Avoiding unplanned readmission into hospital is important. A significant proportion of hospital readmissions are avoidable and vulnerable groups, such as older people, are disproportionally affected by unplanned readmissions. Unplanned readmissions are associated with poorer health outcomes, lower satisfaction with healthcare, and increased health system costs.
The transition process between hospital and home is risky for the patient, however it is also a phase where patients may not necessarily need the intensity of a hospital bed, nor might patients actually want to remain in hospital especially if the same level of patient safety could be assured in the patient’s own home.
Tracey Johnson is the CEO of Inala Primary Care, a not-for-profit general practice located in Inala serving approximately 7000 patients; 4400 of whom attend clinic regularly. Inala is a suburb of Brisbane, Queensland and has a population of great cultural and linguistic diversity, with just under 40% of residents speaking English at home. It is also one of Queensland’s most socioeconomically marginalised urban areas.
Australian Health Journal spoke with Tracey on the role of Inala Primary care in reducing hospital admissions.
The delivery of care in a culturally and linguistically sensitive manner across all levels of the healthcare system is seen as deficient. In an effort to improve healthcare access and equity, Inala Primary Care and the Mater Integrated Refugee Health Service (MIRHS) co-developed the Mater Culturally & Linguistically Diverse Healthcare Coordinator Service (MCHooSe).
Commonly delivered services included following up with external health services, chart reviews and helping patients coordinate external health care appointments. Surveys of primary care clinicians (GPs and practice nurses) revealed that MCHooSe improved patient access to external health services and improved patient understanding of their treatments.
The data also revealed that the primary care clinicians felt the patients’ wellbeing improved after their patients had access to the service and that patients were more likely to be compliant with attendance and treatments. Most importantly, primary care clinicians said they received communications from the hospital quicker if MCHooSe was involved.
In combination, these factors are known to reduce the risk of hospital readmissions. MCHooSe highlights the potential to improve hospital outcomes through better healthcare coordination and improved healthcare equity for multicultural patients.
Tracey also talks about the outcomes of non-dispensing pharmacists in general practice in a pilot running at Inala Primary Care. Prior health research has shown the integration of non-dispensing pharmacists in the general practice clinic has significantly reduced emergency department presentations and hospital readmissions in certain patient groups (long-term polypharmacy suffering from congestive heart failure or chronic obstructive pulmonary disease).
As part of the pilot, pharmacists are working towards averting hospital readmissions, new hospital presentations and adverse health outcomes. Formal evaluation of the pilot is currently being completed by Brisbane South PHN and Griffith University.
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Detection and prevention of Alzheimer’s Disease and Related Dementias
Professor Vicky Vass serves as the Chief Executive Officer of Alzheimer’s Research Australia, which is based in Perth, Western Australia. Australian Health Journal met with Professor Vass to hear of the organisation’s mission to solve the mysteries surrounding Alzheimer’s disease, and focus on detection as the key to their efforts.
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HIGHLIGHTS The power of social determinants of health, panel discussion
Clinicians and consumers know only too well that life circumstances such as poor housing, income and food insecurity can have a negative impact on health outcomes. Conversely, participation in community activities, social connection and access to nature parks and leisure facilities can help maintain health and wellbeing.
More recent phenomena in public health have also focused us on the health and social care connection. Stress factors such as the sudden loss of employment and social interaction, moving to remote work or schooling, and the impacts of sudden, localised COVID-19 ‘lockdowns’ to prevent further outbreaks were triggers of increased psychological distress.
And loneliness is being described as our latest epidemic with chronic loneliness inked to a myriad of health problems and earlier death. A recent report found one in four Australians say they feel persistently lonely, and that loneliness costs $2.7 bn a year in health costs alone.
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Cardinal Health brings device reprocessing plant to Australia
Cardinal Health is global medical products manufacturer and leading provider of single-use device reprocessing services in the U.S. In Australia and New Zealand, as one of the largest suppliers of medical devices, announced on 23 May 2024 that it will be opening a single-use medical device reprocessing facility in Australia – its first reprocessing facility outside the United States.
On 18 March 2025 at the Health Innovation Living Lab at the John Hunter Hospital, a further announcement was made, on the chosen single-use medical device remanufacturing facility in Beresfield, Newcastle, set to commence operation late 2025, supported by the NSW Department of Primary Industries and Regional Development.
