Bmc Health Serv Res
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Bmc Health Serv Res · Jan 2014
Trends and changes in prescription opioid analgesic dispensing in Canada 2005-2012: an update with a focus on recent interventions.
Prescription opioid analgesic (POA) utilization has steeply increased globally, yet is far higher in established market economies than elsewhere. Canada features the world's second-highest POA consumption rates. Following increases in POA-related harm, several POA control interventions have been implemented since 2010. ⋯ Further examinations regarding the sustained nature, drivers and consequences of the recent trend changes in POA dispensing--including possible 'substitution effects' for oxycodone reductions--are needed.
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Bmc Health Serv Res · Jan 2014
Quality improvement in practice: improving diabetes care and patient outcomes in Aboriginal Community Controlled Health Services.
Management of chronic disease, including diabetes, is a central focus of most Aboriginal Community Controlled Health Services (ACCHSs) in Australia. We have previously demonstrated that diabetes monitoring and outcomes can be improved and maintained over a 10-year period at Derby Aboriginal Health Service (DAHS). While continuous quality improvement (CQI) has been shown to improve service delivery rates and clinical outcome measures, the process of interpreting audit results and developing strategies for improvement is less well described. This paper describes the evaluation of care of patients with type 2 diabetes mellitus (T2DM) and features of effective CQI in ACCHSs in the remote Kimberley region of north Western Australia. ⋯ Well-designed health care delivery and CQI systems, with a strong sense of ownership over diabetes management led to increased service delivery rates and improved clinical outcome measures in ACCHSs. Locally run CQI processes may be more responsive to individual health services and more sustainable than externally driven systems.