Mental health

PHN Discussion Paper #2 – Mental Health notes a key role for Primary Health Networks in realising effective and lasting improvement in mental health outcomes, through adopting a person-centred approach in service design and enabling integration across service providers in local health systems. The 2014 National Mental Health Commission report noted that “They (PHNs) can work in partnership and apply targeted, value-for-money interventions across the whole continuum of mental wellbeing and ill-health to meet the needs of their communities.” Notwithstanding this, there are challenges and barriers to be resolved in order to effect meaningful and sustainable improvement in mental health outcomes and health system performance.  Further exploration of the challenges and barriers is warranted in order to enable PHNs to deliver on their objectives.&nbsp

Primary Health Network critical success factors

The Primary Health Network (PHN) program has the potential to make a significant positive difference in health outcomes for all Australians. PHN Discussion Paper #1 - Primary Health Network Critical Success Factors reflects on the lessons learnt from previous organised primary health care models in Australia, considers the factors that are essential for PHNs to create true public value, and identifies some key issues which PHNs and the Government need to address to ensure that PHNs are given every opportunity to succeed

Catholic Hospital Ethics

This is the final Report of the Commission on Ethical and Religious Directives for Catholic Hospitals - a study commission established by the Catholic Theological Society of America in June, 1971. Publication of the Report, which is not an official position of the CTSA, was accepted by the CTSA Board of Directors on September 1, 1972. This study is not presented as the final word on codes of ethics for Catholic hospitals, but is proposed as a moral theological rationale for understanding the purposes and functions of a set of ethical directives in Catholic hospitals, and as a basis for dialogue, reresearch, and the revision and interpretation of policies. Reactions to the Report are welcomed. As the list at the end of the Report indicates, it is the work of an eminent group of scholars with special insights into medicine and ethics; they in turn consulted others of equal competence in their fields. Since the directives were approved by the bishops in November, 1971, a number of diocesan meetings have been held to discuss the code. As more meetings are convened, the Linacre hopes to keep its readers up-to-date on the resulting dialogue

General Hospitals, Specialty Hospitals and Financially Vulnerable Patients

Examines whether specialty hospitals draw well-insured patients away from general and safety-net hospitals, reducing their ability to cross-subsidize less profitable services and uncompensated care, in three cities. Notes challenges and implications

Higher Readmissions at Safety-Net Hospitals and Potential Policy Solutions

The Hospital Readmissions Reduction Program (HRRP), established by the Affordable Care Act, ties a hospital's payments to its readmission rates -- with penalties for hospitals that exceed a national benchmark -- to encourage hospitals to reduce avoidable readmissions. This new Commonwealth Fund analysis uses publicly reported 30-day hospital readmission rate data to examine whether safety-net hospitals are more likely to have higher readmission rates, compared with other hospitals. Results of this analysis find that safety-net hospitals are 30 percent more likely to have 30-day hospital readmission rates above the national average, compared with non-safety-net hospitals, and will therefore be disproportionately impacted by the HRRP. Policy solutions to help safety-net hospitals reduce their readmission rates include targeting quality improvement initiatives for safety-net hospitals; ensuring that broader delivery system improvements include safety-net hospitals and care delivery systems; and enhancing bundled payment rates to account for socioeconomic risk factors

Hospitals

A hospital was one of the first European institutions set up in Australia in 1788. The aim in this article is to summarise the ensuring events, and particularly to demonstrate how hospitals have dramatically changed. One theme is to clarify the nature of convict hospitals and the low level of care expected in charity hospitals during the nineteenth and early twentieth centuries. Other themes are the impact of medical innovations, and the strong and increasingly interventionist role of the state in hospital governance. More recently, a theme has been the closure of small hospitals and the development of large hospital complexes. Throughout, the role of nurses has been crucial as they have provided the bulk of hospital care. Hospitals have always been plagued by scandals but the striking feature throughout their history in Sydney is the strength of the demand for hospital care

Comparison of performance achievement award recognition with primary stroke center certification for acute ischemic stroke care.

BackgroundHospital certification and recognition programs represent 2 independent but commonly used systems to distinguish hospitals, yet they have not been directly compared. This study assessed acute ischemic stroke quality of care measure conformity by hospitals receiving Primary Stroke Center (PSC) certification and those receiving the American Heart Association's Get With The Guidelines-Stroke (GWTG-Stroke) Performance Achievement Award (PAA) recognition.Methods and resultsThe patient and hospital characteristics as well as performance/quality measures for acute ischemic stroke from 1356 hospitals participating in the GWTG-Stroke Program 2010-2012 were compared. Hospitals were classified as PAA+/PSC+ (hospitals n = 410, patients n = 169,302), PAA+/PSC- (n = 415, n = 129,454), PAA-/PSC+ (n = 88, n = 26,386), and PAA-/PSC- (n = 443, n = 75,565). A comprehensive set of stroke measures were compared with adjustment for patient and hospital characteristics. Patient characteristics were similar by PAA and PSC status but PAA-/PSC- hospitals were more likely to be smaller and nonteaching. Measure conformity was highest for PAA+/PSC+ and PAA+/PSC- hospitals, intermediate for PAA-/PSC+ hospitals, and lowest for PAA-/PSC- hospitals (all-or-none care measure 91.2%, 91.2%, 84.3%, and 76.9%, respectively). After adjustment for patient and hospital characteristics, PAA+/PSC+, PAA+/PSC-, and PAA-/PSC+ hospitals had 3.15 (95% CIs 2.86 to 3.47); 3.23 (2.93 to 3.56) and 1.72 (1.47 to 2.00), higher odds for providing all indicated stroke performance measures to patients compared with PAA-/PSC- hospitals.ConclusionsWhile both PSC certification and GWTG-Stroke PAA recognition identified hospitals providing higher conformity with care measures for patients hospitalized with acute ischemic stroke, PAA recognition was a more robust identifier of hospitals with better performance