The non-medical surgical assistant and inequity in the Australian healthcare system

IF 1.2 4区 医学 Q3 NURSING Australian Journal of Advanced Nursing Pub Date : 2020-09-01 DOI:10.37464/2020.374.278
Toni Hains, D. Rowell, H. Strand
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引用次数: 3

Abstract

Objectives: The objective of this discussion paper is two-fold. The first is to quantify if the non-medical surgical assistant increases access to surgery by investigating what percentages of cases these clinicians undertake in the private sector surgical units where they work. The second is to examine procedural and distributive justice and how they impact on private sector surgical care. Aim: The aim of this paper is to investigate if the non-medical surgical assistant increases equity via access, for the patient, to private sector surgical care; and if government policy has an impact on equity in the form of access. Background: The private healthcare sector completes approximately two-thirds of all elective surgery in Australia; without this contribution, there would be more pressure on the public healthcare sector. In the private sector, recognition and federal funding of the surgical assistant differs depending on whether this clinician has a medical or non-medical, eg. nursing, qualification. The role of the non-medical surgical assistant is well established internationally and this role has been practiced in Australia for more than 20 years. Discussion: Inequity; as a result of the procedural injustice of government funding policy, impacts the private sector surgical patient causing distributive injustice. This distributive injustice results in an out-of-pocket expense to the patient. Rising outof-pocket expenses has started a trend of patients moving away from private health insurance and into the public sector. The registered nurse and nurse practitioner are qualified to practise as a non-medical surgical assistant and provide increased access to care, and effective care compared to the medical surgical assistant. The nurse practitioner is an eligible provider of Medical Benefits Schedule services but restricted from accessing the intraoperative assisting item numbers. Conclusion: The non-medical surgical assistant; or at least the nurse practitioner as non-medical surgical assistant; require access to the Medical Benefits Schedule intraoperative item numbers. Access would alleviate the out-of-pocket expense incurred by Australian patients when a non-medical surgical assistant assists with their surgery. Lack of access to these item numbers means patients may have their surgery delayed until an appropriately skilled medical surgical assistant is available, or the public healthcare sector can accommodate them. AUTHORS TONI HAINS RN, MClinSc (PNSA), MNPractSt, PhD Cand.1 DAVID ROWELL RN, MHEcon (Advanced), PhD (Econ.)3 HAAKAN STRAND RN, MNPractSt, PhD1,2 1 The University of Queensland, School of Nursing, Midwifery and Social Work, St Lucia, Queensland, Australia. 2 College of Nursing and Midwifery, Charles Darwin University, Casuarina, Northern Territory, Australia. 3 The University of Queensland, Centre for the Business and Economics of Health, Woolloongabba, Queensland, Australia. The non-medical surgical assistant and inequity in the Australian healthcare system CORRESPONDING AUTHOR TONI HAINS School of Nursing, Midwifery and Social Work, Level 3, Chamberlain Building, The University of Queensland, St Lucia QLD 4072. Phone: +61 405 469 463. Email: toni@hains.com.au REVIEWS & DISCUSSION PAPERS 6
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非医疗手术助理与澳大利亚医疗体系中的不公平
目的:本讨论文件的目的有两个。首先是通过调查这些临床医生在其工作的私营部门手术室中的病例百分比,来量化非医疗手术助理是否增加了手术机会。第二是审查程序正义和分配正义,以及它们对私营部门外科护理的影响。目的:本文的目的是调查非医疗外科助理是否通过患者获得私营部门的外科护理来增加公平性;以及政府政策是否以准入的形式对公平产生影响。背景:私人医疗部门完成了澳大利亚约三分之二的择期手术;如果没有这笔捐款,公共医疗部门将面临更大的压力。在私营部门,对外科助理的认可和联邦资助取决于该临床医生是否具有医疗或非医疗资格,例如护理资格。非医疗外科助理的角色在国际上已经确立,这一角色在澳大利亚已经实践了20多年。讨论:不公平;由于政府资助政策的程序不公,影响了民营外科病人的分配不公。这种分配不公导致病人自付费用。自付费用的增加引发了患者从私人医疗保险转向公共部门的趋势。注册护士和执业护士有资格作为非医疗外科助理执业,与医疗外科助理相比,他们可以获得更多的护理和有效的护理。执业护士是医疗福利计划服务的合格提供者,但被限制访问术中辅助项目编号。结论:非医学手术辅助;或者至少是执业护士作为非医疗外科助理;需要访问“医疗福利计划”术中项目编号。当一名非医疗外科助理协助澳大利亚患者进行手术时,该服务将减轻他们的自付费用。由于无法获得这些项目编号,患者的手术可能会被推迟,直到有一位技术熟练的外科助理,或者公共医疗部门能够为他们提供服务。作者Tony HAINS RN,MClinSc(PNSA),MNPractSt,PhD。1 DAVID ROWELL RN,MHEcon(高级),PhD(经济学)3 HAAKAN STRAND RN,MNPractSt,PhD1,21昆士兰大学护理、助产和社会工作学院,澳大利亚昆士兰圣卢西亚。2澳大利亚北领地卡苏里纳查尔斯·达尔文大学护理和助产学院。3昆士兰大学健康商业与经济中心,澳大利亚昆士兰Woolongabba。非医疗手术助理与澳大利亚医疗系统中的不公平现象通讯作者托尼·海因斯护理、助产和社会工作学院,昆士兰大学张伯伦大厦3层,昆士兰州圣卢西亚4072。电话:+61 405 469 463。电子邮件:toni@hains.com.au评论与讨论论文6
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来源期刊
CiteScore
2.30
自引率
7.10%
发文量
27
审稿时长
>12 weeks
期刊介绍: The Australian Journal of Advanced Nursing publishes a wide variety of original research, review articles, practice guidelines, and commentary relevant to nursing and midwifery practice, health- maternity- and aged- care delivery, public health, healthcare policy and funding, nursing and midwifery education, regulation, management, economics, ethics, and research methodology. Further, the journal publishes personal narratives that convey the art and spirit of nursing and midwifery. As the official peer-reviewed journal of the ANMF, AJAN is dedicated to publishing and showcasing scholarly material of principal relevance to national nursing and midwifery professional, clinical, research, education, management, and policy audiences. Beyond AJAN’s primarily national focus, manuscripts with regional and international scope are also welcome where their contribution to knowledge and debate on key issues for nursing, midwifery, and healthcare more broadly are significant.
期刊最新文献
Can personal psychological resources reduce burnout and turnover in Australian hospital nurses? Rising to the climate challenge: integrating climate action in the undergraduate curriculum Do contemporary patient assessment requirements align with expert nursing practice? The impact of using an academic electronic medical record program on first-year nursing students’ confidence and skills in using E-documentation: a quasi-experimental study Corrigendum to ‘Understanding COPD Emergency Department presentations: using thematic analysis to explore the voices of patients, nurses, and doctors on the lived experience of managing COPD’ [Australian Journal of Advanced Nursing, volume 40, issue 1 (2022), DOI 10.37464/2023.401.195]
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