Patterns of complementary and alternative medicine use and health literacy in general practice patients in urban and regional Australia.

BACKGROUND: The majority of Australians use complementary and alternative medicine (CAM). Despite concerns about safety, patterns of health literacy and CAM use in Australian general practice are unknown. METHODS: Pre-existing questionnaires assessing health literacy and CAM use (HLQ and I-CAM-Q) were distributed by eight practices across four Australian states to 800 patients aged 18 years and older for self-completion. Regression modelling and cluster analysis were applied to the data. RESULTS: The response rate was 47% (n = 374), the mean age was 53 years and 68% of participants were female. Two-thirds of participants used some form of CAM in the previous 12 months, and 60% believed CAM aided wellbeing. There were significant associations between cluster membership, education, sex and CAM use. DISCUSSION: Our findings suggest CAM use is a complex phenomenon, associated with gender and education. We demonstrated a cluster of female patients with high CAM use and lower health literacy warranting further research.

The acute surgical unit: improving emergency care.

BACKGROUND: Acute care surgical teams are a new concept in the provision of emergency general surgery. Juggling emergency patients around the surgeons' and staffs' elective commitments resulted in semi-emergency procedures routinely being delayed. In an era of increasing financial pressure and the recent introduction of 'safe work hours' practices, the need for a new system which optimized available resources became apparent. METHODS: At Fremantle Hospital we developed a new system in a concerted effort to minimize the waiting time for general surgical referrals in the Emergency Department, as well as to move semi-urgent operating from the afterhours to the daytime. To analyse the impact of the ASU, data were collected during February, March, and April 2009 and compared with data from the same period in 2008. RESULTS: Although most referrals were received afterhours, over 85% of operations were performed during working hours compared with 72% in the 2008 period. The time from referral to review decreased from an average of 3.2 h in 2008 to 2.1 h. The mean duration of stay in 2009 was 3 days, which was a reduction from 4.2 days in 2008. An increase in weekend discharge rates was seen after the introduction of the ASU. CONCLUSION: Despite an increased workload, more referrals were seen and more operations performed during working hours and the time from referral to review was reduced. Higher discharge rates and reduced length of stays increased the availability of beds. We have demonstrated a successful new model which continues to evolve.