Exploring equity in cancer treatment, survivorship, and service utilisation for culturally and linguistically diverse migrant populations living in Queensland, Australia: a retrospective cohort study.

Background: There is strong international evidence documenting inequities in cancer care for migrant populations. In Australia, there is limited information regarding cancer equity for Culturally and Linguistically Diverse (CALD) migrant populations, defined in this study as migrants born in a country or region where English is not the primary language. This study sought to quantify and compare cancer treatment, survivorship, and service utilisation measures between CALD migrant and Australian born cancer populations.

Rethinking cancer prevention for migrant populations in Queensland, Australia: A retrospective cohort study comparing culturally and linguistically diverse and Australian born cancer patients.

International evidence suggests migrants experience significant cancer inequities. In Australia, there is limited information assessing equity for Culturally and Linguistically Diverse (CALD) migrant populations, particularly in cancer prevention. Cancer inequities are often explained by individualistic, behavioural risk factors; however, scarce research has quantified or compared engagement with cancer prevention strategies.

Potential role of general practice in reducing emergency department demand: A qualitative study.

Objective: To inform local, state and national strategies intended to reduce demand for ED care, the present study aimed to identify key factors influencing the current provision of acute care within primary healthcare (PHC) and explore the policy and system changes potentially required.

Methods: Semi-structured interviews with key stakeholders were audio-recorded, transcribed verbatim and analysed through content and thematic approaches incorporating the Walt and Gilson health policy framework.

Results: Eleven interviews were conducted.

Acceptability of emergency department triage nurse's advice for patients to attend general practice: A cross-sectional survey.

Objectives: Demand for ED care is increasing at a rate higher than population growth. Strategies to attenuate ED demands include diverting low-acuity general practice-type ED attendees to alternate primary healthcare settings. The present study assessed the ED attendees' receptiveness to accept triage nurse's face-to-face advice to explore alternate options for medical care and what factors influence the level of acceptance.

Impact of the Four-Hour Rule policy on emergency medical services delays in Australian EDs: a longitudinal cohort study.

Introduction: Delayed handover of emergency medical services (EMS) patients to EDs is a major issue with hospital crowding considered a primary cause. We explore the impact of the 4-hour rule (the Policy) in Australia, focusing on ambulance and ED delays.

Methods: EMS (ambulance), ED and hospital data of adult patients presenting to 14 EDs from 2002 to 2013 in three jurisdictions were linked.

General practitioner-type patients in emergency departments in metro North Brisbane, Queensland: A multisite study.

Objective: To estimate the proportion of ED patients in urban Queensland who are potentially suitable for general practitioner (GP) care.

Methods: A retrospective analysis was conducted using ED Information System data from Metro North Hospital and Health Service in Brisbane, Australia for three consecutive financial years (2014-2015 to 2016-2017). The hospitals included two Principal Referral and two Public Acute hospitals.

When a health policy cuts both ways: Impact of the National Emergency Access Target policy on staff and emergency department performance.

Objective: To explore the impact of the Four-Hour Rule/National Emergency Access Target (4HR/NEAT) on staff and ED performance.

Methods: A mixed-methods study design was used to link performance data from 16 participating hospitals with the experiences reported by 119 ED staff during policy implementation. Quantitative and qualitative measures were triangulated to identify the staff and organisational effects on hospital performance.

Emergency department models of care in Queensland: a multisite cross-sectional study.

Objective The acuity and number of presentations being made to emergency departments (EDs) is increasing. In an effort to safely and efficiently manage this increase and optimise patient outcomes, innovative models of care (MOC) have been implemented. What is not clear is how these MOC reflect the needs of patients or relate to each other or to ED performance.

Qualitative analysis of perceptions and experiences of emergency department staff in relation to implementation and outcomes of the Four-Hour Rule/National Emergency Access Target in Australia.

Objective: The implementation of the time target policy (Four-Hour Rule/National Emergency Access Target [4HR/NEAT]) constituted a major change for ED, and potentially on quality of care. The present study aimed to understand perceptions and experiences of ED staff during 4HR/NEAT implementation.

Methods: A semi-structured interview was used to explore views and perceptions of 119 ED staff from 16 EDs in New South Wales, Australian Capital Territory, Queensland and Western Australia.

Impact of the Four-Hour Rule/National Emergency Access Target policy implementation on emergency department staff: A qualitative perspective of emergency department management changes.

Objective: It has been 10 years since the ACEM Access Block Solutions Summit and 5 years since the introduction of the Four-Hour Rule/National Emergency Access Target (4HR/NEAT) policy. The impact of this policy on ED management and on ED staff has been poorly understood. The aim of the present study was to identify changes in ED management resulting from the policy based on ED staff experiences.

Impact of the four-hour National Emergency Access Target on 30 day mortality, access block and chronic emergency department overcrowding in Australian emergency departments.

Objective: Previous research reported strong associations between ED overcrowding and mortality. We assessed the effect of the Four-Hour Rule (4HR) intervention (Western Australia (WA) 2009), then nationally rolled out as the National Emergency Access Target (Australia 2012) policy on mortality and patient flow.

Methods: A longitudinal cohort study of a population-wide 4HR, for 16 hospitals across WA, New South Wales (NSW), Australian Capital Territory (ACT) and Queensland (QLD).

Impact of the National Emergency Access Target policy on emergency departments' performance: A time-trend analysis for New South Wales, Australian Capital Territory and Queensland.

Objective: To evaluate the impact of the Australian National Emergency Access Target (NEAT) policy introduced in 2012 on ED performance.

Methods: A longitudinal cohort study of NEAT implementation using linked data, for 12 EDs across New South Wales (NSW), Australian Capital Territory (ACT) and Queensland (QLD) between 2008 and 2013. Segmented regression in a multi-level model was used to analyse ED performance over time before and after NEAT introduction.

Temperature Variability and Gastrointestinal Infections: A Review of Impacts and Future Perspectives.

The objectives of this research are to review and assess the current state of knowledge of the association between environmental temperature and gastrointestinal (GI) infections. A review of the published literature was undertaken using standard approaches. Initially, four electronic databases including Embase, Medline, Scopus, and Web of Science were chosen to retrieve studies published from 1 January 2006 to 31 December 2017 based on selected keywords used in the primary search.

Understanding ED performance after the implementation of activity-based funding.

Objective: The aim of this study was to describe emergency department (ED) activities and staffing after the introduction of activity-based funding (ABF) to highlight the challenges of new funding arrangements and their implementation.

Methods: A retrospective study of public hospital EDs in Queensland, Australia, was undertaken for 2013-2014. The ED and hospital characteristics are described to evaluate the alignment between activity and resourcing levels and their impact on performance.

Patients' choice between public and private hospital emergency departments: a cross-sectional survey.

Objective: The aim of this study was to understand what factors influence patients' choice between public and private hospital ED and the relative weight of those factors among adult patients with private health insurance in Australia.

Methods: A survey of 280 patients was conducted in four public and private hospitals' EDs in Brisbane between May and August 2015. The survey included information about respondent's demographics, nature of illness, decision-making, attitudes and choice.

Agreement between triage category and patient's perception of priority in emergency departments.

Background: Patients attending hospital emergency departments (ED) commonly cite the urgency and severity of their condition as the main reason for choosing the ED. However, the patients' perception of urgency and severity may be different to the nurses' perception of their urgency and severity, which is underpinned by their professional experience, knowledge, training and skills. This discordance may be a cause of patient dissatisfaction.

Qualitative study of patients' choice between public and private hospital emergency departments.

Objective: The aim of this study was to gather patients' perceptions regarding their choice between public and private hospital EDs for those who hold private health insurance. The findings of this study will contribute to knowledge regarding patients' decision-making processes and therefore may contribute to the development of evidence based public policies.

Methods: An in-depth semi-structured guide was used to interview participants at public and private hospital EDs.

Projecting excess emergency department visits and associated costs in Brisbane, Australia, under population growth and climate change scenarios.

The direct and indirect health effects of increasingly warmer temperatures are likely to further burden the already overcrowded hospital emergency departments (EDs). Using current trends and estimates in conjunction with future population growth and climate change scenarios, we show that the increased number of hot days in the future can have a considerable impact on EDs, adding to their workload and costs. The excess number of visits in 2030 is projected to range between 98-336 and 42-127 for younger and older groups, respectively.

Public use and perceptions of emergency departments: A population survey.

Objectives: To inform demand management strategies aimed at reducing congestion in EDs by: (i) identifying public use of EDs, decision-making and reasons; and (ii) measuring acceptance of alternative care models.

Methods: A cross-sectional telephone survey of a random sample of Queensland population aged 18 years or older residing in a dwelling unit in Queensland that could be contacted on a land-based telephone service was conducted. One person per household was selected according to a predetermined algorithm to ensure sex and regional balance were interviewed.

Review article: Emergency department models of care in the context of care quality and cost: a systematic review.

To identify current ED models of care and their impact on care quality, care effectiveness, and cost. A systematic search of key health databases (Medline, CINAHL, Cochrane, EMbase) was conducted to identify literature on ED models of care. Additionally, a focused review of the contents of 11 international and national emergency medicine, nursing and health economic journals (published between 2010 and 2013) was undertaken with snowball identification of references of the most recent and relevant papers.

Socio-demographic vulnerability to heatwave impacts in Brisbane, Australia: a time series analysis.

Objective: Examining the association between socioeconomic disadvantage and heat-related emergency department (ED) visits during heatwave periods in Brisbane, 2000-2008.

Methods: Data from 10 public EDs were analysed using a generalised additive model for disease categories, age groups and gender.

Results: Cumulative relative risks (RR) for non-external causes other than cardiovascular and respiratory diseases were 1.

Funding emergency care: Australian style.

The ongoing challenge for ED leaders is to remain abreast of system-wide changes that impact on the day-to-day management of their departments. Changes to the funding model creates another layer of complexity and this introductory paper serves as the beginning of a discussion about the way in which EDs are funded and how this can and will impact on business decisions, models of care and resource allocation within Australian EDs. Furthermore it is evident that any funding model today will mature and change with time, and moves are afoot to refine and contextualise ED funding over the medium term.

Assessment of the temperature effect on childhood diarrhea using satellite imagery.

A quasi-Poisson generalized linear model combined with a distributed lag non-linear model was used to quantify the main effect of temperature on emergency department visits (EDVs) for childhood diarrhea in Brisbane from 2001 to 2010. Residual of the model was checked to examine whether there was an added effect due to heat waves. The change over time in temperature-diarrhea relation was also assessed.

Emergency healthcare of the future.

Emergency healthcare is a high profile component of modern healthcare systems, which over the past three decades has fundamentally transformed in many countries. However, despite this rapid development, and associated investments in service standards, there is a high level of concern with the performance of emergency health services relating principally to system wide congestion. The factors driving this problem are complex but relate largely to the combined impact of growing demand, expanded scope of care and blocked access to inpatient beds.

Epidemiologic patterns of Ross River virus disease in Queensland, Australia, 2001-2011.

Ross River virus (RRV) infection is a debilitating disease that has a significant impact on population health, economic productivity, and tourism in Australia. This study examined epidemiologic patterns of RRV disease in Queensland, Australia, during January 2001-December 2011 at a statistical local area level. Spatio-temporal analyses were used to identify the patterns of the disease distribution over time stratified by age, sex, and space.