Spike in palliative care
Palliative care hospital admissions in Australia rose >50% between 2001 and 2010, according the Australian Institute of Health and Welfare (AIHW) report, Palliative care services in Australia – 56,000 palliative care admissions to public and private hospitals in 2009-10 (average age 71.9 yrs; males 54% to females 46%). We apparently do things differently here in the West. Most palliative care admissions in WA (61%) were to private hospitals compared with a public hospital admission rate in NSW of 92% and Victoria 89%. AIHW spokesperson Brent Diverty said this reflected local service delivery and noted that higher private hospital use was still funded from the public purse.
Read the fine print
Australian Doctor is promoting its ‘online community for doctors’ – www.just4docs.com.au. Check out Rule 6 in their terms and conditions. It reads: By uploading content to or submitting any materials for use on this Web Site, you grant (or warrant that the owner of such rights has expressly granted) RBI a perpetual, worldwide, royalty-free, irrevocable, non-exclusive right and license, with right to sublicense, to use, reproduce, modify, adapt, publish, publicly perform, publicly display, digitally display and digitally perform translate, create derivative works from and distribute such materials or incorporate such materials into any form, medium, or technology now known or later developed throughout the universe. That covers just about everything.
Aged care, staff jab
Flu vaccination of staff at aged care facilities in 2013 might just be a very good idea. HDWA had a whopping bill for Tamiflu this year because Commonwealth Guidelines say if an outbreak occurs, state-funded Tamiflu 10-day course at $30-40 a pop is the next best thing for those not vaccinated. Vaccination at around $20 each is given to patients by GPs but is of dubious value because of a poor immune response in the elderly. Vaccination of staff is not an accreditation requirement but remains the responsibility of the employer. What a great business opportunity for pharmacists and OH providers! Meanwhile, Pharma in Focus reports that Roche has defended Tamiflu following reports that unpublished data undermines the effectiveness of the drug.
Folate brain connection
TA recent article in Cancer Epidemiology, Biomarkers and Prevention (August 2012) sings the praises of folic acid supplements prior to pregnancy. The retrospective national study from the Telethon Institute for Child Health Research found that taking folic acid pre-pregnancy reduced the risk of childhood brain tumours by around 30%. The report’s principal author, Prof Elizabeth Milne said that GPs could add brain tumour protection to neural chord protection in promoting folate supplementation.
Danish researchers have led a systematic Cochrane review of general health check-ups. Do they reduce deaths from serious diseases such as cancer and heart disease? No, they don’t. Nonetheless, 14 trials involving 182,880 people did pick up new problems but the nine trials relating to death yielded no difference whatsoever. Although other outcomes were poorly studied, the Cochrane reviewers suggested that offering general health checks has no impact on hospital admissions, disability, specialist referrals or time off work. It would seem that health checks don’t succeed as a public health initiative. And disease-specific programs? Now that’s another story.
Consumer choice is a wonderful thing but it can turn ugly. In the red corner are orthopaedic surgeons; in the blue, the Australasian College of Podiatric Surgeons (ACPS). The ACCC will be sending a report to the Federal Senate on any anti-competitive practices by health funds or providers which reduces the extent of health cover for consumers and/or increases their out-of-pocket medical expenses. Some podiatric procedures are covered by health insurance if carried out by an orthopaedic surgeon, but that same cover is refused if undertaken by a podiatric surgeon.