Sharing knowledge: a key to improved rural health
 Inaugural Rural and Remote Scientific Symposium
6-8 July 2008, Brisbane
Attended by Ellen McIntyre, PHC RIS
Delegates to the three-day inaugural Rural and Remote Scientific Symposium held in Brisbane recently, agreed on the need to raise the status of rural and remote health research as a step towards improving the health of Australia's rural communities.
A key challenge is to strengthen the relationship between researchers and policy makers, and to enhance the mutual respect and contacts between them. This stronger relationship will build an understanding of the key determinants of health of the 7 million people who live in rural Australia. The symposium thus welcomed the establishment of the new Office of Rural Health in the Department of Health and Ageing and expressed their support of this new Office.
Over 60 research experts from all parts of the country and overseas agreed that years of research have provided good evidence about the health status of rural communities. Symposium Convenor, Professor Desley Hegney, from the Research and Practice Development Centre, School of Nursing and Midwifery, University of Queensland , said a better mechanism must be found for sharing existing knowledge to alleviate the inequalities that exist between those who live in metropolitan areas and those who do not.
Overseas delegates to the Symposium included Professor Ray Pong, Research Director, Centre for Rural and Northern Health Research at Laurentian University in Canada, Professor John Beard from the Centre for Urban Epidemiological Studies at the New York Academy of Medicine and Professor Jane Farmer, Chair of Rural Health Policy and Management, UHI Millennium Institute, Scotland .
Professor Pong examined the distinctive aspects of morbidity and mortality in rural and remote areas while Prof Beard – who spent almost 25 years working in rural NSW – explained the startling influence of socioeconomic and cultural factors on rural health at a time when regional Australia is doing it tough. His address dealt with factors currently influencing the decline of so many rural communities, including climate change and the flight of young families to urban centres. Professor Jane Farmer presented ways to evaluate policy outcomes as a means to improve access to care.
Delegates agreed further on the need for community consultation to determine the process by which people achieve and maintain good health in rural and remote Australia.
Gordon Gregory from the National Rural Health Alliance (NRHA) discussed the impact of rurality on the provision of health care in non-metropolitan areas while Professor John Wakerman, prompted discussion over the research priorities for innovative rural and remote primary health care models, and NRHA policy adviser Andrew Phillips outlined the varying patterns of disease in country areas. His paper confirmed poorer health outcomes in rural and remote areas, and identified coronary heart disease, traffic accidents and suicide as the major causes of higher rates of death outside Australia 's major cities.
Professor Desley Hegney argued the need for further research to identify the characteristics of ‘evidence-based practice' that will work in rural and remote environments. Emeritus Professor Max Kamien, from the University of Western Australia, argued that solutions lie in the regular collection of local quantitative and qualitative data as a reality check of the outcomes of national and state government policies.
The symposium program, as well as speech abstracts and some keynote addresses, is available on-line through the NRHA website at <www.ruralhealth.org.au>.
The Symposium was organised by a collaboration including University of Queensland, University of Tasmania, University of Melbourne, PHC RIS and the National Rural Health Alliance.
Facilitating knowledge exchange and transfer for a dynamic future
 13th Health Outcomes Conference
30 April-1 May 2008
Attended by Libby Kalucy & Ann-Louise Hordacre, PHC RIS
The main theme(s) of this conference were:
- The need for knowledge transfer between many different groups: eg. between practitioners and patients, such as those making rapid decisions about treatment for cancer; between research and practice in specific areas; between health care organisations and public for accountability.
- Embedding outcomes management into routine delivery at patient level, and reporting outcomes so that practitioners, managers and the public can monitor progress and performance.
Collecting and monitoring of agreed outcomes by practitioners and health care organisations can provide powerful evidence of achievement in specific areas of health care, and provide the data for quality improvement initiatives embedded in routine care. National structures and strategies with cooperation of all jurisdictions provide a sound basis for outcomes measurement and use. Two examples illustrate this.
- Achievements in knowledge transfer in palliative care show what is possible with research, policy, education and practice working together across Australia, with excellent intergovernmental cooperation around a National Palliative Care Strategy. Through the Palliative Care Outcomes Consortium, agreed outcomes are reported voluntarily in 75% palliative care episodes; the clinical studies collaborative conducts multi-centre trials which will provide evidence for PBAC listing for palliative care drugs; CareSearch provides a comprehensive on-line resource for palliative care; and the national palliative care curriculum for undergraduates aims to include palliative care in every health undergraduate curriculum.
- The Australian Rehabilitation Outcomes Consortium has members comprising most private and public hospitals across Australia. After collecting outcome data for some years, in October 2007 members developed targets for rehabilitation outcomes for fractured neck of femur. The targets agreed across the industry will be quality targets, which will be used for members to evaluate their performance and network to improve their performance.
Primary care & data key components to Australia's health
 Australian Institute of Health and Welfare Conference, 2008
24 June 2008, Canberra
Attended by Sara Howard, PHC RIS
Australia's health is a biennial report produced by the Australian Institute of Health and Welfare (AIHW) that covers a range of aspects about health care in Australia including health status (eg. life expectancy, disease prevalence), health determinants (eg. smoking) and health services (eg. general practice accreditation, elective surgery waiting lists). The 2008 report was launched by the Minister for Health and Ageing, Nicola Roxon, at the AIHW conference. Minister Roxon considered the report to be the premier source of health information in Australia and emphasised the importance of obtaining good quality data. Her address focused on the decreasing supply of GPs, and GP super clinic policy as a means to lure young doctors to general practice by providing flexible working hours and a team-based working environment.
The importance of data was reflected in the sentiments of the former Federal Health Minister, Dr Neal Blewett, who opened the conference. Dr Blewett stated that obtaining longitudinal data was critical to the evaluation of the health system as without it small changes occurring from year to year can be overlooked. He acknowledged the increased sophistication of data records (eg. disease registers) from 1988 (AIHW's first report) to 2008. Data was a burning issue in several of the parallel sessions where Susan Killion (AIHW) discussed the lack of available information about general practice, particularly from the patient's perspective, as well as the increased role that electronic data collection and management could play. David Crosbie (Mental Health Council of Australia) stated that data are the ‘hallmark of reform' and expressed frustration about the lack of statistics sharing between organisations.
In summary, the conference showcased current health knowledge in cancer, chronic disease, oral health, mental health, Indigenous health and rural health. This was balanced by a focus on what we don't know and what we can do to find out. Australia's Health, 2008 is available from: <www.aihw.gov.au>.
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