The development of national injury prevention policy in the Australian health sector: and the unmet challenges of participation and implementation

For the last 20 years injury prevention policy in Australia has been hampered by poor consultation practices, limited stakeholder involvement, inadequate allocation of resources, poor implementation, and an absence of performance measures. This paper describes the development of injury prevention policy in Australia from its beginnings in 1981 to the current day and considers what measures should be undertaken to create an effective platform for the reduction of the burden of injury in Australia. The National Injury Prevention and Safety Promotion Plan 2004–2014, released in 2005, needs to be supported by a whole of government commitment to the reduction of injury. The Council of Australian Governments would be an ideal forum to monitor progress, supported by a cross-government Ministerial Council

Impact of telephone triage on emergency after hours GP Medicare usage: a time-series analysis

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Alcohol Use during Pregnancy: Considerations for Australian Policy

Although there is an extensive recorded history of concerns related to alcohol exposed pregnancies and possible outcomes of fetal alcohol spectrum disorder in recent scientific literature, Australia has only recently begun to accurately or systematically diagnose and record these conditions, or to provide comprehensive, coordinated, policy-guided funding, prevention, and treatment. This article discusses some considerations that can guide policy development within the Australian context including the social context and determinates of alcohol consumption during pregnancy and the need to consider the issue as one that goes beyond the decision making of individual women. The article also identifies the contribution of research to guide evidence-based policy development, including emerging evidence of epigenetics, and systematic reviews for prevention. Other policy considerations include costs, and the possibility of the prevention paradox applying to this field, with its associated impact on costs and focus of prevention

Depression in multicultural Australia: Policies, research and services

BACKGROUND: Depression is one of the leading causes of disability in Australia. The cultural and linguistic diversity of the Australian population poses a significant challenge to health policy development, service provision, professional education, and research. The purpose of this study is to explore the extent to which the fact of cultural and linguistic diversity has influenced the formulation of mental health policy, the conduct of mental health research and the development of mental health services for people with depression from ethnic minority communities. METHODS: The methods used for the different components of the study included surveys and document-based content and thematic analyses. RESULTS: Policy is comprehensive but its translation into programs is inadequate. Across Australia, there were few specific programs on depression in ethnic minority communities and they are confronted with a variety of implementation difficulties. The scope and scale of research on depression in Ethnic minority communities is extremely limited. CONCLUSION: A key problem is that the research that is necessary to provide evidence for policy and service delivery is lacking. If depression in Ethnic minority communities is to be addressed effectively the gaps between policy intentions and policy implementation, and between information needs for policies and practice and the actual research that is being done, have to be narrowed

'Zero tolerance' and drug education in Australian Schools

For a decade in Australia, drug education in schools has been shaped by the approach of harm minimization adopted by state and national governments alike. Harm minimization has been accepted broadly by drug educators, and has encouraged schools to deepen their commitment to drug education, allowed them to communicate honestly with students, and to respond to instances of drug use in a less confrontational and more caring manner. Despite those advances, the notion of 'zero tolerance' within schools has been promoted recently by protagonists in the formulation of drug policy and it is mentioned in the recently published national school drug education policy. This article suggests that the adoption of a zero tolerance policy will end the consensus among drug educators, reduce the efficacy of drug education, lead to more punitive treatment of youthful drug experimenters, while doing nothing to reduce drug use. It concludes the existing policy of harm minimization offers schools more scope to address drug issues in a constructive manner than does zero tolerance, which in practice may inflate the harmful effects on young people of drug use

Developing future injury prevention research leaders - in support of 'mentoring'

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Medical emergencies in general practice in south-east Queensland: prevalence and practice preparedness

Objective: To determine the type and frequency of emergencies in general practice, and the extent to which general practices are equipped to appropriately respond to emergencies

Barriers and enablers to the provision of alcohol treatment among Aboriginal Australians: A thematic review of five research projects

Introduction and Aims: To review the results of five research projects commissioned to enhance alcohol treatment among Aboriginal Australians, and to highlight arising from them. Design and Methods: Drafts of the papers were workshopped by project representatives, final papers reviewed and results summarised. Lessons arising were identified and described. Results: While the impact of the projects varied, they highlight the feasibility of adapting mainstream interventions in Aboriginal Australian contexts. Outcomes include greater potential to: screen for those at risk; increase community awareness; build capacity and partnerships between organisations; and co-ordinate comprehensive referral networks and service provision. Discussion: Results show a small investment can produce sustainable change and positive outcomes. However, to optimise and maintain investment, cultural difference needs to be recognised in both planning and delivery of alcohol interventions; resources and funding must be responsive to and realistic about the capacities of organisations; partnerships need to be formed voluntarily based on respect, equality and trust; and practices and procedures within organisations need to be formalised. Conclusions: There is no simple way to reduce alcohol-related harm in Aboriginal communities. However, the papers reviewed show that with Aboriginal control, modest investment and respectful collaboration, service enhancements and improved outcomes can be achieved. Mainstream interventions need to be adapted to Aboriginal settings, not simply transferred. The lessons outlined provide important reflections for future research

Increase in computed tomography in Australia driven mainly by practice change: A decomposition analysis

Background: Publicly funded computed tomography (CT) procedure descriptions in Australia often specify the body site, rather than indication for use. This study aimed to evaluate the relative contribution of demographic versus non-demographic factors in driving the increase in CT services in Australia. Methods: A decomposition analysis was conducted to assess the proportion of additional CT attributable to changing population structure, CT use on a per capita basis (CPC, a proxy for change in practice) and/or cost of CT. Aggregated Medicare usage and billing data were obtained for selected years between 1993/4 and 2012/3. Results: The number of billed CT scans rose from 33 per annum per 1000 of population in 1993/94 (total 572,925) to 112 per 1000 by 2012/13 (total 2,540,546). The respective cost to Medicare rose from $145.7 million to$790.7 million. Change in CPC was the most important factor accounting for changes in CT services (88%) and cost (65%) over the study period. Conclusions: While this study cannot conclude if the increase is appropriate, it does represent a shift in how CT is used, relative to when many CT services were listed for public funding. This ‘scope shift’ poses questions as to need for and frequency of retrospective/ongoing review of publicly funded services, as medical advances and other demand- or supply-side factors change the way health services are used