NT Health Research and Publications Online

Welcome to NT Health Research and Publications Online, an open access digital repository that showcases the research projects and output of researchers working for the Northern Territory Department of Health (NT Health), while also collecting and preserving publications and multimedia produced in an official capacity, that represent the department. This service is maintained by NT Health Library Services
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4213
Projects
61
People
231
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  • Publication
    Journal Article
    Costs and healthcare use of patients with chronic kidney disease in the Northern Territory, Australia.
    (2024-07-09)
    Chen, Winnie
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    Howard, Kirsten
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    Gorham, Gillian
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    ; ;
    Adegboye, Oyelola
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    ;
    Talukder, Mohammad Radwanur Rahman
    ;
    ;
    Cass, Alan
    The burden of chronic kidney disease (CKD) is high in the Northern Territory (NT), Australia. This study aims to describe the healthcare use and associated costs of people at risk of CKD (e.g. acute kidney injury, diabetes, hypertension, and cardiovascular disease) or living with CKD in the NT, from a healthcare funder perspective.We included a retrospective cohort of patients at risk of, or living with CKD, on 1 January 2017. Patients on kidney replacement therapy were excluded from the study. Data from the Territory Kidney Care database, encompassing patients from public hospitals and primary health care services across the NT was used to conduct costing. Annual healthcare costs, including hospital, primary health care, medication, and investigation costs were described over a one-year follow-up period. Factors associated with high total annual healthcare costs were identified with a cost prediction model.Among 37,398 patients included in this study, 23,419 had a risk factor for CKD while 13,979 had CKD (stages 1 to 5, not on kidney replacement therapy). The overall mean (± SD) age was 45 years (± 17), and a large proportion of the study cohort were First Nations people (68%). Common comorbidities in the overall cohort included diabetes (36%), hypertension (32%), and coronary artery disease (11%). Annual healthcare cost was lowest in those at risk of CKD (AUD$7,958 per person) and highest in those with CKD stage 5 (AUD$67,117 per person). Inpatient care contributed to the majority (76%) of all healthcare costs. Predictors of increased total annual healthcare cost included more advanced stages of CKD, and the presence of comorbidities. In CKD stage 5, the additional cost per person per year was + $53,634 (95%CI 32,769 to 89,482, p < 0.001) compared to people in the at risk group without CKD.The total healthcare costs in advanced stages of CKD is high, even when patients are not on dialysis. There remains a need for effective primary prevention and early intervention strategies targeting CKD and related chronic conditions.
  • Publication
    Journal Article
    Tele-otology for Aboriginal and Torres Strait Islander People Living in Rural and Remote Areas.
    (2024-07-10)
    Habib, Al-Rahim
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    Sacks, Raymond
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    Singh, Narinder
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    To evaluate a referral-based, tele-otology service in rural and remote areas of the Northern Territory, Australia.A retrospective observational cohort study was performed of a tele-otology service in 93 Aboriginal and Torres Strait Islander communities (2011 to 2019). Assessments included face-to-face examinations performed by Clinical Nurse Consultants and audiologists, and asynchronous reviews performed by otolaryngologists. Multivariable logistic regression was performed to determine the likelihood of ear disease, adjusted for age and gender. Intra- and inter-rater agreement was assessed between otolaryngologists.A total of 3,950 patients were reviewed (6,838 encounters, 13,726 ear assessments). The median age of patients was 9.8 years (interquartile range: 7.2 years). Overall, 62.2% of patients were identified with ear disease and 62.5% identified with hearing loss. Substantial intra- and inter-rater agreement in diagnosis was found between otolaryngologists (κ = 0.71 and κ = 0.78, respectively). The most common ear conditions identified were chronic otitis media (COM, 28.1%) and otitis media with effusion (OME, 16.5%). Topical or oral antibiotics were initiated in 14.1% of all encounters, most often for acute otitis media or COM. Surgery was recommended in 27.7% of all encounters, most often myringoplasty, adenoidectomy, and myringotomy with insertion of tympanostomy tubes.Tele-otology is a critical component of an integrated approach to evaluating ear disease in Indigenous people living in rural and remote areas. The high prevalence of OME, COM, and surgical recommendations highlights the need for community engagement, regular follow-up, and early interventions to prevent long-term hearing loss.N/A Laryngoscope, 2024.
  • Publication
    Journal Article
    Chronic traumatic encephalopathy (CTE) in the context of longstanding intimate partner violence.
    (2024-07-08) ;
    Byard, R W
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    Vink, R
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    Affleck, A J
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    Blumbergs, P
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    Buckland, M E
    No abstract available
  • Publication
    Journal Article
    Clinical Presentation and Outcomes Following Infection With Vibrio spp, Aeromonas spp, Chromobacterium violaceum, and Shewanella spp Water-Associated Organisms in Tropical Australia, 2015-2022
    (2024-06-30T14:00:00Z) ;
    MacGregor, Kirsten
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    ;
    Kanitkar, Tanmay
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    Water-associated bacterial infections cause a wide spectrum of disease. Although many of these infections are typically due to human host commensal or spp, water exposure can result in infections with environmental gram negatives such as spp, spp, , and spp (collectively VACS).We performed a retrospective analysis of the epidemiology, clinical presentation, and outcomes of deep and superficial infections associated with VACS organisms in our health service between 1 January 2015 and 31 December 2023.We identified 317 patient episodes of infection with VACS organisms over this period. Of these, spp (63%) was the most common, followed by spp (19%), spp (13%), and (5%). The majority were isolated from males (74.4%) and involved the lower limb (67.5%). Mild infections were more common than severe presentations, with only 15 (4.7%) admissions to the intensive care unit and 8 (2.5%) deaths. Colonization occurred in 6.9% of patients, in contrast to the perceived severity of some of these bacteria. Copathogens were common and included (48%) and enteric bacteria (57%). The majority of patients (60%) had no documented water exposure. Initial empiric antimicrobial therapy presumptively covered the susceptibilities of the isolated organisms in 47.3% of patients; however, a lack of VACS-covering empirical therapy was not associated with readmission.The isolation of a VACS organism in our setting was often not associated with documented water exposure, which has implications for empiric antimicrobial therapy. Severe disease and death were uncommon.
  • Person
    Smith, Emma
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