from solely continuity of provider, when designing policy and financial incentives for GP-led primary care.

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