DORA Site:
https://dora.health.qld.gov.au/qldresearchjspui/handle/1/885
2024-03-28T06:04:22ZAeromedical retrievals as a measure of potentially preventable hospitalisations and cost comparison with provision of GP-led primary health care in a remote community
https://dora.health.qld.gov.au/qldresearchjspui/handle/1/5444
Title: Aeromedical retrievals as a measure of potentially preventable hospitalisations and cost comparison with provision of GP-led primary health care in a remote community
Authors: Wieland, Lara; Abernethy, Gail
Abstract: Kowanyama is a very remote Aboriginal community. It is ranked amongst the top five most disadvantaged communities in Australia and has a very high burden of disease. Currently, the community has access to GP-led Primary Health Care (PHC) 2.5 days a week for a population of 1200 people. This audit aims to assess whether GP access correlates with retrievals and/or hospital admissions for potentially preventable conditions and whether it is cost effective and improves outcomes to provide the benchmarked staffing of GPs. A clinical audit was undertaken of aeromedical retrievals for the year 2019 to assess whether access to a rural GP would have prevented the need for retrieval and whether the condition for retrieval was 'preventable' or 'not preventable'. A cost-analysis was undertaken to compare the cost of providing accepted benchmark levels of GPs in community with the cost of potentially preventable retrievals. There were 89 retrievals of 73 patients in 2019. 61% of all retrievals were potentially preventable. Most (67%) of the preventable retrievals occurred with no doctor on site. For preventable condition retrievals, the mean number of visits to the clinic compared with non-preventable condition retrievals was higher for registered nurse or health worker visits (1.24 vs 0.93) and lower for GP visits (0.22 vs 0.37). The conservatively calculated costs of retrievals for 2019 matched the maximum cost of providing benchmark numbers (2.6 FTE) of rural generalist (RG) GPs in a rotating model for the audited community. Greater access to GP-led PHC appears to lead to fewer retrievals and hospital admissions for potentially preventable conditions. It is likely that some preventable condition retrievals would be avoided if a GP was always on site. Providing benchmarked numbers of RG GPs in a rotating model in remote communities is cost-effective and would improve patient outcomes.2023-01-01T00:00:00ZGenomic analysis of an outbreak of toxin gene bearing Corynebacterium diphtheriae in Northern Queensland, Australia reveals high level of genetic similarity
https://dora.health.qld.gov.au/qldresearchjspui/handle/1/5443
Title: Genomic analysis of an outbreak of toxin gene bearing Corynebacterium diphtheriae in Northern Queensland, Australia reveals high level of genetic similarity
Authors: Graham, Rikki M A; Rathnayake, Irani U; Sandhu, Sumeet; Bhandari, Murari; Taunton, Caroline; Fisher, Valmay; Hempenstall, Allison; Marquardt, Tonia; Jennison, Amy V
Abstract: Toxigenic diphtheria is rare in Australia with generally fewer than 10 cases reported annually; however, since 2020, there has been an increase in toxin gene-bearing isolates of Corynebacterium diphtheriae cases in North Queensland, with an approximately 300% escalation in cases in 2022. Genomic analysis on both toxin gene-bearing and non-toxin gene-bearing C. diphtheriae isolated from this region between 2017 and 2022 demonstrated that the surge in cases was largely due to one sequence type (ST), ST381, all of which carried the toxin gene. ST381 isolates collected between 2020 and 2022 were highly genetically related to each other, and less closely related to ST381 isolates collected prior to 2020. The most common ST in non-toxin gene-bearing isolates from North Queensland was ST39, an ST that has also been increasing in numbers since 2018. Phylogenetic analysis demonstrated that ST381 isolates were not closely related to any of the non-toxin gene-bearing isolates collected from this region, suggesting that the increase in toxigenic C. diphtheriae is likely due to the expansion of a toxin gene-bearing clone that has moved into the region rather than an already endemic non-toxigenic strain acquiring the toxin gene.2023-05-22T00:00:00ZCape York Kidney Care: service description and baseline characteristics of a client-centred multidisciplinary specialist kidney health service in remote Australia
https://dora.health.qld.gov.au/qldresearchjspui/handle/1/5442
Title: Cape York Kidney Care: service description and baseline characteristics of a client-centred multidisciplinary specialist kidney health service in remote Australia
Authors: Miller, Andrea; Brown, Leanne; Tamu, Clara; Cairns, Alice
Abstract: Chronic Kidney disease (CKD) is over-represented amongst First Nation people with more than triple the rate of CKD in those aged 15 years and over. The impact of colonisation, including harmful experiences of health practices and research, has contributed to these health inequities. Cape York Kidney Care (CYKC) has been created as an unique service which provides specialist care that aims to centre the client within a multidisciplinary team that is integrated within the primary care setting of the remote health clinics in six communities in western Cape York, Australia. This research aims to describe the Cape York Kidney Care service delivery model, and baseline service data, including aggregated client health measures. The model of care is described in detail. Review of the first 12 months of service provision has been undertaken with client demographic and clinical profile baseline data collected including kidney health measures. Participants are adults (> 18 years if age) with CKD grades 1-5. This data has been de-identified and aggregated. CYKC reviewed 204 individuals, with 182 not previously been reviewed by specialist kidney health services. Three quarters of clients identified as Aboriginal. The average age was 55 with a high level of comorbidity, with majority having a history of hypertension and Type 2 diabetes (average Hba1c 8.2%). Just under one third had cardiovascular disease. A large proportion of people had either Grade 2 CKD (32%) or Grade 3 CKD (~ 30%), and over half had severely increased albuminuria (A3), with Type 2 diabetes being the predominant presumed cause of CKD. Most clients did not meet evidence-based targets for diabetes, blood pressure or lipids and half were self-reported smokers. The proportion of clients reviewed represents 6.2% of the adult population in the participating First Nation communities. The CYKC model was able to target those clients at high risk of progression and increase the number of people with chronic kidney disease reviewed by specialist kidney services within community. Baseline data demonstrated a high burden of chronic disease that subsequently will increase risk of CKD progression and cardiovascular disease. People were seen to have more severe disease at younger ages, with a substantial number demonstrating risk factors for rapid progression of kidney disease including poorly controlled Type 2 diabetes and severely increased albuminuria. Further evaluation concerning implementation challenges, consumer and community satisfaction, and health outcomes is required.2023-08-24T00:00:00ZA low burden of severe illness: the COVID-19 Omicron outbreak in the remote Torres and Cape region of Far North Queensland
https://dora.health.qld.gov.au/qldresearchjspui/handle/1/5431
Title: A low burden of severe illness: the COVID-19 Omicron outbreak in the remote Torres and Cape region of Far North Queensland
Authors: Taunton, Caroline; Hawthorne, Leanne; Matysek, Rittia; Neville, Johanna; Coates, Marlow; Pickering, Emma; Hanson, Josh; Smith, Simon; Hempenstall, Allison
Abstract: A coronavirus disease 2019 (COVID-19) outbreak was declared in the remote Torres and Cape region of Far North Queensland soon after the Queensland border opened for quarantine-free domestic travel in December 2021, with a total of 7,784 cases notified during the first ten-month outbreak period. We report a crude attack rate among residents of 25.6% (95% confidence interval [95% CI]: 25.1-26.1%), a hospitalisation rate of 1.6% (95% CI: 1.3-1.9%) and a crude case fatality rate of 0.05% (95% CI: 0.01-0.13%). Hospitalisation and case fatality rates were similar among First Nations and non-Indigenous people, with double dose COVID-19 vaccination rates higher among First Nations than non-Indigenous people by the end of the outbreak period. We attribute the low burden of severe illness to local community leadership, community engagement, vaccination coverage and recency, and community participation in a local culturally considered COVID-19 care-in-the-home program.
Description: Cairns & Hinterland Hospital and Health Service (CHHHS) affiliated authors: Josh Hanson, Simon Smith2023-01-01T00:00:00Z