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Analysis and Comment (40)

Elderly patients increasingly have multiple illnesses and are much more difficult to care for. Elderly patients increasingly have multiple illnesses and are much more difficult to care for. Julian Rovagnati/Shutterstock

Why hospitals need more generalist doctors and specialist nurses

New medical technologies and treatments over the past few decades have led to remarkable improvements in treating older patients. The annual death rate for an 80-year-old male in 2011 was just 5.6%, compared…
Nation wide, rapid response teams save around 12,000 lives per year. Nation wide, rapid response teams save around 12,000 lives per year. AAP

Rapid response teams halve hospital heart attack deaths

Detecting and treating patients before they have a cardiac arrest isn’t rocket science, but it’s a life saver. Rapid response systems identify deteriorating patients by abnormal vital signs and observations…
As the queue grows, small increases in waiting times soon turn into dramatic spikes. As the queue grows, small increases in waiting times soon turn into dramatic spikes. Fotoluminate LLC/Shutterstock

GP co-payment would increase emergency department wait times

The introduction of a GP co-payment could see average emergency department visits increase by between six minutes and almost three hours, new modelling shows, as more patients opt for free hospital care…
The chances of a single level of government taking charge of Australia’s health system are slim. The chances of a single level of government taking charge of Australia’s health system are slim. AAP/Quentin Jones

Federal-state health relations: can anything be salvaged?

The federal budget reignited debate over federal-state relations with a decision to cut $80 billion funding for the state responsibilities of schools and hospitals over the coming years. So how can federal-state…
Effective, safe and patient-centred care is needed across the board. Effective, safe and patient-centred care is needed across the board. Jorgejesus4

Quality of hospital care varies more within countries than between them

Patient safety and quality of care are priorities in health, as is learning from our mistakes when things go wrong. But little is known about what hospitals are doing to make sure the services they deliver…
With the right training and supervision, assistants could safely take on 15% of nurses' workloads. With the right training and supervision, assistants could safely take on 15% of nurses' workloads. John Keith/Shutterstock

Hospital workforce reform: better jobs and more care

Employees are the public hospital system’s most valuable resource, and its biggest cost. Wages account for nearly 70% of recurrent hospital spending. To keep hospital care affordable in a time of rising…
Doctors are focused almost exclusively on treating the potential infection in the patient in front of them. Doctors are focused almost exclusively on treating the potential infection in the patient in front of them. Shutterstock

Infection control: why doctors over-prescribe antibiotics

Health authorities have long warned that antibiotics should only be used when they’re genuinely needed, to restrain antibiotic-resistant superbugs and avoid potentially serious side-effects. But many doctors…
Finding ways to deliver high-quality care at an affordable cost to the nation is just as important as finding cures for diseases. Finding ways to deliver high-quality care at an affordable cost to the nation is just as important as finding cures for diseases. DWaschnig/Flickr

Digital tools for a better, more sustainable health system

It seems that almost every politician, health economist, policy expert and health-care worker has a different take on the state of the nation’s health system and ways to make it more sustainable. But notably…
The cost of operations varies from hospital to hospital but a higher price doesn’t equal better care. The cost of operations varies from hospital to hospital but a higher price doesn’t equal better care. TheTun/Shutterstock

Public hospital efficiency gains could save $1 billion a year

Public hospital spending has been the single fastest-growing area of government spending over the past decade. As governments, policymakers and economists put health spending under the microscope, it’s…
Women report that the birth environment is a key factor in how easy or hard it is to give birth. Women report that the birth environment is a key factor in how easy or hard it is to give birth. Image from shutterstock.com

Babies, not burgers: why we need better-designed labour wards

I recently visited a new McDonald’s outlet on the northern fringes of Sydney. What I found inside left me gawping in astonishment: soft lighting, views of nature, a mixture of private and communal spaces…
The view out of a hospital window can make a big difference to patients and to staff. The view out of a hospital window can make a big difference to patients and to staff. Miranda Lawry

A clearer view on the healing power of the arts

Florence Nightingale was a practical, highly experienced nurse who advocated the role of beauty, aesthetics and nature in medical practice. She believed buildings with windows, beautiful views, central…
Bit of first aid wouldn’t go amiss. Bit of first aid wouldn’t go amiss. Lester Public Library

Silly ambulance call-outs are just the tip of the iceberg

We expect just as much from our ambulance services as we do from accident and emergency departments. But under-resourced and overstretched health systems mean ambulance staff are increasingly under pressure…
Anononymised information from emergency departments can improve policing. Anononymised information from emergency departments can improve policing. Dominic Alves

Hospitals could help police prevent violent crime

With so many lurid reports of violence on our TV screens, it’s easy to think that the police know about all or most incidents. But they don’t. The National Crime Victimisation Survey in the US and the…
You never know what’s coming through the door. You never know what’s coming through the door. Folkstone42

Confessions of a US emergency doctor

Walking into each room to greet my next patient often reminds me of Forrest Gump: “You never know what you’re going to get.” It’s challenging to have only one chance to get it right but I love being an…
Getting everyone to take part is the first step. Getting everyone to take part is the first step. R L Johnson

While some fight over psychiatry, others are forging better ways ahead

The subject of mental health and illness often raises philosophical and ethical issues and fundamental questions revolve around the definition of mental illness – how are health and illness defined, who…
Being sectioned in a mental hospital may not mean the best care. Being sectioned in a mental hospital may not mean the best care. Truester

Patients sectioned for beds, but hospitals not the best place to be

Claims that doctors are sectioning mental health patients in order to get them access to beds on psychiatric wards amount to “more than anecdotal evidence”, according to a committee of MPs who have just…
Whistling while you work should be part of the NHS culture. Whistling while you work should be part of the NHS culture. Flickr/Truthout.org

Sacked for whistleblowing, now the NHS must reform

I lost my job in 2010 after raising concerns about staff shortages and patient safety in the NHS. But despite the NHS Chief Executive’s promise to intervene for whistleblowers and a tribunal in my favour…
The key question is whether the new prime minister regards the hospital system as having been fixed. The key question is whether the new prime minister regards the hospital system as having been fixed. AAP Image/David Crosling

Will the buck stop with Rudd on fixing the hospital system?

One of the key platforms of the first Rudd government was to reform the health and hospital system. The key message from then-prime minister Kevin Rudd was that the health, and particularly hospitals…
Everyone seems to prefer a big punch up. Everyone seems to prefer a big punch up. Flickr/Peacay

Doctors bashing Jeremy Hunt is just a Punch and Judy show

It’s a traditional part of the theatre of health policy for trade unionists to give secretaries of state for health a hard time. The latest example of this was the vote of no confidence in Jeremy Hunt…
A game of two halves: publishing performance can improve services but could also affect who surgeons choose to take on. A game of two halves: publishing performance can improve services but could also affect who surgeons choose to take on. PA/Gareth Fuller

Publishing surgeons' performance could lead to gaming

Data on hospital performance often shows a wide variation and this poses the question of whether it should be available to the public or kept confidential. The government wants more transparency and announced…
Hear ye, hear ye: keep your hands off our hospital. Hear ye, hear ye: keep your hands off our hospital. PA/Lewis Whyld

Fighting over hospital closures hides a lack of radical thinking

The public often suspects that the financial crisis is the real cause of hospital closures, even when other reasons are given. The NHS has found it virtually impossible to proceed with closing, or even…
Passions run high when it comes to the NHS but despite some unprecedented challenges it will do what it always does - survive. Passions run high when it comes to the NHS but despite some unprecedented challenges it will do what it always does - survive. PA

Despite the difficulties, the NHS is not dead yet

The NHS in 2013 is facing a series of unprecedented challenges. A rapidly ageing population is just one of a number of factors fuelling a rise in demand for services and hospitals are struggling to cope…
Four hours in A&E? Haven’t you got homes to go to? Four hours in A&E? Haven’t you got homes to go to? Rui Vieira/PA

Attacking GPs for A&E crisis ignores roots of the problem

Politicians and policy makers are blaming failures in out-of-hours GP care for the rising demand on accident and emergency (A&E) units. The number of attendances at A&E departments in England rose…
GPs and hospitals aren’t incentivised to properly manage demand, which has contributed to the crisis in Accident & Emergency. GPs and hospitals aren’t incentivised to properly manage demand, which has contributed to the crisis in Accident & Emergency. PA/Stephen Kelly

A&E is in crisis because we all take it for granted

Our increasing use of hospital services is out of control and unsustainable and is contributing to the current crisis in accident and emergency (A&E). But the problem isn’t new and 30 years of NHS…
The UK has a strict policy of gender segregation on psychiatric wards, and so should Australia. The UK has a strict policy of gender segregation on psychiatric wards, and so should Australia. Image from shutterstock.com

Sexual assaults in psych wards show urgent need for reform

Women admitted to psychiatry wards experience high levels of violence and sexual assaults, according to a report released this week by the Victorian Mental Illness Alliance Council. Across the nine different…
David Cameron meets nurses during an NHS tour but the government doesn’t want to introduce mandatory staffing levels. David Cameron meets nurses during an NHS tour but the government doesn’t want to introduce mandatory staffing levels. PA

Finding the golden ratio for hospital nurses

Senior nurses warned this week that the number of patients looked after by nurses has become dangerously high in some hospitals. Quoting research from the University of Southampton, the Safe Staffing Alliance…
Like much of what we see on TV, this one’s a myth. Like much of what we see on TV, this one’s a myth. Image from shutterstock.com

Monday’s medical myth: flatlining patients can be shocked back to life

Beep….beep……….beep……….beeeeeeeeeeeeeeeeeeeeeeeeep. “We’re losing him. Out of my way, nurse!” The quick-thinking young doctor charges the defibrillator paddles and places them on the chest of the lifeless…
The biggest and fastest-growing spending category in health is hospitals. The biggest and fastest-growing spending category in health is hospitals. Image from shutterstock.com

Tough choices: how to rein in Australia’s rising health bill

With health costs rising and costly medical innovations on the horizon, it’s crunch time for health funding. In the lead up to the May budget, The Conversation’s experts will explore the options for reining…
Health Minister Tanya Plibersek (centre) announced the Commonwealth would pay the $107 million directly to hospitals. Health Minister Tanya Plibersek (centre) announced the Commonwealth would pay the $107 million directly to hospitals. AAP/Julian Smith

Medi-muddle: hospital funding fight is resolved but the blame game goes on

After months of battle between the Commonwealth and Victorian governments on hospital funding, Federal Health Minister Tanya Plibersek dramatically intervened last Wednesday by announcing a A$107 million…
The Commonwealth and Victorian governments blame each other for hospital budget cuts. The Commonwealth and Victorian governments blame each other for hospital budget cuts. Image from shutterstock.com

Blame game: cutting through the spin on Victoria’s hospital funding cuts

As Victorian hospitals have announced bed closures, job losses and elective surgery delays over the past six weeks, cuts to health service budgets look set to significantly affect patient care in the state…
ED congestion is due to the combination of growing demand for care, sicker patients and access block. ED congestion is due to the combination of growing demand for care, sicker patients and access block. Image from shutterstock.com

Targets alone won’t solve long waits for emergency care

Data released today by the National Health Performance Authority (NHPA) shows just 54% of major metropolitan hospitals and 63% of major regional hospitals are treating or admitting patients within the…
There are a number of design flaws in the new hospital funding system. There are a number of design flaws in the new hospital funding system. xparxy

Why the new way of funding public hospitals won’t work

The first of July saw the introduction of one of the most important health care reforms for Australia’s public hospitals: national activity-based funding (ABF). Hospitals will now be paid a fixed price…
Hospitals provide a regular flow of captive customers for fast food outlets. Hospitals provide a regular flow of captive customers for fast food outlets. Roslyn in Starfish Island

Fast food restaurants have no place in our hospitals

A number of commentators have raised concerns recently about the increasing corporate presence in Australian schools. At a time of burgeoning rates of obesity and chronic disease, the increasing presence…
The deal has a narrower focus than the original but still delivers $20 billion of extra funds. The deal has a narrower focus than the original but still delivers $20 billion of extra funds.

Health agreement diagnosis: ‘watered down but not a total cave in’

Health professionals and patients alike breathed a sigh of relief yesterday when Prime Minister Julia Gillard announced she had struck a final deal with the states to reform the nation’s hospital system…

Research and News (5)

Research Briefs (12)

Using copper against ‘superbugs’

Using copper objects in hospitals reduces infection rates, a US study has found. Patients were randomly assigned to rooms…

ICU physicians defy utilitarianism

Intensive Care Unit clinicians often allocate scarce resources towards gravely-ill existing patients rather than freeing…