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Australian Health Review is a peer-reviewed international journal that publishes articles on all aspects of health policy and management, healthcare delivery systems, clinical programs, health financing and other matters of interest to those working in health care. It also publishes new research from practitioners--managers and clinicians--and reports breakthrough projects that demonstrate better ways of delivering care. It is distributed to members of the Australian Healthcare and Hospitals Association (www.aushealthcare.com.au) and the Australian Institute of Health Policy Studies (www.healthpolicystudies.org.au), as well as subscribers throughout the world. The journal is currently offering open access to the following articles.

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Controlled clinical trial of a self-management program for people with mental illness in an adult mental health service--the Optimal Health Program (OHP).

Monica M. Gilbert, James A. Chamberlain, Carolynne R. White, Paul W. Mayers, Brendan Pawsey, Danny Liew, Matthew Musgrave, Kerry Crawford and David J. Castle

www.publish.csiro.au/nid/270/paper/AH11008.htm

The objective of this study was to evaluate the effect and cost-effectiveness of a self-management intervention, delivered as part of routine care in an adult mental health service. Adult consumers of mental health services in the Australian Capital Territory were eligible for participation. Current literature supports the efficacy of structured self-management programs for chronic conditions such as diabetes (type 1 and 2) and asthma, but there remains limited evidence that self-management programs improve outcomes for people with mental illness. This study adds to the body of evidence supporting self-management as a cost-effective adjunct to routine care in mental health services.

Universal for whom? Evaluating an urban Aboriginal population's access to a mainstream universal health home visiting program.

John Widdup, Elizabeth J. Comino, Vana Webster and Jennifer Knight

www.publish.csiro.au/nid/270/aid/13680.htm

The aim of this study was to investigate access to a universal health home visit program for families of Aboriginal and non-Aboriginal infants and the effect of a one-off home visit on subsequent health service utilisation. Assessing ways in which universal services are delivered, to ensure equity of access, may help to re-evaluate target expectations, reduce demand on nursing staff, improve targeting of vulnerable infants and help in further developing and implementing effective health policy.

The study highlighted the challenges of ensuring equitable access to a universal postnatal home visiting program. Families of Aboriginal infants were found to be less likely than families of non-Aboriginal infants to receive a home visit within two weeks. Being a young mother, an unpartnered mother, a mother with psychosocial risks (identified antenatally), or a mother residing in a disadvantaged suburb were all factors associated with not receiving a visit within two weeks.

Do Indigenous Australians age prematurely? The implications of life expectancy and health conditions of older Indigenous people for health and aged care policy.

Philippa R. Cotter, John R. Condon, Tony Barnes, Ian P. S. Anderson, Leonard R. Smith and Teresa Cunningham

www.publish.csiro.au/nid/270/paper/AH11996.htm

To assess whether Indigenous Australians age prematurely compared with other Australians, as implied by Australian Government aged care policy.

At age 63 for women and age 65 for men, Indigenous people had the same life expectancy as non-Indigenous people at age 70. There is no consistent pattern of a 20-year lead in age-specific prevalence of age-associated conditions for Indigenous compared with other Australians. There is high prevalence, from middle age onwards, of some conditions particularly diabetes (type unspecified) but there is little or no lead for others.

The idea that Indigenous people age prematurely is not well supported by this study of a series of discrete conditions. The current focus and type of services provided by the aged care sector may not be the best way to respond to the excessive burden of chronic disease and disability of middle-aged Indigenous people.

Judging a patient's decision to seek emergency healthcare: clues for managing increasing patient demand.

Amee Morgans and Stephen Burgess

www.publish.csiro.au/nid/270/paper/AH10921.htm

There is a public health issue where some patients seek emergency healthcare when they are not acutely unwell (inappropriate health service users) and some patients fail to seek emergency healthcare when they are acutely unwell (patients who "delay" or avoid using emergency health services). There is a difference in understanding between health professionals and patients about what a health emergency is and when it is appropriate to seek emergency healthcare. There is an increasing demand for emergency health services both nationally and internationally.

This paper provides a review of Australian and international rates of "inappropriate" healthcare utilisation. This paper identifies the limitations on the ability to determine whether patients were appropriate or inappropriate, and instead identifies what motivates patients to seek emergency healthcare for non-acute events and fail to seek healthcare for acute events.
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Publication:The Lamp
Geographic Code:8AUST
Date:Apr 1, 2012
Words:796
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