November – 2013

Mobile GP clinics vaccinate
Sanofi Pasteur is at the ready to supply WA’s mobile GP clinics with hepatitis, Pneumococcus, Tetanus and Pertussis vaccines – the 10 mobile GP clinics intend to promote vaccination to Perth’s homeless and disadvantaged using the $20,000 VaxiGrant from the company. Seven Vaxigrants are awarded nationwide to assist seven innovative ideas that promote vaccine uptake in Australia. Vaccination amongst the homeless fits with the idea of targeting under vaccinated groups.

Ambo service ramping up
In June’s Medical Forum, St John Ambulance CEO Mr Tony Ahern explained the philosophy behind the Ambulance Surge Capacity Unit (ASCU) which was being trialled for four months in the flu season to help alleviate ramping at EDs. The early results are in and they show that 686 patients were sent to the ASCU at Hollywood Hospital. Of those patients, 283 were either sent home after assessment or admitted to a private hospital. A St John spokesman told MF that of those admitted most went to Hollywood with “single figures going to either St John Murdoch or Subiaco”. Given that it costs patients $290 to present at the Murdoch ED, we asked if the patient incurred a cost for being diverted to Hollywood? And if the trial is broadened, which has been mooted, what are other hospitals are being considered? We will tell you when they tell us.

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Too much vs not enough
While in this edition our major sponsor give us the run-down on iron deficiency, WA researchers report they have lifted the bar in defining ferritin overload. Figures from the Busselton Population Study show that we also need to accommodate age and BMI, as well as gender, to avoid unnecessary investigations and treatment. For people not homozygous for the C282Y haemochromatosis gene (0.5% prevalence) and not taking iron, anything under 1000 mcg/L ferritin was highly unlikely to indicate clinical iron overload, according to Prof John Olynyk.

Stretching kids services
There appears no truth to the rumour that Colin Barnett’s crew have relented on more floors to what will be called Perth Children’s Very Tall Hospital. And neither has the basement been dug out to create storage for the extra 100 beds, ready for later use, when staff can be found. Minister for Hospital Beds, Dr Kim Hames, has said he prefers to rearrange what exists (deck chairs?) to create space for an extra 24 beds. We all know children are small and occupy cots. The Premier reportedly said the AAA downgrading played only a minor role in the decision.

Helping rural doctors
Whether a final year med student (Rural Clinical School), intern, PGY2+, PGPPP, registrar or DRANZCOG candidate, navigating the where and what has been helped by Rural Health West’s online map of 15 rural sites in the Rural Practice Pathway. It is expected junior docs will find various rural training options easier to navigate now (see www.ruralhealthwest.com.au/rppmap). And for those going bush, HealthInfoNet has produced two relevant reviews on Indigenous ear health and rheumatic heart disease. Dr Leanne Heredia recently gave their website a favourable review in Medical Forum so you can find their material at www.healthinfonet.ecu.edu.au

Health cost spiral
Australians spent $140.2b on health in Australia in 2011-12 according to the Australian Institute of Health and Welfare (AIHW). That’s up from $82.9b 10 years earlier (adjusted for inflation), which is a bit scary. Almost 70% was government funded, with the rest from individuals, private health insurers, and other non-government sources. Domestic GDP proportion was 9.5%, up from 8.4% in 2001-02. That’s recurrent expenditure on health per person of $5,881. Public hospitals took 31.8% of recurrent health expenditure in 2011-12, and public hospital services accounted for the largest component of the overall rise in health spending. The federal-state split on public hospital funding was 38%-53%.