Department of Primary and Long-Term Care, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
Department of General Practice, University of Melbourne, Parkville, Victoria, Australia.
PLoS One. 2024 Jul 24;19(7):e0306739. doi: 10.1371/journal.pone.0306739. eCollection 2024.
Acute gastroenteritis is a highly contagious disease demanding effective public health and clinical care systems for prevention and early intervention to avoid outbreaks and symptom deterioration. The Netherlands and Australia are both top-performing, high-income countries where general practitioners (GPs) act as healthcare gatekeepers. However, there is a lower annual incidence and per-case costs for childhood gastroenteritis in Australia. Understanding the systems and policies in different countries can lead to improvements in processes and care. Therefore, we aimed to compare public health systems and clinical care for children with acute gastroenteritis in both countries.
A cross-country expert study was conducted for the Netherlands and Australia. Using the Health System Performance Assessment framework and discussions within the research group, two questionnaires (public health and clinical care) were developed. Questionnaires were delivered to local experts in the Netherlands and the state of Victoria, Australia. Data synthesis employed a narrative approach with constant comparison.
In Australia, rotavirus vaccination is implemented in a national program with immunisation requirements and legislation for prevention, which is not the case in the Netherlands. Access to care differs, as Dutch children must visit their regular GP before the hospital, while in Australia, children have multiple options and can go directly to hospital. Funding varies, with the Netherlands providing fully funded healthcare for children, whilst in Australia it depends on which GP (co-payment required or not) and hospital (public or private) they visit. Additionally, the guideline-recommended dosage of the antiemetic ondansetron is lower in the Netherlands.
Healthcare approaches for managing childhood gastroenteritis differ between the Netherlands and Australia. The lower annual incidence and per-case costs for childhood gastroenteritis in Australia cannot solely be explained by the differences in healthcare system functions. Nevertheless, Australia's robust public health system, characterized by legislation for vaccinations and quarantine, and the Netherland's well-established clinical care system, featuring fully funded continuity of care and lower ondansetron dosages, offer opportunities for enhancing healthcare in both countries.
急性肠胃炎是一种传染性很强的疾病，需要有有效的公共卫生和临床护理系统来进行预防和早期干预，以避免疫情爆发和症状恶化。荷兰和澳大利亚都是表现出色的高收入国家，那里的全科医生（GP）充当着医疗保健的把关人。然而，澳大利亚儿童肠胃炎的年发病率和人均治疗费用较低。了解不同国家的制度和政策可以促进流程和护理的改进。因此，我们旨在比较两国儿童急性肠胃炎的公共卫生系统和临床护理。
对荷兰和澳大利亚进行了跨国专家研究。使用卫生系统绩效评估框架和研究小组内部的讨论，开发了两份问卷（公共卫生和临床护理）。问卷分发给荷兰当地专家和澳大利亚维多利亚州的专家。采用叙述性方法进行数据综合，并进行恒定性比较。
在澳大利亚，轮状病毒疫苗接种是在国家计划中实施的，有免疫要求和立法预防，而在荷兰则没有。获得医疗保健的途径也有所不同，荷兰的儿童必须先去看他们的常规全科医生，然后才能去医院，而在澳大利亚，儿童有多种选择，可以直接去医院。资金来源也不同，荷兰为儿童提供全额医疗保健，而在澳大利亚，这取决于他们去看哪个全科医生（是否需要共同支付）和去看哪家医院（公立或私立）。此外，荷兰推荐的止吐药昂丹司琼的剂量也较低。
荷兰和澳大利亚在管理儿童肠胃炎方面的医疗保健方法有所不同。澳大利亚儿童肠胃炎的年发病率和人均治疗费用较低，不能仅仅用医疗保健系统功能的差异来解释。然而，澳大利亚强大的公共卫生系统，以疫苗接种和检疫立法为特色，以及荷兰成熟的临床护理系统，以全额资助的连续性护理和较低的昂丹司琼剂量为特色，为两国改善医疗保健提供了机会。
