摘要:

AbstractThis paper is both a personal account and an analysis of the Medicare Review (part 2) that took place in 1985‐6, to which I acted as Consultant Adviser.* It analyses health policy issues associated with the recent inquiry to consider expanding the Medicare Scheme to include the services of some paramedical occupations. It considers what took place, the history of events leading up to the Review, the complexities of the review process and issues of implementation as well as the wider context. The paper moves from the descriptive to the analytical level to explain and interpret the review process from both a sociological and social policy point of view. The relevance of the Review to public health is twofold: the development and application of a new methodology to evaluate complementary health modalities on one hand, and the role of the Review in promoting both the legitimacy of these occupations, and, from a public policy analysis viewpoint, cost containment, on the othe

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00029.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractThis study examined factors inhibiting and enhancing the development of primary medical care within community health centres. Nine centres with medical services, representing a range of financial administrative arrangements and a spread of locations, were selected for investigation. A modified version of the Community Health Accreditation and Standards Project (CHASP) review process was developed to look at areas of health service functioning. Effective internal management and a shared ethos were the strongest predictors of favourable outcomes overall. Salaried, as opposed to fee‐for‐service, financial arrangements led to better outcomes in most function areas, although salaried arrangements in themselves were not sufficient to produce good outcomes. All centres that performed well had community management structures, but the presence of such structures did not always guarantee good outcomes. The educational background and experience of the doctors had no effect. The study confirmed that primary medical care within community health centres represents a viable, alternative model of general practice in Australia and identified some factors that could strengthen it furt

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00030.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractThe public health problem of head injuries contributes to considerable morbidity in the community and is the commonest cause of death in young adult Australians. However, estimating the incidence of head injury has been difficult, and has varied between countries and over time. This paper critically appraises the methodological issues contributing to head injury/brain injury incidence estimates, in particular case definition, differing data sources, and methods of case ascertainment. The most appropriate definition from a methodological service provider perspective is one which clearly distinguishes between potential and actual brain injury. The results from a study which used the most accurate methods have been extrapolated to NSW, and reduce the estimated brain injury incidence in NSW from a reported 392 to 180 per 100,000 incident cases per year. This revised estimate implies that in 1990 there will be about 10,500 new cases of traumatic brain injury, of which an estimated 400 will result in serious physical or mental disability. These estimates were originally calculated to enable the development of an appropriate level of health service provision for brain‐injured persons through the NSW Brain Injury Progra

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00031.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractRegular participation in a high‐quality screening program by all ‘at risk’ women is necessary if Australia is to be maximally successful in preventing cervical cancer. This paper discusses the use of reminder letters as one method of facilitating participation. Options for the source of the letters are discussed. It is concluded that basing the recall letters on a register of previously screened women is the only feasible approach within the Australian health care system. The impact of reminder letters on achieving regular participation by Australian women remains to be t

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00032.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractTwo surveys in the same defined population in Sydney's western suburbs in 1986 and 1987 provided the opportunity to compare results obtained from a quota and a probability sample survey. These surveys were designed to provide information for the planning of local health promotion programs. The quota sample survey was conducted in shopping centres and used quota sampling to select 1727 respondents. In the second survey, area probability sampling was used to select 484 respondents. This survey had a response rate of 65 per cent. There were 15 questions common to both surveys; results of only three differed significantly (p<0.05) between surveys. None of these differences was important from a public health perspective.The agreement between the results of these two surveys probably reflects the fact that the same selection bias has operated in both. Unless a very high response rate can be achieved, quota sample surveys with age and sex quota controls may be an acceptable alternative to probability sample surveys for gathering local data relevant to the development of health programs.

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00033.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractAccess to disability data from a nationwide survey of New Zealanders provides the opportunity to estimate Life Expectancy Free of Disability (LEFD) for the non‐institutional adult population. This measure of population health status combines mortality and morbidity data into a single index.The analysis is restricted to the 15–64 age range and results on partial life expectancy free of disability are presented for the key socio‐demographic groups.The results conform to the international evidence and highlight the potential impact of disability as a component in a composite measure of population health status: although women live longer than men, almost all this apparent advantage in longevity is spent in some state of disablement; Maori are disadvantaged in comparison with non‐Maori both in terms of longevity and in the proportion of the life span spent disability‐free; and, social class comparisons show a decline in LEFD with declining social class that is steeper than the corresponding mortality gradient.Despite some technical difficulties and the strong requirements of the data, the LEFD measure has many potential applications in public health research and planning. In particular, it has the potential to direct research and policy towards the enhancement of the active years of life rather than just the postponement of

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00034.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractThis paper describes the recruitment, training and supervision of Community Educators for weight‐control programs, reports the results they have achieved to date, and offers suggestions for improving similar programs. This material is discussed in relation to suggestions about nutrition published by the Better Health Commissio

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00035.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00036.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractThis article draws inferences from changes in the style of a nutrition journal which was originally published by the Commonwealth Department of Health, and is now published by the Australian Dietitians' Association. The changes reflect developments in the field of nutrition, towards more ‘scientific’ styles of inquiry and publishing, against the backdrop of a division of labour in which (mainly male) laboratory scientists produced scientific knowledge which was then communicated by (mainly female) dietitians and nutritionists. Consistent with the approach of the ‘new public health’, this paper argues that reliance upon ‘scientific’ methods alone diverts attention from the social, economic and political conditions which help explain not only the improvements earlier in the century, but current difficulties in bringing about further i

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00037.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractBecause of the potential benefits of primary prevention and early detection of cancer, a considerable proportion of the efforts of State cancer organizations has been directed towards public educational programs. The study aimed to determine the level of agreement in the messages contained in the written educational material of the State and Territory cancer organizations in Australia. Pamphlets and brochures dealing with primary and secondary prevention of breast, cervical, skin and bowel cancers were obtained. The materials were compared on a number of dimensions: the characteristics of people who are at increased risk of contracting the cancer, how to avoid the cancer through primary prevention, how and when to screen in the case of secondary prevention, and action to be taken if a sign or symptom indicative of cancer is discovered. The study found a lack of agreement in the messages of the State cancer organizations. Some hypotheses are suggested to explain the discrepancies. In addition, some suggestions for remedying this situation are provided.

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1990.tb00038.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY