Search

This paper presents baseline data from Thrive, a capacity-building program for family day care educators. Educators completed a self-report survey assessing knowledge and confidence in promoting children's social and emotional wellbeing. An in-home observation was used to assess care quality. Twenty-four educators responded to the survey (40 per cent response rate). They had an average of nine years' experience and 82 per cent held childcare qualifications. Educators reported knowledge of, on average, three early signs of social and emotional problems in children, three risk factors and two protective factors. Using a scale from 0-10, mean educator confidence levels ranged from an average of 6.69 to 7.25. Quality of care ratings were moderate. Although educators had a good understanding of children's social and emotional wellbeing, the study identified opportunities for significant changes in the quality of the educators' interactions with children in their care and their professional development

Objective: Each year approximately 3,000 Australians die by suicide. We estimated the population attributable risk for identified target populations to provide evidence on how much of the overall burden of suicide in the Australian population is experienced by each of them. Methods: We identified 17 demographic and clinical target populations at risk of suicide and calculated the population attributable fraction (PAF) using a single or pooled suicide risk and the proportional representation of each target population within Australia. Results: Large PAF estimates were found for men (52%, 95% confidence interval (CI) 51%-53%), people bereaved by suicide (35%, 95% CI 14%-64%), people with a mental health or behavioural condition (33%, 95%CI 17%-48%), people with a chronic physical condition (27%, 95%CI 18%-35%), adults aged 25-64 years (13%, 95%CI 12%-14%), LGB populations (9%, 95%CI 6%-13%), offenders (9%, 95%CI 8%-10%), and people employed in blue collar occupations (8%, 95%CI 4%-12%). Limitations: The PAF is limited by assumptions, namely, that risk factors are independent, and that the relationship between risk factors and outcomes are unidirectional and constant through time. Conclusions and implications for public health: Considerable reductions in the overall suicide rate in Australia may occur if risk factors are addressed in identified populations with large PAF estimates. These estimates should be considered as an adjunct to other important inputs into suicide prevention policy priorities. [ABSTRACT FROM AUTHOR]

Objective: Virtual ED (VED) can potentially alleviate ED overcrowding which has been a public health challenge. The aim of the present study was to conduct a return‐on‐investment analysis of a VED programme developed in response to changing healthcare needs in Australia. Methods: An economic model was developed based on initial patient outcome data to assess the healthcare costs, potential costs saved and return on investment (ROI) from the VED. The VED programme operating as part of Alfred Health Emergency Services. The participants were the first 188 patients accessing the Alfred Health VED. VED is the delivery of emergency assessment and management of specific patients virtually via audio‐visual teleconferencing. ROI ratios that compare cost savings with intervention costs. Results: The mean total operational cost of VED for 79 days for 188 patients was A$344 117 (95% uncertainty interval [UI] $296 800–$392 088). The VED led to a potential A$286 779 (95% UI $241 688–$330 568) healthcare cost saving from reductions in emergency visits and A$97 569 (95% UI $74 233–$123 117) cost saving in ambulance services. The ROI ratio was estimated at 1.12 (95% UI 0.96–1.32). Conclusions: The VED was cost neutral in a conservatively modelled scenario but promising if any hospital admission could be saved. Ongoing research examining a larger cohort with community follow up is required to confirm this promising result. [ABSTRACT FROM AUTHOR]

Objective: Carers of people with cancer provide uncompensated care that is often physically, emotionally, and financially demanding, which results in neglect of their own health. This study's objective was to conduct an economic evaluation following a randomised control trial (RCT) involving a proactive telephone outcall intervention aimed at improving health outcomes among carers of cancer patients.Methods: The trial was a single-blind, multicentre, RCT conducted across four Australian health services, comprising three outcalls from trained Cancer Council 131120 (Cancer Council telephone and information support services) nurses compared with three phone call reminders of the availability of 131120 services (control group). Outcalls consisted of telephone contacts to the caregivers initiated by the Cancer Council nurses. The primary trial outcome was reduced carer burden. Health care resource use was measured using a resource use questionnaire (RUQ), and costs were presented in 2013 $(AUS). Quality-adjusted-life-years (QALYs) were also used as health outcomes. An incremental cost-effectiveness ratio (ICER) was calculated, with bootstrapping used to quantify sampling variability. A $50 000 per QALY-gained willingness-to-pay threshold was used. Sensitivity analyses were conducted.Results: Results showed that the total mean QALYs-gained were higher (0.02 QALYs, P = 0.01) in the control group, and total mean costs were lower in the control group ($477, P < 0.001) over the trial duration. The intervention group was dominated by the control group. Results were robust to sensitivity analyses.Conclusions: Results suggest policy makers should not adopt this intervention into routine health care in its current form. Further research into the efficacy and cost-effectiveness of telephone-based interventions for carers is required. [ABSTRACT FROM AUTHOR]

Objective: The aim of this project was to detail the costs associated with the high prevalence mental disorders (depression, anxiety-related and substance use) in Australia, using community-based, nationally representative survey data. Methods: Respondents diagnosed, within the preceding 12 months, with high prevalence mental disorders using the Confidentialised Unit Record Files of the 2007 National Survey of Mental Health and Wellbeing were analysed. The use of healthcare resources (hospitalisations, consultations and medications), productivity loss, income tax loss and welfare benefits were estimated. Unit costs of healthcare services were obtained from the Independent Hospital Pricing Authority, Medicare and Pharmaceutical Benefits Scheme. Labour participation rates and unemployment rates were determined from the National Survey of Mental Health and Wellbeing. Daily wage rates adjusted by age and sex were obtained from Australian Bureau of Statistics and used to estimate productivity losses. Income tax loss was estimated based on the Australian Taxation Office rates. The average cost of commonly received Government welfare benefits adjusted by age was used to estimate welfare payments. All estimates were expressed in 2013–2014 AUD and presented from multiple perspectives including public sector, individuals, private insurers, health sector and societal. Results: The average annual treatment cost for people seeking treatment was AUD660 (public), AUD195 (individual), AUD1058 (private) and AUD845 from the health sector’s perspective. The total annual healthcare cost was estimated at AUD974m, consisting of AUD700m to the public sector, AUD168m to individuals, and AUD107m to the private sector. The total annual productivity loss attributed to the population with high prevalence mental disorders was estimated at AUD11.8b, coupled with the yearly income tax loss at AUD1.23b and welfare payments at AUD12.9b. Conclusion: The population with high prevalence mental disorders not only incurs substantial cost to the Australian healthcare system but also large economic losses to society. [ABSTRACT FROM AUTHOR]

The article discusses a study which estimated from societal and government perspectives the annual costs of psychosis in Australia for 2010 and assessed whether average costs per person differ by principal service provider at time of census. Results show that the average annual costs of psychosis are estimated at 77,297 Australian dollars per affected individual. It concluded that the costs of psychosis are broad ranging and very high.

• Providing informal care to a person with dementia impacts carers' quality of life • Informal care is associated with negative emotional and physical health outcomes • Freedom, independence, and personal space improve carers' quality of life • Relationship with the person with dementia can influence carers' quality of life • Availability of formal and informal support is crucial in supporting carers Most people with dementia live at home and rely on family and friends who provide unpaid care and support. Informal carers of people with dementia are often described as 'invisible second patients', reflecting the higher-than-normal rates of depression, stress and physical illness. To inform service delivery and the development of evidence-based interventions targeting informal carers of people with dementia, it is important to understand their experiences. The aim of this study was to examine the experiences of caregivers in providing informal care to a person living with dementia and to examine how providing this care impacts their own quality of life. Semi-structured interviews were conducted with 16 informal carers in Australia. Recordings of the interviews were transcribed verbatim and analysed using an inductive approach (thematic analysis) which revealed strong narratives from informal carers regarding (1) available support, (2) the health impacts of caring, (3) new roles and responsibilities, and (4) the motivations around caring. The findings of this study reinforce that a comprehensive approach is needed in supporting informal carers in their caring role, ensuring sustainability of the aged care system and quality of life for people living with dementia. [ABSTRACT FROM AUTHOR]