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37 Number 3: >>
Public Health
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Hospital
Planning: the risks of basing the future on past data
Sandra G Leggat p6 [
pdf
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Abstract
Planning for capital development of public hospitals in Victoria is
guided by a multi-stage process with comprehensive data analysis and
thorough approval processes at each of the stages. The long
development timeframes and the limitations in the data available to
project service utilisation may negatively impact upon the service
planning processes, and in some cases newly developed hospitals have
not been sufficiently planned to meet community needs. This paper
suggests that service utilisation forecasts derived from
administrative databases require a more detailed verification
process than currently exists. The process requires consideration of
the drivers of demand to document the core assumptions about the
future drivers, benchmarks with other jurisdictions,
epidemiological, comparative and corporate needs assessment to
explain the differences in utilisation rates, and sensitivity
analysis. Given the cost of hospital construction and the rate of
change in the healthcare sector, it is important that future
hospital planning processes do not accept current utilisation trends
as valid for future planning without this level of
verification.
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Emergency
department presentations of Victorian Aboriginal and Torres Straight
Islander people
Nadia Costa, Mary Sullivan, Rae Walker and
Kerin M Robinson p15 [
pdf
]
Abstract
This paper explains how routinely collected data can be used to
examine the emergency department attendances of Victorian Aboriginal
and Torres Strait Islander people. The data reported in the
Victorian Emergency Minimum Dataset (VEMD) for the 2006/2007
financial year were analysed. The presentations of Aboriginal and
Torres Strait Islander and non-Aboriginal people were compared in
terms of age, gender, hospital location (metropolitan and rural) and
presenting condition. Aboriginal and Torres Strait Islander people
were found to attend the emergency department 1.8 times more often
than non-Aboriginal people. While the emergency department
presentation rates of metropolitan Aboriginal and Torres Strait
Islander and non-Aboriginal people were similar, rural Aboriginal
and Torres Strait Islander people presented to the emergency
department 2.3 times more often than non- Aboriginal people. The
injuries or poisonings, respiratory conditions and mental disorders
presentation rates of the Aboriginal and Torres Strait Islander and
non-Aboriginal population were compared. No previous studies have
assessed the accuracy of the Indigenous status and diagnosis fields
in the VEMD; therefore the quality of this data is unknown.
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Issues
in the measurement of social determinants of health
Gavin Mooney and Nubong G. Fohtung
p26 [ pdf
]
Abstract
This article focuses on the measurement of the social determinants
of health, and specifically on issues relating to two key variables
relevant to the analysis of public health information: poverty and
inequality. Although the paper has been written from the perspective
of economics, the discipline of the two authors, it is also of
relevance to researchers in other disciplines. It is argued that
there is a need to ensure that, when considering measurement in this
largely neglected area of research,
sufficient thought is given to the relationships that are being
examined or assessed. We argue further that any attempt at
measurement in this area must take into account the historical
backdrop and the complex nature of the relationships between these
key variables.
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Recorded
categories of non-principal diagnoses in Victorian public hospital
transient ischaemic attack and stroke admissions
Shyamala G. Nadathur p33 [
pdf
]
Abstract
Information about the number and types of non-principal diagnoses (NPDs)
would make an important contribution to prediction of outcome and
hence patient management. The study reported here is based on
analysis of three fiscal years of the Victorian public hospital
transient ischaemic attack (TIA) and stroke admissions. The
incidence of NPDs and co-occurrence of NPD-associated prefix
categories (that identify the onset or relevance of each condition
to the episode) are described in each of the broad stroke subtypes.
The distributions of length of stay and in-hospital deaths in the
cohorts without and with NPDs and in the various prefix categories
are determined. The study also compares the age and gender
distribution in the various subpopulations of interest. The
importance of collecting complete and accurate data on nature of
NPDs and its potential in describing the complexity of presentation
are discussed.
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