Australian atlas of healthcare variation; dangerous sunburn; targetted radiation therapy; antibody testing for vaccine efficacy
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What is the focus of today’s Health Report episode?
This is an ABC podcast.
Hello and welcome to this week's Health Report Podcast with me, Norman Swan
and me, Tegan Tyla.
On today's show we look at a more targeted way of using radiotherapy for cancer that's spread to other parts of the body.
Sunburns so bad they need specialist burns units. Who's most at risk?
A relatively quick and cheap way to assess the next generation of COVID vaccines. And a topic we've covered several times on the Health Report unexplained variations in care. Why does the rate of certain operations or treatments vary across Australia, even though the people experiencing the medical pro medical problems are the same? Tegan?
Yes, a recent report that's looked at lots of different facets of Australian healthcare has found that a large proportion of births that happen in the weeks before baby's due dates aren't happening because of medical reasons. Sometimes babies do need to be born early because either mother or baby's health is at risk, or sometimes they just decide to come early and mum goes into labor. But in this instance, we're talking about cesareans and inductions that happen seemingly without medical or obstetric reasons. And experts say it's an issue because being born early increases babies' risks of breathing and feeding problems at birth and learning difficulties when they start school. The report is the fourth Australian Atlas of Healthcare variation and one of its authors joins us.
Welcome Anne Duggan. Thank you. So this report w the first chapter of this report is focusing on births that happen from around the thirty-seventh week of pregnancy onwards and indicating that it's a problem if babies are starting to be born this early without good uh medical reasons. What is happening in these last two or three weeks of pregnancy that has experts concerned?
Well, we bec we've have become much more aware of the importance of the baby's brain and their lungs and their whole body maturing. And when babies are born too early, and some babies just spontaneously born early, but when they're they're they're electively born early, there's a risk that could be prevented if they were allowed to develop. So if they're born early, they're more likely to have jaundice, they're more likely to have low blood sugars, they're more likely to have immature lungs and ne uh need to go to a neonatal intensive care. They're more likely to have feeding problems. But that's not the only problem. As they grow up, there's evidence that if kids that are born by early cesarean section are more likely to be hospitalised with infections.
And when they go to school, they're more likely to have numeracy problems, literacy problems, and they're more likely to have attention deficit hyperactive disorder. So it's suggesting that the baby really does need to to develop its brain and have time to develop its other organs and that's the the benefit of a allowing it to get to full maturity. Now, as you said, there are some babies that need to be born because they've got problems or their mother's got problems. But what we looked at was the early elective cesarean and the the induction of labour where we couldn't there was no recorded medical or obstetric reason for it.
Right. So I mean thirty seven weeks of pregnancy used to be considered full term. What's changed? Yes.
Uh pre two thousand and ten there was the view that term was somewhere between thirty seven and forty weeks. But it that's very much changed and the definition now is that thirty seven and thirty weight uh thirty eight weeks is early term. Full term is thirty nine and forty weeks. And if you look across the world there's guidelines in the UK and America. Uh and here in Australia, the Royal Australian College of Uh Obstetricians and Gynecologists are saying that they sh babies should be born at approximately thirty nine weeks because the evidence has evolved and it's now quite much clearer that babies need that extra time.
I've had two babies since twenty ten and I don't remember sort of being told this by my healthcare providers.
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