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Erratum. 勘误表。
IF 6.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-20 DOI: 10.5694/mja2.52592
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引用次数: 0
Shortages of benzathine benzylpenicillin G in Australia highlight the need for new sovereign manufacturing capability. 澳大利亚苄星苄青霉素G的短缺突出了对新的主权制造能力的需求。
IF 6.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-20 DOI: 10.5694/mja2.52590
Rosemary Wyber, Glenn Pearson, Laurens Manning
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引用次数: 0
Improving palliative care for people who use alcohol and other drugs. 改善对酒精和其他药物使用者的姑息治疗。
IF 6.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-20 DOI: 10.5694/mja2.52585
Grace FitzGerald, Jon Cook, Peter Higgs, Charles Henderson, Sione Crawford, Thileepan Naren
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引用次数: 0
Prisoner of war pathology in Changi, 1942-1945. 1942-1945年在樟宜的战俘病理。
IF 6.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-20 DOI: 10.5694/mja2.52581
Kate Ariotti, Elizabeth Roberts-Pedersen
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引用次数: 0
Evaluating primary care expenditure in Australia: the Primary Care Spend (PC Spend) model. 评估澳大利亚的初级保健支出:初级保健支出(PC支出)模型。
IF 6.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-16 DOI: 10.5694/mja2.52574
Michael Wright, Shona Bates, Andrew W Bazemore, Michael R Kidd

Objectives: To assess the distribution of health care expenditure (public and private) for primary care and primary health care as proportions of overall health care funding.

Study design: The Primary Care Spend model; estimated distribution of expenditure for three tiers of primary care services by provider and function.

Setting: Primary Care Spend model applied to Australian health expenditure, public and private, 2020-21, from a health sector perspective, as recorded by the Australian Institute of Health and Welfare.

Main outcome measures: Proportions of all health care spending for essential community and primary health care functions (tier A), comprehensive primary care (services delivered in general practices and family physician clinics; tier B), and enhanced primary care services (long-term holistic patient care; tier C).

Results: In 2020-21, 33.2% of health spending in Australia was classified as primary health care spending (tier A), 6.0% as comprehensive primary care services (tier B), and 0.8% as long term holistic patient care services (tier C).

Conclusions: The application of the Primary Care Spend model to Australian data provides a more nuanced analysis of expenditure for primary health care than routine health expenditure reports. Its output could be used to inform targets for spending on different tiers, types, and locations of primary care, especially comprehensive and other high value primary care services, and to monitor progress toward these targets.

目的:评估用于初级保健和初级保健的卫生保健支出(公共和私人)在卫生保健资金总额中所占的比例。研究设计:初级保健支出模型;按提供者和职能分列的三级初级保健服务支出的估计分布情况。背景:根据澳大利亚卫生和福利研究所的记录,从卫生部门的角度,初级保健支出模型适用于2020-21年澳大利亚公共和私营卫生支出。主要结果衡量指标:用于基本社区和初级卫生保健职能(A级)、综合初级保健(在全科诊所和家庭医生诊所提供的服务)的所有卫生保健支出的比例;B级),并加强初级保健服务(长期整体病人护理;结果:2020- 2021年,澳大利亚卫生支出的33.2%被分类为初级卫生保健支出(A级),6.0%被分类为综合初级卫生保健服务(B级),0.8%被分类为长期整体患者护理服务(C级)。结论:将初级卫生保健支出模型应用于澳大利亚数据,提供了比常规卫生支出报告更细致入微的初级卫生保健支出分析。其产出可用于为不同层次、类型和地点的初级保健,特别是综合和其他高价值初级保健服务的支出目标提供信息,并监测实现这些目标的进展情况。
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引用次数: 0
The impact of the BreastScreen NSW transition from film to digital mammography, 2002–2016: a linked population health data analysis 2002-2016年新南威尔士州乳房筛查从胶片乳房x光检查到数字乳房x光检查的影响:相关人口健康数据分析。
IF 6.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-12 DOI: 10.5694/mja2.52566
Rachel Farber, Nehmat Houssami, Kevin McGeechan, Alexandra L Barratt, Katy JL Bell
<div> <section> <h3> Objectives</h3> <p>To assess the impact of the transition from film to digital mammography in the Australian national breast cancer screening program.</p> </section> <section> <h3> Study design</h3> <p>Retrospective linked population health data analysis (New South Wales Central Cancer Registry, BreastScreen NSW); interrupted time series analysis.</p> </section> <section> <h3> Setting</h3> <p>New South Wales, 2002–2016.</p> </section> <section> <h3> Participants</h3> <p>Women aged 40 years or older with breast cancer diagnosed during 2002–2017 who had been screened by BreastScreen NSW and for whom complete follow-up information until the end of the recommended re-screening interval was available.</p> </section> <section> <h3> Intervention</h3> <p>Transition from film to digital mammography; 2009 defined as transition year (digital mammography becomes dominant screening modality).</p> </section> <section> <h3> Main outcome measures</h3> <p>Population rates of screen-detected cancer, interval cancer, recalls, and false positive findings.</p> </section> <section> <h3> Results</h3> <p>The study cohort comprised 967 573 women; of the 2 741 555 screens, 1 535 184 used film mammography (2002–2010) and 1 206 371 used digital mammography (2006–2016). The screen-detected cancer rate was 4.86 (95% confidence interval [CI], 4.75–4.97) cases per 1000 screens with film mammography and 6.11 (95% CI, 5.97–6.24) cases per 1000 screens with digital mammography (unadjusted difference, 1.24 [95% CI, 1.06–1.41] cases per 1000 screens). The interval cancer rate was 2.56 (95% CI, 2.48–2.64) cases per 1000 screens with film mammography and 2.84 (95% CI, 2.75–2.94) cases per 1000 screens with digital mammography (unadjusted difference, 0.27 [95% CI, 0.15–0.40] cases per 1000 screens). With the transition to digital mammography, the screen-detected cancer rate increased by 0.07 per 1000 screens, the sum of the decline in the invasive cancer rate (–0.21 cases per 1000 screens) and the rise in the ductal carcinoma in situ detection rate (0.28 cases per 1000 screens); during 2009–2015, it increased by 0.18 cases per 1000 screens per year. With the transition to digital mammography, the interval cancer rate increased by 0.75 cases per 1000 screens (invasive
目的:评估从胶片乳房x线摄影到数字乳房x线摄影对澳大利亚国家乳腺癌筛查计划的影响。研究设计:回顾性关联人群健康数据分析(新南威尔士州中央癌症登记处,BreastScreen NSW);中断时间序列分析。背景:新南威尔士州,2002-2016。参与者:在2002-2017年期间被诊断患有乳腺癌的40岁或以上的女性,她们接受过新南威尔士州乳房筛查筛查,并且在推荐的重新筛查间隔结束之前可以获得完整的随访信息。干预:从胶片乳房x光检查到数字乳房x光检查的过渡;2009年被定义为过渡年(数字乳房x光检查成为主要的筛查方式)。主要结局指标:筛查发现的癌症、间隔期癌症、召回率和假阳性结果的人口比率。结果:研究队列包括967 573名女性;在2741555个筛查中,1535184个使用胶片乳房x光检查(2002-2010年),1206371个使用数字乳房x光检查(2006-2016年)。胶片乳房x光检查的筛查癌率为4.86(95%可信区间[CI], 4.75-4.97) / 1000例,数字乳房x光检查的筛查癌率为6.11 (95% CI, 5.97-6.24) / 1000例(未调整差异,1.24 [95% CI, 1.06-1.41]例/ 1000例)。间隔癌率为胶片乳房x光检查每1000个屏幕2.56例(95% CI, 2.48-2.64),数字乳房x光检查每1000个屏幕2.84例(95% CI, 2.75-2.94)(未经调整的差异,0.27 [95% CI, 0.15-0.40]例/ 1000个屏幕)。随着数字化乳房x线摄影的发展,浸润性癌的检出率下降(-0.21例/ 1000片),导管原位癌的检出率上升(0.28例/ 1000片),检出率增加0.07 / 1000片;在2009-2015年期间,每年每1000次筛查增加0.18例。随着向数字化乳房x线摄影的过渡,间隔期癌症发病率每1000次筛查增加0.75例(浸润性癌症:每1000次筛查增加0.69例);在2009-2015年期间,每年每1000次筛查减少0.13例。转换后,召回率每1000个屏幕增加8.02个,假阳性率每1000个屏幕增加7.16个;这两个比率后来都下降到过渡前的水平。结论:过渡到数字乳房x线摄影后,增加的筛查检测癌症率并不伴随着间隔癌症检出率的降低。
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引用次数: 0
The social and political framework of health 卫生的社会和政治框架。
IF 6.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-12 DOI: 10.5694/mja2.52561
Virginia Barbour
<p>This first 2025 issue of the <i>MJA</i> marks the beginning of a year in which a new US president takes office and in which Australia will have a federal election. Health is always a social and political issue and should not be confined to health portfolios. As the World Health Organization recognises, “population health is not merely a product of health sector programmes but largely determined by policies that guide actions beyond the health sector” (https://www.who.int/activities/promoting-health-in-all-policies-and-intersectoral-action-capacities). One of the most critical ways in which wider policies can affect health is in the way that they recognise, count and subsequently provide for the diversity of a country's population. With regard to multiculturalism, the Australian Government's Multicultural Access and Equity Policy from 2018 (https://www.homeaffairs.gov.au/about-us/our-portfolios/multicultural-affairs/about-multicultural-affairs/access-and-equity) notes that its aim is to ensure that “Australian Government programs and services meet the needs of all Australians, regardless of their cultural and linguistic backgrounds”. Despite this, the 2024 review <i>Towards fairness: a multicultural Australia for all</i> (https://www.homeaffairs.gov.au/multicultural-framework-review/Documents/report-summary/multicultural-framework-review-report-english.pdf) noted “systemic barriers faced by individuals from diverse backgrounds within the healthcare and mental health systems”. In regard to LGBTIQA+ individuals, the policy framework is fragmented although, in 2023, the federal government began developing a draft action plan — <i>LGBTIQA+ Health and Wellbeing 10 Year National Action Plan</i> (https://www.health.gov.au/committees-and-groups/lgbtiqa-plus-health-and-wellbeing-10-year-national-action-plan-expert-advisory-group).</p><p>Several articles in this issue of the <i>MJA</i> reinforce the importance of developing policy coherence and that policies and structures well beyond the health sectors have a direct impact on health outcomes. Possibly one of the most important ways that needs are determined at a population level is the census, next due to be conducted in Australia in 2026. In a letter commenting on the next census, Saxby and Hammoud (https://doi.org/10.5694/mja2.52542) express the concern that many have felt over the discussion of collection of data on LGBTI+ Australians in the 2026 census. After a change of heart by the Australian Government, the 2026 census will include a question on sexual orientation and gender identity. However, as Saxby and Hammoud note, it is not clear if the census will, if it does not align with best practice in collecting these data, provide the evidence base needed for future policy. As they conclude, “Ultimately, health equity is unachievable without data equity. The future of health equity depends on the informed actions we take today to ensure our data accurately reflects the diversity of the entire Austra
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引用次数: 0
Human case of diphyllobothriasis in Australia. 澳大利亚发生人间双叶绦虫病病例。
IF 6.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-09 DOI: 10.5694/mja2.52579
Sadid F Khan, Anson V Koehler, Alistair Tinson, Maidhili Chinnappan, Harsha Sheorey, Robin B Gasser
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引用次数: 0
The role of GLP-1 receptor agonists in the management of obesity: risks and opportunities for the Australian health care system. GLP-1受体激动剂在肥胖管理中的作用:澳大利亚医疗保健系统的风险和机遇。
IF 6.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-09 DOI: 10.5694/mja2.52582
Christopher Kanellis, Kyle Williams, Darcy Q Holt, Jennifer Wong, Rachel David, Ravi Carothers, Suong Le
{"title":"The role of GLP-1 receptor agonists in the management of obesity: risks and opportunities for the Australian health care system.","authors":"Christopher Kanellis, Kyle Williams, Darcy Q Holt, Jennifer Wong, Rachel David, Ravi Carothers, Suong Le","doi":"10.5694/mja2.52582","DOIUrl":"https://doi.org/10.5694/mja2.52582","url":null,"abstract":"","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of differences in bulk-billing rates: strategies for greater equity in Medicare. 批量计费费率差异的影响:提高医疗保险公平性的策略。
IF 6.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2025-01-05 DOI: 10.5694/mja2.52580
Sebastian P Rosenberg, Ian B Hickie
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引用次数: 0
期刊
Medical Journal of Australia
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