Rebecca Mitchell

• University of Ulster

Background Virtual care is increasingly being used to deliver outpatient cancer services, yet people from culturally and linguistically diverse (CALD) backgrounds can experience inequities in accessing these services. A range of complex and context‐specific factors impact the effectiveness of virtual care and equity in its use and outcomes. This st...

General practice-based care for Australian children is facing low levels of clinical guideline adherence particularly in three key areas: asthma, type 1 diabetes and antibiotic use. We offer an implementation science-informed position paper, providing a broad overview of how we aim to address this issue. This is the co-designed National Paediatric...

Objectives Emergency Departments (ED) are increasingly caring for patients with acute, chronic and terminal conditions requiring End of Life Care (EOLC). There is no published and validated tool available to evaluate EOLC delivery of patients dying in the ED. This study describes the face and content validity testing process to develop, refine and...

Objective This study aimed to examine group-based trajectories of hospital service use by people with chronic kidney disease (CKD) in the last 12 months of life. Methods A retrospective cohort study was conducted using hospital admission and mortality data in New South Wales, Australia. Individuals aged ≥18 years who were hospitalised during 2014–2...

Objectives To examine factors associated with indicators of potentially burdensome care provided in hospital, and use of hospital services in the last 12 months of life for people who had a death from cancer. ApproachA population-based retrospective cohort study of people aged ≥20 years with a cancer-related cause of death during 2014-2019 in New S...

Key predictors of three trajectory group membership of potentially preventable hospitalisations were age, the number of comorbidities, the presence of chronic obstructive pulmonary disease and congestive heart failure, and frailty risk at the occurrence of hip fracture. These predictors of their trajectory group could be used in targeting preventio...

Background Integration of virtual and in person care across health systems is a priority to create and sustain healthy nations by improving access to services, along with healthcare experiences, efficiency, and outcomes. Our collaborative project between health services, agencies, consumers, and clinicians across Australia seeks to provide the requ...

Purpose To determine the relationship between three postoperative physiotherapy activities (time to first postoperative walk, activity on the day after surgery, and physiotherapy frequency), and the outcomes of hospital length of stay (LOS) and discharge destination after hip fracture. Methods A cohort study was conducted on 437 hip fracture surge...

Background Many individuals with chronic obstructive pulmonary disease (COPD) experience frequent hospitalization and readmissions, which is burdensome on the health system. This study aims to investigate factors associated with unplanned readmissions and mortality following a COPD-related hospitalization over a 12-month period in Australia, focusi...

Objectives To examine patient, surgical and hospital factors associated with Day‐1 postoperative mobility after hip fracture surgery in older adults. Methods A cohort study using Australia and New Zealand Hip Fracture Registry was conducted. Participants were aged older than 50 years and underwent hip fracture surgery between 1 January 2020 and 31...

Objective Clinician’s experiences of providing care are identified as a key outcome associated with value-based healthcare (VBHC). In contrast to patient-reported experience measures, measurement tools to capture clinician’s experiences in relation to VBHC initiatives have received limited attention to date. Progressing from an initial 18-item clin...

Objective The aim of this study was to examine temporal trends (2016–2020) in hip fracture care in Australian and New Zealand (ANZ) hospitals that started providing patient‐level data to the ANZ Hip Fracture Registry (ANZHFR) on/before 1 January 2016 (early contributors). Methods Retrospective cohort study of early contributor hospitals ( n = 24)...

Aims Reducing preventable hospitalization for congestive heart failure (CHF) patients is a challenge for health systems worldwide. CHF patients who also have a recent or ongoing mental disorder may have worse health outcomes compared with CHF patients with no mental disorders. This study examined the impact of mental disorders on 28 day unplanned r...

Background: Perioperative interventions could enhance early mobilisation and physical function after hip fracture surgery. Objective: Determine the effectiveness of perioperative interventions on early mobilisation and physical function after hip fracture. Methods: Ovid MEDLINE, CINAHL, Embase, Scopus and Web of Science were searched from Janu...

Objective This study aimed to compare academic performance and high school completion of young people hospitalised for a burn compared with young people not hospitalised for an injury. Design A retrospective population-based matched case-comparison cohort study. Participants Young people aged ≤18 years hospitalised for a burn during 2005–2018 in...

Cancer is a leading cause of global morbidity and mortality, accounting for 250 Disability-Adjusted Life Years and 10 million deaths in 2019. Minimising unwarranted variation and ensuring appropriate cost-effective treatment across primary and tertiary care to improve health outcomes is a key health priority. There are few studies that have used li...

Background Often considered an “invisible disability”, hearing loss is one of the most prevalent chronic diseases and the third leading cause for years lived with disability worldwide. Hearing loss has substantial impacts on communication, psychological wellbeing, social connectedness, cognition, quality of life, and economic independence. The Hear...

Objectives: Hospitalisation rates for injury, including at playgrounds, have not changed in the past decade. There are nine Australian Standards specific to playgrounds. The impact (if any) of these standards on playground injury resulting in hospitalisation is unknown. Methods: Retrospective data for patients under 18 years presenting to emerge...

Objective To synthesise the best available epidemiological data on competition and training injuries in amateur boxing. Design Systematic review and meta-analysis. Pooled estimates of competition injury incidence rates per 1000 athlete-exposures (IIRAE) and per 1000 min of exposure (IIRME), and training injury incidence rates per 1000 h of exposur...

Background This study identifies the determinants of unplanned readmission after self-inflicted and non-self-inflicted major injury to inform potential readmission screening. Method A retrospective cohort study of 11,269 individuals aged ≥15 years hospitalised for a major injury during 2013–2017 in New South Wales, Australia was conducted using li...

Introduction To address the challenges of rapidly changing healthcare, governments and health services are increasingly emphasising healthcare delivery models that are flexible, person centred, cost-effective and integrate hospital services more closely with primary healthcare and social services. In addition, such models increasingly embed consume...

Objectives To compare scholastic performance and high school completion of young people hospitalised with a mental disorder compared to young people not hospitalised for a mental disorder by sex. ApproachA population-based matched case-comparison cohort study of young people aged ≤18 years hospitalised for a mental disorder during 2005-2018 in New...

Abstract Background Commercial delivery cyclists represent a uniquely vulnerable and poorly understood road user. The primary aim of this study was to pilot whether cycling injuries could be categorised as either commercial or non-commercial using documentation entered into routine hospital medical records, in order to determine the feasibility of...

Background The effect of potential protective factors and stressors faced by carers on their well-being and ability to provide care for children in out-of-home-care (OOHC) needs examination. Objective To explore the impact of child and placement characteristics, carer resources, perceptions and stressors on caregiving and well-being; and identify...

Introduction : Blunt chest injury in older adults, aged 65 years and older, leads to significant morbidity and mortality. The aim of this study was to evaluate the effect of a multidisciplinary chest injury care bundle (ChIP) on patient and health service outcomes in older adults with blunt chest injury. Methods : ChIP comprised multidimensional i...

Objective To quantify and describe boxing-related deaths in Australia. Design Retrospective analysis of news media reports of all boxing-related fatalities in Australia during 1832 to 2020. Methods Australia and New Zealand Newsstream, Factiva, Informit, Google News, Fairfax Media Archive, and Trove were searched from inception to December 31, 20...

Hip fracture trajectories have not been examined for older adults in aged care or living in the community. Trajectories of health care use were defined by distinct predictive factors. These results can inform the development of targeted strategies to reduce health service use following hip fracture.Objective To examine hospital service use trajecto...

Background Hip fracture is a major public health concern for older adults, requiring surgical treatment for patients presenting at hospitals across Australia. Although guidelines have been developed to drive appropriate care of hip fracture patients in hospitals, data on health outcomes suggest these are not well-followed. Objective This study aim...

Background Blunt chest injury leads to significant morbidity and mortality. The aim of this study was to evaluate the effect of a multidisciplinary chest injury care bundle (ChIP) on patient and health service outcomes. ChIP provides guidance in three key pillars of care for blunt chest injury—respiratory support, analgesia and complication prevent...

Background: Commercial delivery cyclists represent a uniquely vulnerable and poorly understood road user. The aim of this study was to determine whether cyclists could be categorised as commercial or non-commercial from routine medical records and which key demographic, incident and injury characteristics could be identified and attributed to each...

Background Spinal cord injury (SCI) is associated with autonomic imbalance and significant secondary conditions, including cardiac and brain dysfunction that adversely impact health and wellbeing. This study will investigate the effectiveness (intention-to-treat) of a neuro-cardiac self-regulation therapy to improve autonomic and neural/brain activ...

Background Ineffective intervention for patients with blunt chest wall injury results in high rates of morbidity and mortality. To address this, a blunt chest injury care bundle protocol (ChIP) was developed, and a multifaceted plan was implemented using the Behaviour Change Wheel. Objective The purpose of this study was to evaluate the reach, fid...

Background Provision of quality care can help to reduce adverse health outcomes following hip fracture. While surgical management by either a consultant or junior surgeon has shown inconclusive differences in patient outcomes, consultant presence is often recommended, yet little is known about the factors that influence whether a consultant surgeon...

Hip fracture is a common injury in older adults that causes significant morbidity and mortality. Older adults who sustain a hip fracture are at a higher risk of institutionalisation, reduced mobility and subsequent falls and, consequently, have increased rates of morbidity and mortality. Quality improvement strategies that address gaps in hip fract...

Objective To compare demographics, treatment and health outcomes for individuals hospitalised with a hip fracture and examine predictors of postacute discharge destination. Methods A retrospective analysis of data from the Australian and New Zealand Hip Fracture Registry of individuals aged ≥50 years hospitalised with a hip fracture from 2015 to 2...

Introduction Fall injuries are one of the leading causes of hospitalisation for adults aged ≥65 years. Distinguishing key characteristics of older adults who are either living in aged care or in the community who have multiple hospital readmissions after a fall injury may inform targeted approaches to the prevention of hospital readmissions. Objec...

Introduction Value-based healthcare delivery models have emerged to address the unprecedented pressure on long-term health system performance and sustainability and to respond to the changing needs and expectations of patients. Implementing and scaling the benefits from these care delivery models to achieve large-system transformation are challengi...

Objectives To examine the role of frailty in risk of re‐hospitalisation and mortality for aged care residents following a fall injury hospitalisation. Methods Retrospective analysis of linked hospitalisation and aged care data of adults aged ≥65 years residing in aged care. A semi‐competing risk analysis examined risk of hospital readmission. Res...

Injury is the leading cause of hospitalisation of children in Australia and can cause ongoing physical and psychological morbidity. Hospital staff provide excellent physical care to injured children, but there is a need for models of care that improve psychosocial care. To address this gap, a trauma support social work service was trialled at an Au...

Background Fractures represent the most common injury-related hospitalisations of children. Injured children often miss days from school, may experience ongoing pain and disability, as well as a reduced quality of life. To monitor temporal trends, and to enable targeted strategies to prevent fracture-related hospitalisation, an examination of the c...

Background Adult injury severity metrics are often applied to paediatric populations despite differences in anatomy, physiological and mortality risk. Measures to assess paediatric mortality have not been conducted on a population-wide basis. Purpose To determine the predictive ability of the International Classification of Injury Severity Score (...

Record linkage of health data has been beneficial to inform the design, delivery and evaluation of health care practices, and to improve the quality of clinical care and patient outcomes. We discuss some of the key strengths and limitations of using record linkage as the basis of an evidentiary approach for improved health services, and for conduct...

Objectives: This study aimed to examine five-year trajectories of hospital service utilization among individuals living with epilepsy in New South Wales (NSW), Australia, and to identify factors predictive of trajectory group membership. Methods: This study used group-based trajectory modeling of hospital admissions over a five-year period for i...

Introduction: To provide effective care and promote wellbeing and positive outcomes for parents and families following paediatric critical injury there is a need to understand parent experiences and psychosocial support needs. This study explores parent experiences two years following their child's critical injury. Methods: This multi-centre stu...

Background context: Despite its potential to cause serious and life-long disability or death, population-based data on traumatic spinal injury in pediatric populations is scarce. Purpose: To quantify and describe the incidence and cost of hospitalizations for traumatic spinal injury among Australian children, and to examine the trend over a ten-...

Introduction Children who have sustained a serious injury or who have a chronic health condition, such as diabetes or epilepsy, may have their school performance adversely impacted by the condition, treatment of the condition and/or time away from school. Examining the potential adverse impact requires the identification of children most likely to...

Introduction The aged population is increasing rapidly across the world and this is expected to continue. People living in residential aged care facilities (RACFs) represent amongst the sickest and frailest cohort of the aged population, with a high prevalence of chronic conditions and complex comorbidities. Given the vulnerability of RACF resident...

Background Individuals with epilepsy who cannot be adequately controlled with anti-epileptic drugs, refractory epilepsy, may be suitable for surgical treatment following detailed assessment. This is a complex process and there are concerns over delays in referring refractory epilepsy patients for surgery and subsequent treatment. The aim of this st...

Objectives: Adult patients with refractory epilepsy who are potential candidates for resective surgery undergo a period of presurgical investigation in tertiary epilepsy centers (TECs), where they engage extensively with healthcare professionals and receive a range of treatment-related information. This qualitative study aimed to examine the exper...

Background As many as half of all patients with major traumatic injuries do not receive the recommended care, with variance in preventable mortality reported across the globe. This variance highlights the need for a comprehensive process for monitoring and reviewing patient care, central to which is a consistent peer-review process that includes tr...

Aims: To describe the epidemiological profile and cost of hospitalised injuries caused by playground equipment falls of children aged 0-14 years, in New South Wales, Australia. Methods: Linked New South Wales hospitalisation data from 1 January 2010 to 30 June 2014 were used to describe the incidence of hospitalisation for playground falls, the...

Injury is one of the most common reasons why a child is hospitalised. Information gained from injury surveillance activities provides an estimate of the injury burden, describes injury event circumstances, can be used to monitor injury trends over time, and is used to design and evaluate injury prevention activities. This perspective article provid...

Rapport and colleagues highlight the challenges involved in enabling viable transitional care services in a federated landscape, where different care providers are responsible for different aspects of patient care and where care organisations may need to work together to ensure smooth patient throughput, especially when patients are transitioning t...

Background In countries like the United States and the United Kingdom, systematic variation in the classification of intent in pharmaceutical poisoning deaths have been identified between jurisdictions. This study aimed to explore whether the coronial determination of intent (unintentional, intentional, undetermined) for pharmaceutical-related pois...

Introduction One-third of patients with refractory epilepsy may be candidates for resective surgery, which can lead to positive clinical outcomes if efficiently managed. In Australia, there is currently between a 6-month and 2-year delay for patients who are candidates for respective epilepsy surgery from the point of referral for surgical assessme...

Background: Research has associated some chronic conditions with self-harm and suicide. Quantifying such a relationship in mortality data relies on accurate death records and adequate techniques for identifying these conditions. Objective: This study aimed to quantify the impact of identification methods for co-morbid conditions on suicides in i...

Eligibility criteria: Primary research articles written in English that focused on children hospitalised for an acute, unexpected, sudden critical illness, such as that requiring an intensive care admission; and addressed the implementation of a model of care in a paediatric acute care hospital setting. Sample: Thirteen studies met the inclusion...