The creation of Grampians Health - a case study focusing on lessons learned from a health service merger.

This case study of the merger of four hospitals in western Victoria reports on the views of participants affected by the merger - as staff or from the communities - about 2 years after the merger. Respondents reported that many of the sought-after benefits of the merger were being delivered. However, the merger process itself attracted criticism, and it is here that this merger can provide lessons for others.

Hospital utilisation in Australia, 1993-2020, with a focus on use by people over 75 years of age: a review of AIHW data.

Objectives: To assess Australian hospital utilisation, 1993-2020, with a focus on use by people aged 75 years or more.

Design: Review of Australian Institute of Health and Welfare (AIHW) hospital utilisation data.

Setting, Participants: Tertiary data from all Australian public and private hospitals for the financial years 1993-94 to 2019-20.

Public Health Management of the COVID-19 Pandemic in Australia: The Role of the Morrison Government.

The Australian Commonwealth government has four health-related responsibilities during the SARS-CoV-2 pandemic: to provide national leadership; to manage external borders; to protect residents of residential aged care facilities; and to approve, procure and roll-out tests and vaccines. State governments are responsible for determining what public health measures are appropriate and implementing them-including managing the border quarantine arrangements and the testing, tracing, and isolation regime-and managing the hospital response. This paper analyses the national government's response to the pandemic and discusses why it has attracted a thesaurus of negative adjectives.

Remoteness, models of primary care and inequity: Medicare under-expenditure in the Northern Territory.

Objective To analyse Medicare expenditure by State/Territory, remoteness, and Indigenous demography to assess funding equality in meeting the health needs of remote Indigenous populations in the Northern Territory. Methods Analytic descriptions of Medicare online reports on services and benefits by key demographic variables linked with Australian Bureau of Statistics data on remoteness and Indigenous population proportion. The Northern Territory Indigenous and non-Indigenous populations were compared with the Australian average between the 2010/2011 and 2019/2020 fiscal years in terms of standardised rates of Medicare services and benefits.

Election 2022 should address unfinished business in health and aged care.

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Australia's Response to COVID-19.

Australia suffered two waves of the coronavirus disease 2019 pandemic in 2020: the first lasting from February to July 2020 was mainly caused by transmission from international arrivals, the second lasting from July to November was caused by breaches of hotel quarantine which allowed spreading into the community. From a second wave peak in early August of over 700 new cases a day, by November 2020 Australia had effectively eliminated community transmission. Effective elimination was largely maintained in the first half of 2021 using snap lockdowns, while a slow vaccination programme left Australia lagging behind comparable countries.

The problematic place of private payment for healthcare in Australia.

Private funding and private hospital provision play a key role in Australian healthcare. However, this role is inherently inequitable, creating a two-speed health system. Canada should avoid expanding private involvement in paying for healthcare.

Commentary: The Consequences of Private Involvement in Healthcare - The Australian Experience.

The Cambie proposition is the American individualistic one: If I can afford to pay for quick access to care, then that should be my right. It denies any concept of universalism, of the common good or that your rights might adversely impact my rights and my healthcare experience. Some private care proponents offer the magical prospect that this quicker access for the wealthy few has no impact on access for the many.

What should primary care look like after the COVID-19 pandemic?

The response to COVID-19 transformed primary care: new telehealth items were added to the Medicare Benefits Schedule, and their use quickly escalated, general practices and community health centres developed new ways of working and patients embraced the changes. As new coronavirus infections plummet and governments contemplate lifting spatial distancing restrictions, attention should turn to the transition out of pandemic mode. Some good things happened during the pandemic, including the rapid introduction of the new telehealth items.

Value-Based Healthcare: Fad or Fabulous?

Value-based healthcare has entered the lexicon of health service managers and policy makers over the past decade. But translating the idea from a rhetorical device or concept for use in the United States into a policy or action elsewhere is difficult. It has obvious appeal - who can argue against value? In this paper, I discuss the utility of value-based care as a rhetorical device and the complexity of operationalizing it and identifying patient perspectives on value.

Australia's new digital health record created ethical dilemmas.

The last few months of 2018 saw a major battle over privacy, autonomy and use of health information in Australia as the basis for the national electronic health record changed from an opt-in system to one where every person had such a record unless they specifically requested to opt-out of the system. The debate was messy, involving both ethical and wider political concerns, with the ethical concerns partly heightened because of the political context. Canadian health leaders can learn from the mistakes and successes of this situation.

Degenerative meniscal tears of the knee: evaluation and management.

Meniscal injuries are among the most common orthopaedic injuries seen in knee clinics. Meniscal tears can occur as a result of acute injuries or chronic degeneration. However, the exact incidence of meniscal tears is difficult to ascertain because of the high number of asymptomatic tears and the high rate of degenerative tears in patients with advanced degenerative joint disease.

The Canadian health system's "administrative efficiency" is a problem.

The Commonwealth Fund's "administrative efficiency" criterion ranks Canada poorly-sixth of the 11 countries compared. On two of the four patient-sourced measure used in this criterion, Canada was below the international average performance. For two of the three physician-sourced measures, Canada performs well but is significantly behind the best performing country.

Pathways to DRG-based hospital payment systems in Japan, Korea, and Thailand.

Countries in Asia are working towards achieving universal health coverage while ensuring improved quality of care. One element is controlling hospital costs through payment reforms. In this paper we review experiences in using Diagnosis Related Groups (DRG) based hospital payments in three Asian countries and ask if there is an "Asian way to DRGs".

Aligning policy objectives and payment design in palliative care.

Background: Payment models for palliative care vary across nations, with few adopting contemporary payments designs that apply to other parts of the health system.

Aim: To propose optimal payment arrangements for palliative care.

Approach: Review of relevant literature on funding mechanisms in health care generally and palliative care in particular.

Expanding the breadth of Medicare: learning from Australia.

The design of Australia's Medicare programme was based on the Canadian scheme, adapted somewhat to take account of differences in the constitutional division of powers in the two countries and differences in history. The key elements are very similar: access to hospital services without charge being the core similarity, universal coverage for necessary medical services, albeit with a variable co-payment in Australia, the other. But there are significant differences between the two countries in health programmes - whether or not they are labelled as 'Medicare'.

Metalwork Prominence and Operative Interventions for Treating Olecranon Fractures: Systematic Review of Randomised Controlled Trials.

In this systematic review of randomized controlled trials, we aimed to assess the effects of different surgical treatments for olecranon fractures in adults, especially the rate of metalwork prominence. We searched the Cochrane Bone, Joint, and Muscle Trauma Group's Specialized Register (2018), the Cochrane Central Register of Controlled Trials (CENTRAL, 2018, Issue 1), Ovid MEDLINE (1946-2018), and Embase (1980-2018). We also searched ISRCTN registry, ClinicalTrials.

Regionalization as One Manifestation of the Pursuit of the Holy Grail.

Regionalization has strengths and weaknesses. The balance of the two will vary over time, differing in different contexts and with different implementations. Alberta's implementation of a centralized structure had some strengths: economies of scale and expertise; opportunities for province-wide learning; internalization of geographic politics; and improved geographic equity.