Medicine and Health Sciences Commons^™

Effectiveness Of Quality Incentive Payments In General Practice (Equip-Gp): A Study Protocol For A Cluster-Randomised Trial Of An Outcomes-Based Funding Model In Australian General Practice To Improve Patient Care, Gregory Peterson, Grant Russell, Jan Radford, Nicholas Arnold Zwar, Danielle Mazza, Simon Eckermann, Judy Mullan, Marijka Batterham, Athena Hammond, Andrew D. Bonney

Illawarra Health and Medical Research Institute

Background There is international interest in whether improved primary care, in particular for patients with chronic or complex conditions, can lead to decreased use of health resources and whether financial incentives help achieve this goal. This trial (EQuIP-GP) will investigate whether a funding model based upon targeted, continuous quality incentive payments for Australian general practices increases relational continuity of care, and lessens health-service utilisation, for high-risk patients and children. Methods We will use a mixed methods approach incorporating a two-arm pragmatic cluster randomised control trial with nested qualitative case studies. We aim to recruit 36 general practices from Practice-Based Research …

Patient-Centred Care: What's Important To Our Patients?, N Smith

Faculty of Science, Medicine and Health - Papers: part A

Patients were asked what mattered to them in their episode of surgery and anaesthesia. Although most responses were based on the medical condition and procedure, this approach allowed the anaesthetist to customise aspects of care to individual patients. It is a concept that appears relevant and worthwhile to our patients.

Patient Perceptions Of Anaesthesia Research Priorities - A Failed Study, Natalie A. Smith, D Martin

Graduate School of Medicine - Papers (Archive)

Professor Steven Shafer alerted conference delegates at a recent international meeting to the value of considering topics for future research in terms of what the most important questions are that remain to be solved1. He quoted from an issue of Science magazine, in which the editors reported questions they thought pointed to the greatest current scientific knowledge gaps2. Two of the top 25 related to anaesthesia in a broad sense: the biological basis of consciousness and how memories are stored and retrieved. Others have noted the relevance of asking patients what they considered research priorities to be3,4. We designed a …

The Role Of Health Literacy And Social Networks In Arthritis Patient's Health Information-Seeking Behaviour: A Qualitative Study, Janette Ellis, Judy Mullan, Anthony Worsley, Nagesh Brahmavar Pai

Graduate School of Medicine - Papers (Archive)

Background. Patients engage in health information-seeking behaviour to maintain their wellbeing and to manage chronic diseases such as arthritis. Health literacy allows patients to understand available treatments and to critically appraise information they obtain from a wide range of sources. Aims. To explore how arthritis patients’ health literacy affects engagement in arthritis-focused health information-seeking behaviour and the selection of sources of health information available through their informal social network. Methods. An exploratory, qualitative study consisting of one-on-one semi-structured interviews. Twenty participants with arthritis were recruited from community organizations. The interviews were designed to elicit participants’ understanding about their arthritis and …

Patient Perceptions Of Innovative Longitudinal Integrated Clerkships Based In Regional, Rural And Remote Primary Care: A Qualitative Study, Judith N. Hudson, Patricia J. Knight, Kathryn M. Weston

Graduate School of Medicine - Papers (Archive)

No abstract provided.

A Patient Experiencing Pseudoseizures: A Case Report, F Joseph, J Quinlan

Faculty of Health and Behavioural Sciences - Papers (Archive)

Pseudoseizures are a relatively complex problem of unknown aetiology and prognosis. They can at times resemble genuine seizure attacks but they have no abnormal electroencephalograpic (EEG) activity. Understanding the patient's unique psychological background appears to be fundamental in managing seizure frequency. Pseudoseizures can be disruptive to a person's lifestyle, limiting their ability to function and progress in society, particularly when it comes to employment or social interaction. The case discussed involves a 59-year old man who presents with what is believed to be seizurerelated activity but through the course of clinical evaluation, this turned out to be pseudoseizures

The Older Patient, The Doctor And The Trainee: Patients' Attitudes And Implications For Models Of Care, Andrew Bonney, Sandra Jones, Donald Iverson

Faculty of Health and Behavioural Sciences - Papers (Archive)

Aims & rationale/Objectives Population ageing poses major challenges for health systems. Additionally, training future general practitioners in the management of older and chronically ill patients is potentially hampered by the reluctance of these patients to consult trainees for chronic care. This paper reports a cross-sectional study investigating the attitudes of older patients to trainees, to inform strategies to improve older patient-trainee interaction. Methods The survey instrument was distributed to 1900 patients aged 60 and over from 38 training practices from five Australian states using a stratified, randomised cluster sampling process. Generalised estimating equation models were used for analysis. Principal findings …

Patient Satisfaction And Energy Intakes Are Enhanced By Point Of Service Meal Provision, Sarah Mahoney, Amanda Zulli, Karen Walton

Faculty of Health and Behavioural Sciences - Papers (Archive)

Aim: This systemic review aimed to investigate the effects of various methods of point of service meal provision on patient satisfaction and energy intakes of hospital patients. Methods: 'Medline' and 'Wiley Interscience' online databases (1999–2008) were consulted using search terms such as 'food service' and 'food delivery in hospital'. Cross-referencing was also used to select studies that compared the provision of full diets to hospital patients using two different methods of food service delivery. Results: Searching yielded 268 studies, of which 18 met the inclusion criteria (hospitals, all ages, oral intake only). Patient satisfaction was measured in 12 studies, while …

Patient And Professional Accuracy Of Recalled Treatment Decisions In Out-Patient Consultations, Timothy C. Skinner, Katharine D. Barnard, Susan Cradock, Tracey Parkin

Faculty of Health and Behavioural Sciences - Papers (Archive)

Aims  To test the assumption that professional recall of consultation decisions is valid and more accurate than patient recall of consultation decisions.

Methods  One hundred and thirty-four consultations between diabetes specialist nurses and diabetes specialist dietitians in an adult out-patient diabetes service were audiotaped. Patients and professionals were asked to recall the treatment decisions made immediately after the consultation. Patient participants were also asked to complete the Health Care Climate Questionnaire (HCC). Recalled decisions, by patient and professional participants, were then compared with those extracted from the audio tapes, and with each other.

Results  The mean duration of consultations was …

Factors Affecting Patient Recruitment In An Acute Rehabilitation Randomized Controlled Trial, Natasha Lannin, Anne Cusick

Faculty of Health and Behavioural Sciences - Papers (Archive)

OBJECTIVE. To evaluate factors associated with randomized controlled trial patient recruitment by therapists. METHOD. Survey of 18 (of a possible 26) therapists who had agreed to recruit patients for a randomized controlled trial (78% response rate). RESULTS. Sixteen respondents had enrolled at least one patient. The site at which the therapist worked neither influenced the likelihood that a therapist would contact the researcher nor influenced the recruitment rate. Seventeen respondents reported that they contacted the researcher to discuss one or more of their patients for potential inclusion in the trial. Factors reported by therapists as reasons why they did not …

Depression In The Patient With Copd, Ian G. Wilson

Graduate School of Medicine - Papers (Archive)

This paper explores the recent literature surrounding comorbid depression and COPD. The literature reveals a high prevalence of depression in patients with COPD and some evidence that the depression is a result of the disease. The literature highlights the negative impact of depression on quality of life and a possible impact on mortality. Depression also negatively impacts on compliance and smoking cessation. Treatment of depression in COPD, particularly by cognitive behavioral therapy, has positive impact on quality of life. Tricyclic antidepressants have a positive impact on mood and COPD, but side effects limit their use. The advent of the new …

Patients With Metabolic Syndrome: A Study Using Automated Dietary Assessment In Primary Care, Y. C. Probst

Faculty of Health and Behavioural Sciences - Papers (Archive)

An automated dietary assessment website has been developed for patients with metabolic syndrome. Computers have been set up in local GP practices to which the GP may refer their patients. These patients enter their dietary information into the website and receive an individualised dietary prescription put together by a dietitian. This study outlines the profile of patients using the website and their rates of completion of the assessment. Recruited patients were primarily female(66%). Ranging between 22 and 75 years of age patients reported to be overweight(77%), have high cholesterol (53%), elevated blood pressure (54%) and/or type 2 diabetes mellitus (35%). …