Research and Conference Publications

Permanent URI for this collection

This collection contains journal articles and other research publications such as book chapters, conference papers, and posters authored by NT Health staff and provides an overview of the interests, research activities and projects undertaken by NT Health staff. Most journal articles are published in subscription-based or open access publications, so this collection contains mainly citations and links to full text content on external sites, but where permitted, the PDF file has been made available.

Browse

Recent Submissions

Now showing 1 - 5 of 2099
  • Publication
    Conference paper
    Health workforce turnover, stability and employment survival in remote NT health centres 2004-2015
    (2019-03-24)
    Russell, Deborah
    ;
    ; ;
    Guthridge, Steven
    ;
    ;
    Jones, Mike
    ;
    Humphreys, John
    ;
    Wakerman, John
    Delivering effective primary care to where it’s needed most – specifically remote Aboriginal communities – is hampered by high turnover and low stability of health centre staff and a lack of evidence about this to inform remote workforce policy making. This research describes the turnover, stability and employment survival patterns over 12 years in remote Northern Territory (NT) health centres
  • Publication
    Journal Article
    The relationship between number of primary health care visits and hospitalisations: evidence from linked clinic and hospital data for remote Indigenous Australians.
    (2013-11-06) ; ;
    Guthridge, Steven
    ;
    Lawton, P
    Primary health care (PHC) is widely regarded as essential for preventing and treating ill health. However, the evidence on whether improved PHC reduces hospitalisations has been mixed. This study examines the relationship between PHC and hospital inpatient care in a population with high health need, high rates of hospitalisation and relatively poor PHC access.The cross-sectional study used linked individual level PHC visit and hospitalisation data for 52 739 Indigenous residents from 54 remote communities in the Northern Territory of Australia between 1 July 2007 and 30 June 2011. The association between PHC visits and hospitalisations was modelled using simple and spline quadratic regression for key demographics and disease groups including potentially avoidable hospitalisations.At the aggregate level, the average annual number of PHC visits per person had a U-shaped association with hospitalisations. For all conditions combined, there was an inverse association between PHC visits and hospitalisations for people with less than four clinic visits per year, but a positive association for those visiting the clinic four times or more. For patients with diabetes, ischaemic heart disease or renal disease, the minimum level of hospitalisation was found when there was 20-30 PHC visits a year, and for children with otitis media and dental conditions, 5-8 visits a year.The results of this study demonstrate a U-shape relationship between PHC visits and hospitalisations. Under the conditions of remote Indigenous Australians, there may be an optimal level of PHC at which hospitalisations are at a minimum. The authors propose that the effectiveness of a health system may hinge on a refined balance, rather than a straight-line relationship between primary health care and tertiary care.
  • Publication
    Journal Article
    Remoteness, models of primary care and inequity: Medicare under-expenditure in the Northern Territory.
    Objective To analyse Medicare expenditure by State/Territory, remoteness, and Indigenous demography to assess funding equality in meeting the health needs of remote Indigenous populations in the Northern Territory. Methods Analytic descriptions of Medicare online reports on services and benefits by key demographic variables linked with Australian Bureau of Statistics data on remoteness and Indigenous population proportion. The Northern Territory Indigenous and non-Indigenous populations were compared with the Australian average between the 2010/2011 and 2019/2020 fiscal years in terms of standardised rates of Medicare services and benefits. These were further analysed using ordinary least squares, simultaneous equations and multilevel models. Results In per capita terms, the Northern Territory receives around 30% less Medicare funds than the national average, even when additional Commonwealth funding for Aboriginal medical services is included. This funding shortfall amounts to approximately AU$80 million annually across both the Medicare Benefits Schedule and Pharmaceutical Benefits Scheme. The multilevel models indicate that providing healthcare for an Aboriginal and Torres Strait Islander person in a remote area involves a Medicare shortfall of AU$531-AU$1041 less Medicare Benefits Schedule benefits per annum compared with a non-Indigenous person in an urban area. Indigenous population proportion, together with remoteness, explained 51% of the funding variation. An age-sex based capitation funding model would correct about 87% of the Northern Territory primary care funding inequality. Conclusions The current Medicare funding scheme systematically disadvantages the Northern Territory. A needs-based funding model is required that does not penalise the Northern Territory population based on the remote primary health care service model.
  • Publication
    Journal Article
    A new framework for Australian specialty colleges and other healthcare leaders to address bullying, discrimination, and harassment that involves doctors.
    (2024-06-25)
    Haskell, Thomas Lawson
    ;
    Stankovich, Jim
    ;
    Merridew, Nancy Louisa
    Bullying, discrimination, and harassment (BDH) within healthcare teams is a global issue that risks healthcare worker wellbeing, patient safety, public health, and industry reputations. Collectively, fragmented regulation, weak detection and correction processes, conflicts of interest, and fear of retribution for complainants create an environment that enables perpetrators. Specialty training Colleges and other stakeholders can collaborate to address this issue more effectively. This paper examines Australian processes and proposes that the existing disparate mechanisms should be replaced with a national BDH framework that is supported by an independent investigation body. The authors seek to stimulate discussion to reform practice in Australia and in other countries with similar health systems.
  • Publication
    Journal Article
    Engagement and partnership with consumers and communities in the co-design and conduct of Research: Lessons from the INtravenous iron polymaltose for First Nations Australian patients with high FERRitin levels on haemodialysis (INFERR) clinical trial.
    (2024-07-15)
    Long, Stephanie
    ;
    Ross, Cheryl
    ;
    Koops, Joan
    ;
    Coulthard, Katherine
    ;
    Nelson, Jane
    ;
    Shapkota, Archana Khadka
    ;
    Hewett, Leiana
    ;
    ;
    Graham, Jessica
    ;
    ; ;
    Hoppo, Libby
    ;
    ;
    Pawar, Basant
    ;
    ;
    Gold, Lorna Murakami
    ;
    Rathnayake, Geetha
    ;
    ; ; ; ; ; ; ; ; ; ;
    Lawton, P
    ;
    Barzi, Federica
    ;
    ;
    Mayo, Mark
    ;
    Cass, Alan
    ;
    Engagement and partnership with consumers and communities throughout research processes produces high quality research meeting community needs and promoting translation of research into improved policy and practice. Partnership is critical in research involving Aboriginal and/or Torres Strait Islander people (First Nations Peoples) to ensure cultural safety. We present lessons from the design, implementation and progress of the National Health and Medical Research Council funded INtravenous iron polymaltose for First Nations Australian patients with high FERRitin levels on hemodialysis (INFERR) clinical trial.The trial was designed to understand the benefits and harms of iron therapy in First Nations Australians on haemodialysis with anaemia and hyperferritinaemia. The lack of evidence for treatment was discussed with patients who were potential participants. A key element ensuring safe conduct of the INFERR trial was the establishment of the Indigenous Reference Groups (IRGs) comprising of dialysis patients based in the Top End of Australia and Central Australia. Two IRGs were needed based on advice from First Nations communities and researchers/academics on the project regarding local cultural differences and approaches to trial conduct. The IRGs underpin culturally safe trial conduct by providing input into study materials and translating study findings into effective messages and policies for First Nations dialysis patients. Throughout the trial conduct, the IRGs' role has developed to provide key mechanisms for advice and guidance regarding research conduct both in this study and more broadly. Support provided to the IRGs by trial First Nations Research Officers and independent First Nations researchers/academics who simplify research concepts is critical. The IRGs have developed feedback documents and processes to participants, stakeholders, and the renal units. They guarantee culturally safe advice for embedding findings from the trial into clinical practice guidelines ensuring evidence-based approaches in managing anaemia in haemodialysis patients with hyperferritinaemia.Active consumer and community partnership is critical in research conduct to ensure research impact. Strong partnership with consumers in the INFERR clinical trial has demonstrated that First Nations Consumers will engage in research they understand, that addresses health priorities for them and where they feel respected, listened to, and empowered to achieve change.In this paper, we present the importance of actively involving consumers in the planning, implementation and conduct of research using the example of a clinical trial among Aboriginal and/or Torres Strait Australians (First Nations Australians) who have kidney disease and are currently receiving haemodialysis. The study assesses how safe and effective it is for people on dialysis to receive iron given through the vein during dialysis when they have anaemia and high levels of a blood test called ferritin, a test used routinely to measure iron levels. Two consumer reference groups of First Nations patients on dialysis, one based in the Top End of Australia and the other based in Central Australia, are supported by First Nations Research Officers and Research Academics to make sure that the research is performed in a way that involves, respects and values First Nations participation, culture, and knowledge. Active consumer and community partnership in this study has supported robust research governance processes which we believe are crucial for knowledge translation to have a positive impact for patients.