Incorporating Safety and Quality Measures Into Australia's Activity-Based Funding of Public Hospital Services.

In a bid to improve quality of care, numerous countries have incorporated rewards and penalties into the funding and pricing of hospital services. This paper outlines recent advances in Australia to incorporate financial penalties for hospital acquired complications (HACs) and avoidable hospital readmissions (AHRs) adjustments into the funding of public hospital services. It describes the work in the development of suitable measures to identify episodes, the design of the analytical approach used for risk adjustment and the calculation of the funding implications including dampening effects to account for the level of risk. Using the 2019 to 20 round of data collection, this paper reports on the risk adjustment analysis, incremental costs of HACs and AHRs, and the funding dampening effects, the paper further discusses the implementation strategies undertaken by the Independent Health and Aged Care Pricing Authority (IHACPA) to ensure transparency, stakeholder consultation and engagement. The paper argues that both the technical development and its implementation strategies have been central to making safety and quality an integral and accepted part of Australia's public hospital funding arrangements.

On the Way to a Trisanionic {Cu3 O2 } Core for Oxidase Catalysis: Evidence of an Asymmetric Trinuclear Precursor Stabilized by Perfluoropinacolate Ligands.

CuI complexes of the form K[(R3 P)Cu(pinF )], in which (pinF )2- is the bidentate, oxygen-donating ligand perfluoropinacolate, were synthesized and characterized. Low-temperature oxygenation of the K[(R3 P)Cu(pinF )(PR3 )] species resulted in a trisanionic bis(µ3 -oxo) trinuclear copper(II,II,III) core characterized by UV/Vis spectroscopy (λmax [nm] = 330, 535, 630), cryospray-ionization mass spectrometry, and X-band electron paramagnetic resonance spectroscopy (derivative resonance at 3300 G, Δms =2 at 1500 G). The kinetic behavior of the trimeric {Cu3 O2 } species was quantified by stopped-flow spectroscopy and the associated electronic structures were investigated by DFT calculations. An asymmetric {Cu3 O2 } species, As TpinF , which bears a structure similar to multicopper oxidases, forms prior to full formation of the symmetric trinuclear core, Sy TpinF . The trimer catalytically oxidizes para-hydroquinone to benzoquinone (a form of oxidase chemistry).

Using linkage between hospital and ABS mortality data to enhance reporting of deaths among Aboriginal and Torres Strait Islander peoples.

OBJECTIVE: To investigate the potential of record linkage between the Australian Bureau of Statistics (ABS) mortality data and the NSW Admitted Patient Data Collection (APDC) to improve reporting of deaths among Aboriginal and Torres Strait Islander peoples. METHODS: ABS mortality data for 2002 to 2006 were linked with APDC records for 2001 to 2006. Six algorithms were developed to enumerate deaths. Possible biases by age, sex and geographic remoteness were investigated. RESULTS: Levels of reporting ranged from baseline reporting on the ABS mortality data to the largest enhancement with the 'ever reported as Aboriginal or Torres Strait Islander' algorithm. Enhancement was more likely in females, older people and residents of major cities. CONCLUSIONS: Data linkage substantially improved reporting of Aboriginal and Torres Strait Islander deaths. An algorithm that includes both the number of APDC records and the number of facilities reporting a person as Aboriginal or Torres Strait Islander was considered most promising. IMPLICATIONS: Inclusion of other datasets in the enhancement process is warranted to further improve reporting and address possible bias produced by using APDC records only. Further work should take into account the possibility that a person may be falsely reported as Aboriginal or Torres Strait Islander or not reported in either hospital or death records.

Newborn feeding practices at the time of discharge from hospital in NSW in 2007: a descriptive study.

OBJECTIVES: To describe the pattern of infant feeding at discharge from care after birth and the characteristics of mothers who are at risk of low rates of breastfeeding. METHODS: Data were obtained from the NSW Midwives Data Collection for 2007. Information on infant feeding was obtained for babies who were alive at discharge from care after birth. Of 96 030 births reported, 93 505 (97.4%) were eligible for analysis. A descriptive analysis of factors associated with variations in breastfeeding was carried out. RESULTS: In 2007, 80% of babies were fully breastfed, 7% were partially breastfed, and 13% were not breastfed. Babies born to mothers with the following characteristics had relatively low rates of full breastfeeding: teenage mothers (69%); Aboriginal mothers (64%); mothers born in South-East Asia (71%), North-East Asia (72%) and Melanesia, Micronesia and Polynesia (74%); mothers who commenced antenatal care later than 20 weeks gestation (74%); mothers who smoked (67%); mothers who received general anaesthetic during delivery (67%); mothers who gave birth by caesarean section (76%); mothers living in the most socially disadvantaged areas (73%); mothers living in remote and very remote areas (73% and 76% respectively); and mothers of preterm infants (70%). CONCLUSION: There is a need to improve overall rates of breastfeeding initiation in NSW. Particular attention and support needs to be given to the groups of mothers identified in this study as having relatively low rates of full breastfeeding.