Khic-Houy Prang

A method for cross-cultural adaptation of a verbal memory assessment.

Verbal memory tests—although important to the neuropsychological assessment of memory—are biased to many cultures. In the present article, we highlighted the limitations associated with the direct translation of tests and word matching, as well as the lack of ecological validity and cultural appropriateness when tests developed in one culture are used in another. To overcome these limitations, a verbal memory paradigm was developed that framed the memory assessment with a shopping-list format, but that developed culturally specific stimuli for the different language groups. The aim of the present study was to determine the equivalence of this shopping list memory test in different cultural and language groups. Eighty-three adults from English-, French-, Malay-, and Chinese-speaking cultures participated in four experiments. The results of all the experiments indicated that performance of verbal list learning is equivalent, irrespective of the language used. These results support the use of this methodology for minimizing cross-cultural test bias, and have important implications for testing culturally and linguistically diverse individuals.

Healthcare and disability service utilization in the 5-year period following transport-related traumatic brain injury.

Primary objective: To describe the type, intensity and direct cost of healthcare and disability services used following transport-related traumatic brain injury (TBI). Methods and procedures: Using the transport accident compensation regulator database, claims records were examined of 423 cases of adult (18–65 years of age) transport-related TBI occurring between 1 January 1995 and 31 December 2004. Claimants were stratified by TBI severity using the Glasgow Coma Scale (GCS) score. Service utilization and costs were examined by TBI severity in the 5-year period post-injury. Main outcomes and results: Claimants accessed a total of 409 740 services. Claimants with severe TBI accessed more medical (median 333 per claimant) and paramedical services (median 436 per claimant) than claimants with mild and moderate TBI. Almost 60% of claimants with severe TBI accessed attendant care services compared to 39% and 45% of claimants with moderate and mild TBI, respectively. Average total costs of services were highest among claimants with severe TBI (AUD

Return to work outcomes for workers with mental health conditions: A retrospective cohort study.

324 515 per claimant). Conclusions: Healthcare service utilization and the economic burden of TBI are substantial. Injury compensation data provides a unique opportunity to explore patterns of healthcare usage post-injury, which is important for the planning and management of resources.

The use of public performance reporting by general practitioners: a study of perceptions and referral behaviours

OBJECTIVES The aims of this study were to describe predictors of sustained return to work (RTW) among a cohort of workers with compensated work-related mental health conditions (MHCs); and to examine predictors of subsequent absences due to the same condition. METHODS This study was a retrospective analysis of compensation claims data in Victoria, Australia. We selected workers with an accepted wage replacement claim due to a work-related MHC from 1 January 2002 to 31 December 2009, with two years of follow-up data. RESULTS We identified 8358 workers meeting our inclusion criteria. The median age of workers was 44 years (Interquartile range (IQR): 36-51) and 56% were female. In a multivariable Cox regression analysis, older age, being from a small organisation, working in some specific industry segments, consulting a psychiatrist or psychologist, using medications, and having a previous claim were all associated with a delayed RTW. Workers experiencing work pressure, assault/workplace violence or other mental stress factors, working in the public administration and safety industry and having a medical incapacity certification between 3-4 days and 5-7 days had a higher rate of multiple RTW attempts. CONCLUSION This study identified a number of risk factors associated with a delayed RTW and multiple attempts at RTW. Predictors may help identify high-risk groups and facilitate the RTW process of workers with MHCs.

That's what you do for people you love: A qualitative study of social support and recovery from a musculoskeletal injury

BackgroundPublic performance reporting (PPR) of hospital data aims to improve quality of care in hospitals and to inform consumer choice. In Australia, general practitioners (GPs) are gatekeepers to secondary care with patients requiring their referral for non-emergency access. Despite their intermediary role, GPs have been generally overlooked as potential users of PPR of hospital data, with the majority of the PPR research focussing on consumers, surgeons and hospitals.MethodsWe examined the use of PPR of hospital data by GPs when referring patients to hospitals. Semi-structured interviews were conducted with 40 GPs, recruited via the Victorian Primary Care Practice-Based Research Network and GP teaching practices in Victoria, Australia. The interviews were recorded, transcribed and analysed thematically.ResultsWe found that the majority of GPs did not use PPR when referring patients to hospitals. Instead, they relied mostly on informal sources of information such as their own or patients’ previous experiences. Barriers that prevented GPs’ use of PPR in their decision making included: lack of awareness and accessibility; perceived lack of data credibility; restrictive geographical catchments for certain hospitals; limited choices of public hospitals in regional and rural areas; and no mandatory PPR for private hospitals.ConclusionsOur findings suggest that lack of PPR awareness prevented GPs from using it in their referral practice. As gatekeepers to secondary care, GPs are in a position to guide patients in their treatment decisions and referrals using available PPR data. We suggest that there needs to be greater involvement by GPs in the development of hospital performance and quality indicators in Australia if GPs are to make greater use of them. The indicators require further development before GPs perceive them as valid, credible, and of use for informing their referral practices.

The impact of public performance reporting on health plan selection and switching: A systematic review and meta-analysis

Background Social support has been identified as a significant factor in facilitating better health outcomes following injury. However, research has primarily focused on the role of social support from the perspective of the person experiencing an injury. Limited research has examined the experiences of the family members and friends of a person with injury. This study aims to explore the perceptions and experiences of social support and recovery following a transport-related musculoskeletal injury (MSI) in a population of injured persons and their family members and friends. Methods This study was conducted using a phenomenological qualitative research design. In-depth semi-structured interviews were conducted with ten persons with MSI, recruited via the Transport Accident Commission (TAC) in Victoria, Australia. Seven family members and friends were also interviewed. The data was analysed using constant comparative method and thematic analysis. Results Several themes were identified including: (1) key sources and types of support received, (2) relationship development and (3) challenges of providing and receiving support. Participants with MSI reported stories about how the social network provided emotional and tangible support. Family members and friends confirmed the supportive acts provided to the participants with MSI. Positive iterative changes in relationships were reported by the participants with MSI. Participants with MSI, their family members and friends described several difficulties including loss of independence, feeling like a burden, and the impact of caring on health and well-being. Conclusions The role of social support is complex given the multitude of people involved in the recovery process. The findings of this study suggest that persons with MSI may benefit from support groups and maintenance of existing support networks. Furthermore, family members and friends engaged in the recovery process may benefit from support in this role.

Public performance reporting and hospital choice: a cross-sectional study of patients undergoing cancer surgery in the Australian private healthcare sector

The dissemination of public performance reporting (PPR) cards aims to increase utilisation of information on quality of care by consumers when making health plan choices. However, evaluations of PPR cards show that they have little impact on consumer choices. The aim of this study is to undertake a systematic review and meta-analysis of the impact of PPR cards in promoting health plan selection and switching between health plans by consumers. We searched five online databases and eight previous reviews for studies reporting findings on PPR and health plans. We extracted data and conducted quality assessment, systematic critical synthesis and meta-analyses on the included studies. We identified eight relevant health plan articles related to selection (n = 2), switching (n = 4), selection/switching (n = 2). Meta-analyses showed that PPR was associated with an improvement in health plan selection and a very small deterioration in switching health plans though these changes were not statistically significant. Differences were observed between employer-sponsored health insurance and Medicare/Medicaid insurance. Given the small number of studies included in the review, further research examining the impact of PPR on health plan selection and switching in a range of insurance markets is required.

Does medical certification of workers with injuries influence patterns of health service use

Objectives National mandatory public performance reporting (PPR) for Australian public hospitals, including measures of cancer surgery waiting times, was introduced in 2011. PPR is voluntary for private hospitals. The aims of this study were to assess whether PPR of hospital data is used by patients with breast, bowel or lung cancer when selecting a hospital for elective surgery and how PPR could be improved to meet their information needs. Design A national cross-sectional postal questionnaire. Setting Australian private healthcare sector. Participants Private patients with breast, bowel or lung cancer who attended a public or private hospital for elective surgery (n=243) in 2016. Outcome measures Patients’ choice of hospital, use of PPR information and preferred areas of PPR information. Descriptive and conventional qualitative content analyses were conducted. Results Two hundred and twenty-eight respondents (94%) attended a private hospital. Almost half could choose a hospital. Choice of hospital was not influenced by PPR data (92% unaware) but by their specialist (90%). Respondents considered PPR to be important (71%) but they did not want to see the information, preferring their general practitioners (GPs) to tell them about it (40%). Respondents considered surgery costs (59%), complications (58%) and recovery success rates (57%) to be important areas of information that should be publicly reported. Almost half suggested that quality indicators should be reported at the individual clinician level. Analysis of the open-ended questions identified four themes: (1) decision-making factors; (2) data credibility; (3) unmet information needs and (4) unintended consequences. Conclusions PPR of hospital data had no substantial impact on patients’ choice of hospital. Nonetheless, many respondents expressed interest in using it in future. To increase PPR awareness and usability, personalised and integrated information on cost and quality of hospitals is required. Dissemination of PPR information via specialists and GPs could assist patients to interpret the data and support decision-making.

304 “That’s what you do for people you love”: a qualitative study of social support and recovery from musculoskeletal injury

BACKGROUND Among workers with injuries who seek compensation, a general practitioner (GP) usually plays an important role in a persons return to work (RTW) by advising if the worker is unfit for work (UFW), is able to work on alternate (ALT) duties or is fit for work and also providing referrals to other health service providers. OBJECTIVE To examine patterns of health service utilization (HSU) in workers with injuries by condition and type of certificate issued by GP. METHODS Zero-inflated negative binomial and logistic regressions were conducted for major healthcare services accessed over the 12-month period post-initial medical examination. Services included GP consultations, pharmacy, physiotherapy, occupational rehabilitation and psychology. RESULTS The average number of physiotherapy services was greater in workers with musculoskeletal disorders, back pain and fractures. In contrast, the median number of psychological services was greater in mental health conditions (MHC). Workers with ALT certificates were more likely to use GPs, pharmacy and physiotherapy services. CONCLUSION HSU in the 12 months post-initial medical certification varied substantially according to the workers condition, certificate type, age, gender and residential location. Understanding these factors can facilitate more appropriate resource allocation; strategic thinking on optimal use of particular health services and enables better targeting of particular provider groups for more education on the health benefits of RTW.

Compensation Research Database: population-based injury data for surveillance, linkage and mining

Background Social support has been identified as a key factor in facilitating better health outcomes following injury. However, research has primarily focused on the role of social support from the perspective of the person experiencing an injury. Limited research has examined the experiences of the family members/friends to a person with injury. This study aims to explore the perceptions and experiences of social support and recovery following a transport-related musculoskeletal injury (MSI) in a population of injured persons and their family members/friends. Methods This study was conducted using a phenomenology qualitative research design. In-depth semi-structured interviews were conducted with ten persons with MSI, recruited via the Transport Accident Commission (TAC) in Victoria, Australia. Seven family members/friends were also interviewed. Interviews were audio-recorded and transcribed verbatim. The data was analysed using thematic analysis. Results Several themes were identified including: (i) key sources of support, (ii) types of support received, (iii) relationship development and (iv) challenges of providing and receiving support. The presence of social support was perceived as fundamental to recovery. Different members of the social network provided different types of support. Iterative changes in relationships and barriers in providing and receiving support following the injury were noted. Conclusions This study provides valuable insights into the perceptions and experiences of social support and recovery from MSI. The study revealed complexities in the interactions between persons with MSI and their family members/friends, in particularly related to caregiving demands. The findings of this study have implication for involving and supporting family members/friends in the planning and implementation of treatment plan.