A full report on the workshop has been published by the Office of the Assistant Secretary for Health and will be widely distributed through State maternal and child health and crippled children's services directors as well as through voluntary agencies.

The term 'subacute' is used in Australia to describe health care in which the goal--a change in functional status or improvement in quality of life--is a better predictor of the need for, and the cost of, care than the patient's underlying diagnosis. The results suggest that phase of care (stage of illness) is the best predictor of the cost of Australian palliative care. Other predictors of cost are functional status and age. In the ambulatory setting, symptom severity and the model of palliative care are also predictive of cost. These variables are used in the AN-SNAP Version 1 classification to create 33 palliative care classes. The classification has clinical meaning but the overall statistical performance is only moderate. The structure of the classification allows for it to be improved over time as models of palliative care service delivery develop.

Implementation of the resultant AN-SNAP classification has been proceeding since 1998 in some Australian jurisdictions. The development and implementation of a classification such as AN-SNAP provides the possibility of having a consistent approach to collecting palliative care data in Australia as well as a growing body of experience on how to progressively improve the classification over time.

This study characterized the costs and benefits associated with adopting ISO 14001 environmental management system (EMS) standard, based on a survey of ISO 14001-registered organizations in Canada. Decision makers are contemplating whether it is necessary to register to one or more of the ISO and other international standards and, if so, which ones. Furthermore, an organization that has registered separate departments to different standards and contemplates integrating such standards across the different units may be interested in attributes of particular units that will facilitate integration. Discriminant analysis was conducted to characterize the factors that distinguish between organizations that adopted ISO 14001 alone (single standard), versus those that registered to ISO 14001 along with other quality, health, and safety standards (i.e., multiple standards). The most important factor that motivated adoption to ISO 14001 was to establish a positive environmental profile, thereby promoting goodwill and integrity. Internal factors tended to dominate the motivations for adopting ISO 14001, supporting the hypothesis that external benefits may not be fully realized due to market and policy failure. Internal costs associated with registration depended on the size of the organization and ranged, on average, from CND$17,000 (for organizations with less than 100 employees), to CND$42,000 (for organizations with more than 500 employees). External costs depended more on the type (i.e., sector of the Canadian economy) than on size of the organization. The most important variable that distinguished between Canadian organizations that adopted ISO 14001 alone versus those that adopted ISO 14001 and other standards was whether the organization had an international orientation, that is, those with more than 50% of services or exports to other countries. [EconLit citations: L150, L200, Q290]. © 2003 Wiley Periodicals, Inc. Agribusiness 19: 439-457, 2003.

This paper presents the results of a recent review of the Australian National Sub-acute and Nonacute Patient (AN-SNAP) classification system. The AN-SNAP system was developed by the Centre for Health Service Development, University of Wollongong in 1997. The review was conducted between August 2005 and September 2006. Four clinical sub-committees comprising more than 50 clinicians from sub-acute services across New South Wales as well as representatives from Queensland and the Australian Capital Territory were established to develop a set of proposals to be considered for incorporation into