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Demetriou EA, Boulton KA, Thapa R, Sun C, Gilroy J, Bowden MR, Guastella A. Burden of paediatric hospitalisations to the health care system, child and family: a systematic review of Australian studies (1990-2022). THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 40:100878. [PMID: 38116503 PMCID: PMC10730319 DOI: 10.1016/j.lanwpc.2023.100878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 07/15/2023] [Accepted: 08/03/2023] [Indexed: 12/21/2023]
Abstract
Background Paediatric hospitalisations represent a significant cost to the health system and cause significant burden to children and their families. Understanding trends in hospitalisation costs can assist with health planning and support strategies across stakeholders. The objective of this systematic review is to examine the trends in costs and burden of paediatric hospitalisations in Australia to help inform policy and promote the well-being of children and their families. Methods Electronic data sources (Embase, Medline, Web of Science, PSYCH-Info, CINAHL and Scopus) were searched from 1990 until December 2022. Any quantitative or qualitative studies conducted in Australian tertiary hospitals were included in the review. Eligible studies were those that included paediatric (<18 years) hospitalisations and reported on economic and/or non-economic costs for the child, family unit and/or health system. Study quality and risk of bias for each study were assessed with the Joanna Briggs Critical Appraisal Tools. We present a summary of the findings of the hospitalisation burden across major diagnostic admission categories and for the child and family unit. The systematic review was registered with Prospero (ID: CRD42021276202). Findings The review summarises a total of 88 studies published between 1990 and December 2022. Overall, the studies identified that paediatric hospitalisations incur significant financial costs, which have not shown significant reductions over time. In-patient direct hospital costs varied depending on the type of treatment and diagnostic condition. The costs per-case were found to range from just below AUD$2000 to AUD$20,000 or more. The financial burden on the family unit included loss of productivity, transport and travel costs. Some studies reported estimates of these costs upward of AUD$500 per day. Studies evaluating 'hospital in the home' options identified significant benefits in reducing hospitalisations and costs without compromising care. Interpretation Increasing focus on alternative models of care may help alleviate the significant costs associated with paediatric hospitalisation. Funding This research was supported by Hospitals United for Sick Kids (formerly Curing Homesickness).
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Affiliation(s)
- Eleni Andrea Demetriou
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Australia
| | - Kelsie Ann Boulton
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Australia
| | - Rinku Thapa
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Australia
| | - Carter Sun
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Australia
| | | | - Michael Russell Bowden
- Mental Health Branch, NSW Health, Sydney Children's Hospitals Network, Discipline of Psychiatry, Westmead Clinical School and The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Australia
| | - Adam Guastella
- Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, 2050, Australia
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Diab J, Flapper WJ, Moore MH. Facial Fractures in Indigenous and Non-indigenous Populations of South Australia. J Craniofac Surg 2023; 34:1207-1211. [PMID: 36694300 DOI: 10.1097/scs.0000000000009195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/13/2022] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Maxillofacial trauma in indigenous populations is complex with sociocultural factors, access to health care, and poorer general health issues that impact outcomes. Assaults and road traffic accidents are disproportionately experienced by indigenous persons compared with non-indigenous. METHODS A retrospective review was conducted from January 2012 to January 2017 at the Women and Children's Hospital and Royal Adelaide Hospital, Adelaide. All maxillofacial fractures that attended or were referred to the unit were included in this study. The primary objective was to analyze epidemiological trends of facial fractures and clinical outcomes in the South Australian indigenous and non-indigenous populations. RESULTS Maxillofacial fractures in indigenous persons were less than in non-indigenous (31.2 versus 38.2 y, P < 0.001) with 3.8 odds of a facial fracture. Assault was 2.9 times more likely to result in a facial fracture, falls 40.9% less likely, and sports 29.4% less likely compared with non-indigenous ( P < 0.001). Alcohol-related facial fractures had significantly higher rates [odds ratio (OR = 3.8)] compared with non-indigenous. Indigenous from most disadvantaged areas and very remote areas also had significantly higher odds of a facial fracture. Indigenous persons had higher operative rates (OR = 2.8), postoperative complications (OR = 3.1), and a 3.7-day mean difference for the length of stay (6.6 versus 2.9 d, P < 0.001). CONCLUSIONS Indigenous people are more likely to experience facial fractures from assault resulting in mandibular fractures, whereas non-indigenous people are likely to have sport or fall-related midface fractures. Young indigenous women from outer regional and very remote areas have greater odds of facial fractures caused by assault and alcohol with higher operative rates, postoperative complications, and extended length of stay.
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Affiliation(s)
- Jason Diab
- Australian Craniofacial Unit
- Royal Adelaide Hospital
- Women and Children's Hospital
- School of Medicine, University of Notre Dame, Sydney, Australia
| | - Walter J Flapper
- Australian Craniofacial Unit
- Royal Adelaide Hospital
- Women and Children's Hospital
- University of Adelaide, Adelaide
| | - Mark H Moore
- Australian Craniofacial Unit
- Royal Adelaide Hospital
- Women and Children's Hospital
- University of Adelaide, Adelaide
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Assessing the impact of computerised and written advice in changing the habit and behaviour of alcohol use in patients who have suffered alcohol-related facial injuries-a pilot study. Oral Maxillofac Surg 2019; 23:149-157. [PMID: 30762139 DOI: 10.1007/s10006-019-00749-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 02/05/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Alcohol screening and a brief intervention (SBI) can be effective in changing harmful drinking behaviour and reducing the chance of future alcohol-related traumas. However, there is no standardised method in its application. This study aims to deliver a novel method of SBI to patients with alcohol-related facial fractures and to assess changes in their alcohol intake and attitudes to drinking following this intervention. METHODS Twenty consecutive patients at two Victorian Hospitals were consented to undergo a novel SBI program. This study analysed the results of the initial survey and the follow-up survey completed at least 3 months later. RESULTS Of the 20 patients recruited for the initial survey, 18 returned for the follow-up (90% response rate). All patients were males, 50% were aged between 18 and 29 years, 61% involved in interpersonal violence, 56% sustained mandibular fractures and 89% underwent surgery. The alcohol risk score increased in the follow-up survey; however, the relationship is not statistically significant. A high proportion of the patients were still unaware of their risk. Patients showed greater awareness of their drinking and willingness to accept help and more readiness to accept written advice rather than computerised materials. CONCLUSION This study found a high rate of acceptance among trauma patients to the intervention program. Although there was no significant change in the risk scores between the initial and follow-up surveys, certain subgroup was more amenable to the intervention given. There is generally an improvement in the attitudes towards and knowledge of harmful drinking.
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Should alcohol screening be a routine practice in alcohol-related facial trauma care? A narrative review. Oral Maxillofac Surg 2017; 21:375-382. [PMID: 29063305 DOI: 10.1007/s10006-017-0662-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 10/11/2017] [Indexed: 10/18/2022]
Abstract
The link between alcohol intoxication and Emergency Department (ED) attendance for management of alcohol-related injuries has been well documented. The acute settings such as ED and surgical wards may not be the most appropriate environment for treatment of chronic conditions, but traumatic episode presentation to ED may offer the most opportunistic time to focus on screening against harmful alcohol use in order to provide timely feedback and support. Although ED provides an opportunity to identify patients with alcohol problems, the initial challenge is finding suitable ways to identify and screen affected patients. This paper is a narrative review on methods of alcohol screening and its effectiveness and efficacy in trauma care setting. It is second part in a series on implementation of screening and brief intervention in managing trauma patients.
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Brennan-Olsen SL, Vogrin S, Leslie WD, Kinsella R, Toombs M, Duque G, Hosking SM, Holloway KL, Doolan BJ, Williams LJ, Page RS, Pasco JA, Quirk SE. Fractures in indigenous compared to non-indigenous populations: A systematic review of rates and aetiology. Bone Rep 2017; 6:145-158. [PMID: 28560269 PMCID: PMC5437735 DOI: 10.1016/j.bonr.2017.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 04/24/2017] [Accepted: 04/25/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Compared to non-indigenous populations, indigenous populations experience disproportionately greater morbidity, and a reduced life expectancy; however, conflicting data exist regarding whether a higher risk of fracture is experienced by either population. We systematically evaluate evidence for whether differences in fracture rates at any skeletal site exist between indigenous and non-indigenous populations of any age, and to identify potential risk factors that might explain these differences. METHODS On 31 August 2016 we conducted a comprehensive computer-aided search of peer-reviewed literature without date limits. We searched PubMed, OVID, MEDLINE, CINAHL, EMBASE, and reference lists of relevant publications. The protocol for this systematic review is registered in PROSPERO, the International Prospective Register of systematic reviews (CRD42016043215). Using the World Health Organization reference population as standard, hip fracture incidence rates were re-standardized for comparability between countries. RESULTS Our search yielded 3227 articles; 283 potentially eligible articles were cross-referenced against predetermined criteria, leaving 27 articles for final inclusion. Differences in hip fracture rates appeared as continent-specific, with lower rates observed for indigenous persons in all countries except for Canada and Australia where the opposite was observed. Indigenous persons consistently had higher rates of trauma-related fractures; the highest were observed in Australia where craniofacial fracture rates were 22-times greater for indigenous compared to non-indigenous women. After adjustment for socio-demographic and clinical risk factors, approximately a three-fold greater risk of osteoporotic fracture and five-fold greater risk of craniofacial fractures was observed for indigenous compared to non-indigenous persons; diabetes, substance abuse, comorbidity, lower income, locality, and fracture history were independently associated with an increased risk of fracture. CONCLUSIONS The observed paucity of data and suggestion of continent-specific differences indicate an urgent need for further research regarding indigenous status and fracture epidemiology and aetiology. Our findings also have implications for communities, governments and healthcare professionals to enhance the prevention of trauma-related fractures in indigenous persons, and an increased focus on modifiable lifestyle behaviours to prevent osteoporotic fractures in all populations.
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Affiliation(s)
- Sharon L Brennan-Olsen
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne, Western Health, 176 Furlong Road, St Albans, 3021, VIC, Australia.,Department of Medicine, University of Melbourne-Western Precinct, 176 Furlong Road, St Albans, 3021, VIC, Australia.,Deakin University, Pigdon Road, Geelong, 3220, VIC, Australia.,Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, 3000, VIC, Australia
| | - Sara Vogrin
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne, Western Health, 176 Furlong Road, St Albans, 3021, VIC, Australia
| | - William D Leslie
- Department of Medicine (C5121), University of Manitoba, 409 Tache Avenue, Winnipeg R2H 2A6, Canada
| | - Rita Kinsella
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne, Western Health, 176 Furlong Road, St Albans, 3021, VIC, Australia.,Western Health, 176 Furlong Road, St Albans, 3021, VIC, Australia
| | - Maree Toombs
- Rural Clinical School, School of Medicine, University of Queensland, Toowoomba, 4350, QLD, Australia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne, Western Health, 176 Furlong Road, St Albans, 3021, VIC, Australia.,Department of Medicine, University of Melbourne-Western Precinct, 176 Furlong Road, St Albans, 3021, VIC, Australia
| | - Sarah M Hosking
- Deakin University, Pigdon Road, Geelong, 3220, VIC, Australia
| | - Kara L Holloway
- Deakin University, Pigdon Road, Geelong, 3220, VIC, Australia
| | | | - Lana J Williams
- Deakin University, Pigdon Road, Geelong, 3220, VIC, Australia
| | - Richard S Page
- Deakin University, Pigdon Road, Geelong, 3220, VIC, Australia.,Barwon Centre for Orthopaedic Research and Education (B-CORE), Barwon Health, St John of God Hospital, Ryrie Street, PO Box 281, Geelong, 3220, VIC, Australia
| | - Julie A Pasco
- Department of Medicine, University of Melbourne-Western Precinct, 176 Furlong Road, St Albans, 3021, VIC, Australia.,Deakin University, Pigdon Road, Geelong, 3220, VIC, Australia.,Department of Preventive Medicine and Epidemiology, Monash University, Alfred Centre, Commercial Road, Prahran, VIC, Australia
| | - Shae E Quirk
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Wellington Road, Clayton, 3168, VIC, Australia
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Kruger E, Tennant M. Ten years of hospitalisation for oral health-related conditions in Western Australia: an unjust dichotomy. Aust J Prim Health 2017; 22:153-158. [PMID: 25586799 DOI: 10.1071/py14087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 11/27/2014] [Indexed: 11/23/2022]
Abstract
The objective of this study was: (1) to examine the demographics of in-patient oral health care by Aboriginal status; (2) to identify the mix of oral conditions by Aboriginal status; and (3) to describe trends over a 10-year period, comparing Aboriginal and non-Aboriginal groups. Hospitalisation data were obtained from the Western Australian Morbidity Data System (HMDS). The principal diagnosis, as classified by the International Classification of Disease (ICD-10AM), was obtained for every episode for adult patients who were discharged from all hospitals in Western Australia (WA) for the financial years 1999-2000 to 2008-09. Results indicated that more than 130000 persons were admitted to hospitals in WA over 10 years, for oral health-related conditions, at a direct cost of more than $400million. Most of those admitted were younger than 30 years, and 2.8% of all those admitted were Aboriginal people. Aboriginal people were admitted at significantly higher rates, for a very different mix of conditions, they were mostly from younger age groups, were mostly from very remote and the most disadvantaged areas and were almost all uninsured, compared with non-Aboriginal people. Hospital admissions for oral health-related conditions, as well as the mix of conditions that drive these hospitalisations, are strongly divided across social, racial and geographic variables, and remain a burden to the health-care system.
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Affiliation(s)
- Estie Kruger
- International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, Faculty of Sciences, The University of Western Australia, 35 Stirling Highway, Nedlands, WA 6009, Australia
| | - Marc Tennant
- International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, Faculty of Sciences, The University of Western Australia, 35 Stirling Highway, Nedlands, WA 6009, Australia
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Kruger E, Tennant M. Socioeconomic disadvantage and oral-health-related hospital admissions: a 10-year analysis. BDJ Open 2016; 2:16004. [PMID: 29607065 PMCID: PMC5842864 DOI: 10.1038/bdjopen.2016.4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 06/16/2016] [Indexed: 11/28/2022] Open
Abstract
Objective: The aim of this Western Australian population study was to assess the relationship of socioeconomic disadvantage and: 1) trends in hospitalisations for oral-health-related conditions over 10 years; 2) insurance status, costs and length of stay in hospital; and 3) specific conditions (principal diagnosis) patients were admitted for. Methods: Hospitalisation data (of oral-health-related conditions) were obtained for every episode of discharge from all hospitals in Western Australia for the financial years 1999–2000 to 2008–2009. Area based measures (using the Index of Relative Socioeconomic Disadvantage) was used to determine relationships between socioeconomic status and other variables. Results: The most disadvantaged in the population are being hospitalised at significantly higher rates than other groups, stay in hospital for longer, and at higher costs. This trend remained over a period of 10 years. Those least disadvantaged have the second highest rates of hospitalisation, but the likelihood of being admitted for different procedures differ between these two extremes. Conclusions: The importance of socioeconomic determinants of health are evident when analysing these hospitalisations. Recognition that lifestyle choices are severely restricted among the most marginalised and disadvantaged groups in the population can no longer be ignored in attempts to reduce health inequalities.
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Affiliation(s)
- Estie Kruger
- International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, Faculty of Sciences, The University of Western Australia, Nedlands, WA, Australia
| | - Marc Tennant
- International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, Faculty of Sciences, The University of Western Australia, Nedlands, WA, Australia
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Abstract
BACKGROUND Previous analysis of jaw fracture hospitalisations in Western Australia (WA) indicated disproportionately high rates of hospitalisations for Aboriginal people. This study was to follow-up on the earlier analysis to determine if inequalities in terms of jaw fracture hospitalisation rates between Aboriginal and non-Aboriginal people have changed. AIMS This study, done over a 10-year period from 1999/2000 to 2008/2009, aimed to determine rates of hospitalisations for jaw fractures in WA, trends over the 10-year period, and direct costs associated with these hospital admissions. METHODS Hospitalisation data were obtained from the Western Australian Hospital Morbidity Data System (HMDS). Episodes were selected on the basis of an ICD10-AM code being S02.4 (Fracture of the malar and maxillary bones) and S02.6 (Fracture of the mandible). Self-reported Aboriginality were used to compare Aboriginal to non-Aboriginal populations. Estimated cost of care was determined for each episode using the national standard diagnostic-related group (DRG) average price. RESULTS Our findings indicate that inequalities between Aboriginal and non-Aboriginal people in terms of hospital admissions for jaw fractures exist in WA, and continued over a decade-long period. Higher fracture rates occurred amongst males, Aboriginal people, younger adult age-groups, those from low socioeconomic areas, and those from remote and very remote areas. The DRG cost per person for jaw fractures ranged between AUD $842 and $109,002, with a median cost of $4,965. CONCLUSION Hospital admission rates for the treatment of maxillary and mandibular fractures is very strongly divided along racial and socioeconomic lines in WA.
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Affiliation(s)
- Estie Kruger
- International Research Collaborative - Oral Health and Equity, Department of Anatomy, Physiology and Human Biology, The Unversity of Western Australia, Nedlands, WA, Australia
| | - Marc Tennant
- International Research Collaborative - Oral Health and Equity, Department of Anatomy, Physiology and Human Biology, The Unversity of Western Australia, Nedlands, WA, Australia
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Kruger E, Tennant M. Potentially preventable hospital separations related to oral health: a 10-year analysis. Aust Dent J 2015; 60:205-11. [PMID: 25989466 DOI: 10.1111/adj.12322] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aims of this study were to assess the rates of hospitalizations for potentially preventable dental conditions over a 10-year period in Western Australia; to analyse trends over 10 years in rate changes of hopitalizations; and to analyse the mix of preventable dental conditions by age group and Aboriginal status. METHODS The principal diagnosis, as classified by the International Classification of Disease (ICD-10AM), was used to select hospitalization data for all patients who were discharged from hospital in Western Australia for the financial years 1999-2000 to 2008-2009, for a potentially preventable oral health condition. RESULTS Over a 10-year period more than 65 000 people were hospitalized. Population rates of hospitalization increased significantly over the period for both Aboriginal and non-Aboriginal population groups. Admission rates were higher for Aboriginal people. Children under 14 were more likely to be admitted; the most common condition that required hospitalization was dental caries, and the highest rates of hospitalization were for those from the most socio-economically disadvantaged areas. CONCLUSIONS These hospitalizations remain a considerable and increasing financial burden on health budgets. An increase in efforts is necessary to curb escalating government health expenditure by reducing avoidable and preventable oral health related hospitalizations.
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Affiliation(s)
- E Kruger
- International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, The University of Western Australia, Nedlands, Western Australia
| | - M Tennant
- International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, The University of Western Australia, Nedlands, Western Australia
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Whitty M, Nagel T, Jayaraj R, Kavanagh D. Development and evaluation of training in culturally specific screening and brief intervention for hospital patients with alcohol-related injuries. Aust J Rural Health 2015; 24:9-15. [DOI: 10.1111/ajr.12195] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2015] [Indexed: 11/28/2022] Open
Affiliation(s)
- Megan Whitty
- Menzies School of Health Research; Darwin Northern Territory Australia
- Charles Darwin University; Darwin Northern Territory Australia
| | - Tricia Nagel
- Menzies School of Health Research; Darwin Northern Territory Australia
- Charles Darwin University; Darwin Northern Territory Australia
- School of Medicine; Flinders University; Adelaide South Australia Australia
| | - Rama Jayaraj
- Menzies School of Health Research; Darwin Northern Territory Australia
- Charles Darwin University; Darwin Northern Territory Australia
| | - David Kavanagh
- School of Psychology and Counselling; Queensland University of Technology; Brisbane Queensland Australia
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Kruger E, Tennant M. Hospital admissions of older people for oral health-related conditions: implications for the future. Gerodontology 2015; 33:490-498. [DOI: 10.1111/ger.12189] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Estie Kruger
- International Research Collaborative - Oral Health and Equity; Faculty of Sciences; The University of Western Australia; Perth WA Australia
| | - Marc Tennant
- International Research Collaborative - Oral Health and Equity; Faculty of Sciences; The University of Western Australia; Perth WA Australia
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Mabrouk A, Helal H, Mohamed AR, Mahmoud N. Incidence, etiology, and patterns of maxillofacial fractures in ain-shams university, cairo, egypt: a 4-year retrospective study. Craniomaxillofac Trauma Reconstr 2014; 7:224-32. [PMID: 25136412 DOI: 10.1055/s-0034-1374061] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 08/07/2013] [Indexed: 10/25/2022] Open
Abstract
Although there is a worldwide increase in maxillofacial trauma incidence; the pattern and etiology of these injuries varies from one country to another depending on socioeconomic, cultural, and environmental factors. This study aims to realize the epidemiological characteristics of maxillofacial fractures in our department. A retrospective cross-sectional study of all facial trauma patients admitted to our department during 2009 to 2012. Patients' data including gender, age, etiology of trauma, the pattern and demographic distribution of fractures of maxillofacial skeleton, and associated injuries were analyzed and compared with previously published data. The chi-square test was used with a p value of less than 0.05, which was considered statistically significant. There is a significant increase in maxillofacial fractures incidence in the past 2 years than former ones. There is a male predominance with highest incidence in the age group of 20 to 40 years. Road traffic accident is the most common etiological factor followed by violence. There is increase in mandibular fracture incidence compared with midface. The significant increased incidence of maxillofacial fracture due to motor car accidents and assaults in the past 2 years reflects a behavioral change within the community.
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Affiliation(s)
- Amr Mabrouk
- Department of Plastic Surgery, Ain Shams University, Cairo, Egypt
| | - Hesham Helal
- Department of Plastic Surgery, Ain Shams University, Cairo, Egypt
| | | | - Nada Mahmoud
- Department of Plastic Surgery, Ain Shams University, Cairo, Egypt
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Lee K. Global trends in maxillofacial fractures. Craniomaxillofac Trauma Reconstr 2012; 5:213-22. [PMID: 24294404 DOI: 10.1055/s-0032-1322535] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2012] [Accepted: 02/12/2012] [Indexed: 10/27/2022] Open
Abstract
Background The etiology, demographics, fracture site in facial injury patients have been reported worldwide. However, few studies have attempted to identify changes in maxillofacial fractures over time periods and between countries. The statistics are vastly different due to variations in social, environmental, and cultural factors. Methods Data were collected from departmental records between 1996 and 2006 for patients treated at Christchurch Hospital for facial fractures. Variables examined included incidence, demographics, site of fracture, and treatment methods. Results A total of 2563 patients presented during the study period, 1158 patients in the first half and 1404 patients in the second half. Male-to-female ratio was 4:1 in both periods and males in 16- to 30-year group accounted for about half of all patients. Interpersonal violence was the most common cause of injuries, and there was a decrease in injuries caused by motor vehicle accidents. Approximately half of all patients required hospitalization and surgery, and the most common method of treatment was open reduction and internal fixation. Conclusion Maxillofacial fracture is a common injury in young males following interpersonal violence in New Zealand. Studies in other countries and over different time periods yield interesting differences in the etiology, demographics, and fractures patterns. These are due to environmental, societal, cultural, and legislative differences.
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Affiliation(s)
- Kai Lee
- Department of Oral & Maxillofacial Surgery, Geelong Hospital, Geelong, Victoria, Australia
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Kruger E, Heitz-Mayfield LJA, Perera I, Tennant M. Geographic modelling of jaw fracture rates in Australia: a methodological model for healthcare planning. Dent Traumatol 2010; 26:217-22. [PMID: 20572838 DOI: 10.1111/j.1600-9657.2010.00896.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIM While Australians are one of the healthiest populations in the world, inequalities in access to health care and health outcomes exist for Indigenous Australians and Australians living in rural or urban areas of the country. Hence, the purpose of this study was to develop an innovative methodological approach for predicting the incidence rates of jaw fractures and estimating the demand for oral health services within Australia. MATERIALS AND METHODS Population data were obtained from the Australian Bureau of Statistics and was divided across Australia by statistical local area and related to a validated remoteness index. Every episode of discharge from all hospitals in Western Australia for the financial years 1999/2000 to 2004/2005 indicating a jaw fracture as the principle oral condition, as classified by the International Classification of Disease (ICD-10AM), was the inclusion criterion for the study. Hospitalization data were obtained from the Western Australian Hospital Morbidity Data System. RESULTS The model estimated almost 10 times higher jaw fracture rates for Indigenous populations than their non-Indigenous counterparts. Moreover, incidence of jaw fractures was higher among Indigenous people living in rural and remote areas compared with their urban and semi-urban counterparts. In contrast, in the non-Indigenous population, higher rates of jaw fractures were estimated for urban and semi-urban inhabitants compared with their rural and remote counterparts. CONCLUSIONS This geographic modelling technique could be improved by methodological refinements and further research. It will be useful in developing strategies for health management and reducing the burden of jaw fractures and the cost of treatment within Australia. This model will also have direct implications for strategic planning for prevention and management policies in Australia aimed at reducing the inequalities gap both in terms of geography as well as Aboriginality.
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Affiliation(s)
- Estie Kruger
- The Centre for Rural and Remote Oral Health, The University of Western Australia, Crawley, WA, Australia.
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Lee KH. Interpersonal violence and facial fractures. J Oral Maxillofac Surg 2009; 67:1878-83. [PMID: 19686924 DOI: 10.1016/j.joms.2009.04.117] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Accepted: 04/23/2009] [Indexed: 11/27/2022]
Abstract
PURPOSE Interpersonal violence is a major health hazard that contributes to the high volume of trauma seen in the emergency department. It is also one of the principal causes of maxillofacial fractures. MATERIALS AND METHODS The present study was a retrospective analysis of patients referred to, and treated at, the Oral and Maxillofacial Surgery Unit at Christchurch Hospital during an 11-year period (1996 to 2006). The variables examined included patient demographics, fracture types, mode of injury, and treatment delivered. RESULTS An increase was found in the number of fractures due to interpersonal violence in the second half of the study, although the proportion remained the same. The age of the patients ranged from 9 to 89 years (mean 28). The male-to-female ratio was 9:1. Of the patients, 87% had alcohol involvement. The mandible was the most common site of fracture, followed by the zygoma. Other midface fractures, including Le Fort fractures, were less frequently observed. Of the patients, 59% were hospitalized and 56% required surgery, with internal fixation necessary in 41% of patients. CONCLUSION An increase occurred in the number of facial fractures associated with interpersonal violence during the study period. Young male adults were the most affected demographic group, with alcohol a main contributing factor. Violence-related facial fracture is a health hazard that deserves more public awareness and implementation of preventive programs.
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Affiliation(s)
- Kai H Lee
- Maxillofacial and Dental Department, Waikato Hospital, Hamilton, New Zealand.
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Jetté N, Quan H, Faris P, Dean S, Li B, Fong A, Wiebe S. Health resource use in epilepsy: Significant disparities by age, gender, and aboriginal status. Epilepsia 2008; 49:586-93. [DOI: 10.1111/j.1528-1167.2007.01466.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jamieson LM, Roberts-Thomson KF. Hospitalized head injuries among older people in Australia, 1998/1999 to 2004/2005. Inj Prev 2007; 13:243-7. [PMID: 17686934 PMCID: PMC2598353 DOI: 10.1136/ip.2007.015354] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2007] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To explore rates of hospitalized head injury among older Australians by a range of risk indicators. DESIGN Head injury data for 60+-year-olds were obtained from the Australian Institute of Health and Welfare Hospital Morbidity Database from 1998/1999 to 2004/2005. Poisson regression modeling was used to examine head injury rates in relation to age, sex, Indigenous status, location, and injury type. RESULTS Rates of hospitalized head injury among the older population increased 1.4-fold between 1998/1999 (582.8 per 100,000) and 2004/2005 (844.3 per 100,000) (p<0.001). Those aged 85+ years had 10.8 times the rate of their 60-64-year-old counterparts (95% CI 10.6 to 11.0) after adjustment for other covariates. Men had 1.1 times the rate of women (95% CI 1.1 to 1.2), and those living in rural/remote areas had 3.1 times the rate of their metropolitan-dwelling counterparts (95% CI 3.0 to 3.1). Those identifying themselves as Indigenous had 1.7 times the rate of non-Indigenous persons (95% CI 1.6 to 1.8). The most prevalent injuries were open wounds of the head (38.0%), followed by superficial injuries (24.7%) and intracranial trauma (18.3%). Falls accounted for 81.4% of all head injury admissions. CONCLUSIONS The oldest old were disproportionately represented among those sustaining hospitalized head injuries, along with men, those living in rural/remote areas, and Indigenous persons. Given the increasing proportion of older people in Western societies and the costs of treating hospitalized head injuries, the ability to reduce risk of such trauma in this age group is of critical public health importance.
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Affiliation(s)
- Lisa M Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide, South Australia 5005, Australia.
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