The Medical journal of Australia
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To assess self-reported adherence to measures for preventing infection in patients registered in the Victorian Spleen Registry (VSR). ⋯ The proportion of VSR registrants adhering to current postsplenectomy guidelines was higher than rates reported elsewhere, and over a third reported infections requiring a course of antibiotics within the prior 12 months. However, only one OPSI occurred. These results support the view that a spleen registry can promote health maintenance behaviour in asplenic patients, which is likely to help prevent serious infections.
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Multicenter Study
A national study of the processes and outcomes of paediatric formulary applications in Australia.
To evaluate the processes by which pharmaceuticals are added to the formularies of Australian paediatric hospitals. ⋯ There is limited high-quality evidence informing paediatric hospital-based drug approvals. Approval processes vary considerably among institutions with substantial duplication of effort and variable outcomes. Resources and training appear insufficient given the technical complexity of submissions. A national, standardised approach to hospital-based drug evaluation could reduce overlap and improve decision making.
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Some aspects of health care in the United States would be beneficial to Australia and New Zealand, but others should be avoided. Positive aspects, which should be emulated, include: •health care reform that is focused on the continuum of care and patient-centred care •trials of new models to organise, deliver and pay for health care services, where quality of care is rewarded over quantity of services •an integral view of, and strong support for, health services research as a means of evaluating reforms aimed at improving patient outcomes and systems-level efficiencies •physician engagement in reforms--for example, participating in the Choosing Wisely initiative, and trialling and implementing new payment models that are not fee-for-service. Negative aspects, which should be avoided, include: •increasingly fragmented provider and financing structures (funding provided by state and federal governments, private insurance and out-of-pocket costs) that cause frustration in terms of access and care coordination and increase administrative waste •an overemphasis on technological solutions, with insufficient acknowledgment of the importance of addressing value in health care •a focus on hospital and doctor-based health care rather than environmental and social inputs into health.