Breathlessness hits employment and hip pocket
Worsening persisting breathlessness is associated with lower paid workforce participation as patients with diseases such as COPD modify their lifestyle to minimise exertion.
The South Australian Health Omnibus Survey of almost 9,000 people aged 20-65 years found people with the most severe breathlessness were far less likely to be in full- or part-time work (odds ratio 0.14).
Disparities in full- or part-time workforce participation worsened in the cohort with the most severe persisting breathlessness, among those aged 45–65 (OR 0.10) and among males (OR 0.05).
“Annual income foregone by people with persisting breathlessness for full-time work was AU$9.1 billion and for part-time work, AU$1.6 b totalling AU$10.7b,” the study said.
“This study suggests that clinicians should ask routinely about work history, work foregone and limitations that impair working abilities in order to align as closely as possible with each person’s occupational goals.”
Read more in BMC Pulmonary Medicine
Focus on optimising COPD ahead of lung cancer surgery
A diagnosis of COPD is associated with an increased risk of complications following lung cancer resection, according to respiratory researchers at Austin Health, Melbourne.
Their study of 1,013 patients undergoing curative intent surgery found COPD was associated with a higher frequency of both post-operative pulmonary complications (65% vs 35%, AOR 1.76, 95% CI 1.02–2.41, p<0.01) and overall complications (60% vs 40%, AOR 1.53, 95% CI 1.17–2.01, p<0.01).
“Of the individual pulmonary complications, sputum retention (77% vs 23%, AOR 3.93, 95% CI 1.49–10.4), respiratory failure (78% vs 22%, AOR 3.21, 95% CI 1.13–9.12) and air leak (66% vs 34%, AOR 2.85, 95% CI 1.12–7.20) were more common in those with COPD,” the study authors said.
The study also found an increase in post-operative pulmonary complications in current smokers compared to never smokers however no significant difference in ex-smokers compared to current or never smokers.
The findings suggest that referral of patients to respiratory physicians for pre-operative maximisation of COPD therapy was more important than efforts towards smoking cessation in the preoperative period, they concluded.
“Future studies should assist in determining the most appropriate peri-operative program of smoking cessation, “prehabilitation” and pharmacotherapy to maximise outcomes in patients undergoing lung cancer surgery,” they suggested.
Read more in PLOS ONE
Doctors win, nurses lose under Stage 3 tax changes
High income medical specialists such as surgeons will get a $9000 windfall from the government’s planned stage-three tax cuts, whereas other healthcare workers such as nurses will be worse off, a new analysis suggests.
The stage 3 tax cuts, worth $15.7 billion per year will come into effect in July 2024, and will increase the income at which the top tax bracket begins from $180,001 to $200,000.
According to the Australia Institute think tank, this will mean that medical practitioners such as surgeons and anaesthetists with average incomes over $200,000 will get the maximum tax cut worth $9,075 per year.
In contrast, healthcare occupations that currently qualify for the Low- and Middle-Income Tax Offset (LMITO), worth $7 billion per year, will be net losers when it is discontinued at the of end this year, the institute says.
It cites the example of a midwife with a salary of $78,784 who will gain $845 from the stage 3 tax cuts but lose $1,080 when the LMITO is removed.
Workers on incomes below $50,000 such as aged care staff, secretaries and receptionists will be worst off, receiving no tax cuts and losing up to $832 from the LMITO, the institute predicts.
Treasurer Josh Frydenberg confirmed in the 2022 Budget that the government has chosen to phase out the LMITO, but it will increase the payment for everyone, by $420, for its last year of operation.