ORCID Profile
0000-0002-1658-494X
Current Organisation
Macquarie University
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Applied Economics | Health Economics | Health Promotion | Social Policy | Policy and Administration | Welfare Economics | Health Policy | Preventive Medicine | Health Economics | Welfare Economics |
ANZSRC Socio-Economic Objective (SEO)
Ability and disability | Income policy | Human Capital Issues | The distribution of wealth | Employment | Preventive medicine | Health policy economic outcomes | Health Policy Economic Outcomes | Health Policy Evaluation
Related Links
Publications
Is there a mismatch between who gets iron supplementation and who needs it? A cross-sectional study of iron supplements, iron deficiency anaemia and socio-economic status in Australia
Publisher: Cambridge University Press (CUP)
Date: 21-12-2016
DOI: 10.1017/S0007114515004912
Abstract: Fe deficiency anaemia (IDA) is more prevalent in lower socio-economic groups however, little is known about who actually receives Fe supplements. This paper aims to determine whether the groups most likely to have IDA are the most likely to be taking Fe supplements. Logistic regression analysis was conducted using the cross-sectional, nationally representative National Nutrition and Physical Activity Survey and National Health Measures Survey. After adjusting for other factors, those whose main language spoken at home was not English had twice the odds of having IDA compared with those whose main language spoken at home was English (95 % CI 1·00, 4·32). Those who were not in the labour force also had twice the odds of having IDA as those who were employed (95 % CI 1·16, 3·41). Those in income quintile 1 had 3·7 times the odds of having IDA compared with those in income quintile 5 (95 % CI 1·42, 9·63). Those whose main language spoken at home was not English were significantly less likely to take Fe supplements ( P =0·002) than those whose main language spoken at home was English. There was no significant difference in the likelihood of taking Fe supplements between those who were not in the labour force and those who were employed ( P =0·618) between those who were in income quintile 1 and in higher income quintiles and between males and females ( P =0·854), after adjusting for other factors. There is a mismatch between those who are most in need of Fe supplements and those who currently receive them.
Financial toxicity of childhood cancer and changes to parents’ employment after treatment completion
Publisher: Wiley
Date: 25-04-2020
DOI: 10.1002/PBC.28345
Abstract: Childhood cancer can have short‐ and long‐term impacts on parents’ finances and employment. It is important to understand how families adjust to the financial and employment changes caused by childhood cancer, the ongoing impacts after treatment completion, and which families need more targeted support. Qualitative research is necessary to facilitate an in‐depth understanding of the employment and financial impacts on families and to capture parents’ complex and nuanced experiences and perspectives. We interviewed 56 parents of childhood cancer survivors ( M = 2.13 years after treatment completion 89% mothers) using the vocational and financial impact section of the Psychosocial Adjustment to Illness Scale–Carer Interview Form. We analyzed interviews using content analysis. Parents reported multiple sources of financial toxicity including travel to and from the hospital and needing to reduce their working hours during their child's cancer treatment. Workplace flexibility was an important factor to protect against unwanted vocational changes. After treatment completion, families living in low socioeconomic areas commonly reported ongoing financial difficulties. Mothers, particularly those who were on maternity leave when their child was diagnosed with cancer, reported ongoing employment impacts including unemployment. Clinical staff including social workers could more consistently assess families’ financial distress and refer to professional services who can offer guidance for financial decision‐making as standard care. Flexible workplace agreements appear important for parents of children with cancer. Our findings can assist organizations to understand that cancer‐related disruptions are likely to continue after treatment completion, and therefore should offer benefits to parents where possible.
Rising cost of anticancer drugs in Australia
Publisher: Wiley
Date: 05-2014
DOI: 10.1111/IMJ.12399
Abstract: Anticancer drugs are often expensive and are contributing to the growing cost of cancer care. Concerns have been raised about the effect rising costs may have on availability of new anticancer drugs. This study aims to determine the recent changes in the costs of anticancer drugs in Australia. Publicly available expenditure and prices paid by the Australian Pharmaceutical Benefits Scheme (PBS) for anticancer drugs from 2000 to 2012 were reviewed. The measures used to determine changes in cost were total PBS expenditure and average price paid by the PBS per prescription for anticancer drugs and for all PBS listed drugs. An estimated monthly price paid for newly listed anticancer drugs was also calculated. Annual PBS expenditure on anticancer drugs rose from A$65 million in 1999-2000 to A$466 million in 2011-2012 an average increase of 19% per annum. The average price paid by the PBS per anticancer drug prescription, adjusted for inflation, increased 133% from A$337 to A$786. The real average annual increase in the price per anticancer drug prescription was more than double that for all other PBS drugs combined (7.6% vs 2.8%, difference 4.8%, 95% confidence interval -0.4% to 10.1%, P = 0.07). The median price for a month's treatment of the new anticancer drugs listed was A$4919 (range A$1003 to A$12 578, 2012 prices). PBS expenditure and the price of anticancer drugs in Australia rose substantially from 2000 to 2012. Dealing with these burgeoning costs will be a major challenge for our health system and for those affected by cancer.
Association between co-morbidities and labour force participation amongst persons with back problems
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2012
DOI: 10.1016/J.PAIN.2012.06.020
Abstract: There are few studies that have looked at the occurrence of co-morbid conditions amongst patients with back problems. This study assesses the association between of a range of co-morbidities and the labour force participation rates of 45- to 64-year-old Australians with back problems. Logistic regression models were applied to the 2003 Survey of Disability, Ageing and Carers (SDAC) data to look at the relationship between chronic back problems, labour force participation and comorbidities. For some conditions, there is a significant increase in the chance of an in idual being out of the labour force, relative to those with back problems alone. For ex le, an in idual with back problems and heart disease is more than 10 times more likely to be out of the labour force than those with back problems alone (OR=10.90, 95% CI=2.91-40.79, P=.0004). Amongst conditions that have a significant impact on labour force participation rates, back problems and multiple co-morbidities are significantly more likely to cause persons with these conditions to be out of the labour force than those with back problems alone or those with no chronic health condition. It is important to consider which co-morbidities an in idual has when assessing the impact of back problems on labour force participation, as co-morbid conditions vary in their association with labour force participation.
Baby boomer doctors and nurses: demographic change and transitions to retirement
Publisher: AMPCo
Date: 07-2005
Quantifying the effect of early retirement on the wealth of individuals with depression or other mental illness
Publisher: Royal College of Psychiatrists
Date: 02-2011
DOI: 10.1192/BJP.BP.110.081679
Abstract: In addition to the health burden caused by mental illnesses, these conditions contribute to economic disadvantage because of their impact on labour force participation. To quantify the cost of lost savings and wealth to Australians aged 45–64 who retire from the labour force early because of depression or other mental illness. Cross-sectional analysis of the base population of Health& WealthMOD, a microsimulation model built on data from the Australian Bureau of Statistics' Survey of Disability, Ageing and Carers and STINMOD, an income and savings microsimulation model. People who are not part of the labour force because of depression or other mental illness have 78% (95% CI 92.2–37.1) and 93% (95% CI 98.4–70.5) less wealth accumulated respectively, compared with people of the same age, gender and education who are in the labour force with no chronic health condition. People who are out of the labour force as a result of depression or other mental illness are also more likely to have the wealth that they do have in cash assets, rather than higher-growth assets such as superannuation, home equity and other financial investments. This lower accumulated wealth is likely to result in lower living standards for these in iduals in the future. This will compound the impact of their condition on their health and quality of life, and put a large financial burden on the state as a result of the need to provide financial assistance for these in iduals.
The indirect economic impacts of co-morbidities on people with depression
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.JPSYCHIRES.2013.02.014
Abstract: It is known that people with depression often have other co-morbid conditions however this is rarely acknowledged in studies that access the economic impacts of depression. This paper aims to quantify the association between co-morbid health conditions and labour force status and economic circumstances of people with depression. This study undertakes cross-sectional analysis using a dataset that is representative of the 45-64 year old Australian population with depression. The probability of being out of the labour force increases with increasing number of co-morbidities, and the amount of weekly income received by people with depression decreased with increasing numbers of co-morbidities. Those with depression and three or more co-morbidities were 4.31 times more likely to be out of the labour force (95% CI: 1.74-10.68), and received a weekly private income 88% lower (95% CI: -94%, -75%) than people with depression alone. It is important to consider the co-morbid conditions an in idual has when assessing the impact of depression on labour force participation and economic circumstances.
Multidimensional poverty and health status as a predictor of chronic income poverty
Publisher: Wiley
Date: 02-10-2015
DOI: 10.1002/HEC.3112
Abstract: Longitudinal analysis of Wave 5 to 10 of the nationally representative Household, Income and Labour Dynamics in Australia dataset was undertaken to assess whether multidimensional poverty status can predict chronic income poverty. Of those who were multidimensionally poor (low income plus poor health or poor health and insufficient education attainment) in 2007, and those who were in income poverty only (no other forms of disadvantage) in 2007, a greater proportion of those in multidimensional poverty continued to be in income poverty for the subsequent 5 years through to 2012. People who were multidimensionally poor in 2007 had 2.17 times the odds of being in income poverty each year through to 2012 than those who were in income poverty only in 2005 (95% CI: 1.23-3.83). Multidimensional poverty measures are a useful tool for policymakers to identify target populations for policies aiming to improve equity and reduce chronic disadvantage.
The effect of lactoferrin supplementation on death or major morbidity in very low birthweight infants (LIFT): a multicentre, double-blind, randomised controlled trial
Publisher: Elsevier BV
Date: 06-2020
Indirect costs of depression and other mental and behavioural disorders for Australia from 2015 to 2030
Publisher: Royal College of Psychiatrists
Date: 05-2019
DOI: 10.1192/BJO.2019.26
Abstract: The impact of mental disorders has been assessed in relation to longevity and quality of life however, mental disorders also have an impact on productive life-years (PLYs). To quantify the long-term costs of Australians aged 45–64 having lost PLYs because of mental disorders. The Survey of Disability, Ageing and Carers 2003, 2009 formed the base population of Health& WealthMOD2030 – a microsimulation model integrating output from the Static Incomes Model, the Australian Population and Policy Simulation Model, the Treasury and the Australian Burden of Disease Study. For depression, in iduals incurred a loss of AU$1062 million in income in 2015, projected to increase to AU$1539 million in 2030 (45% increase). The government is projected to incur costs comprising a 22% increase in social security payments and a 45% increase in lost taxes as a result of depression through its impact on PLYs. Effectiveness of mental health programmes should be judged not only in terms of healthcare use but also quality of life and economic well-being. None.
Retirement intentions of dentists in New South Wales, Australia
Publisher: Springer Science and Business Media LLC
Date: 04-2010
Multidisciplinary management of complex care
Publisher: Wiley
Date: 21-01-2009
DOI: 10.1111/J.1440-1584.2008.01036.X
Abstract: Rural and remote areas of Australia are facing serious health workforce shortages. Multidisciplinary teams are one way of making the most of the rural workforce. In this paper, the advantages of multidisciplinary care in terms of patient outcomes, clinician satisfaction and system efficiency are considered with reference to an innovative rural multidisciplinary model that highlights how these positive outcomes can be achieved. Ways of developing the capacity of the future workforce for work in multidisciplinary teams are discussed.
A profile of Australian nuclear medicine technologist practice
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2008
The costs of diabetes among Australians aged 45-64 years from 2015 to 2030
Publisher: BMJ
Date: 2017
The Lifetime Distributional Impact of Government Health Outlays
Publisher: Wiley
Date: 12-2002
The role of oncology nurse practitioners in current oncology practice and lessons for Australia
Publisher: AMPCo
Date: 04-2014
DOI: 10.5694/MJA13.10535
The indirect costs of ischemic heart disease through lost productive life years for Australia from 2015 to 2030
Publisher: Springer Science and Business Media LLC
Date: 21-06-2019
Letter to the editor regarding Kawada's comments on the paper labour force participation and the influence of having CVD on income poverty of older workers
Publisher: Elsevier BV
Date: 05-2012
The promise of personalised medicine
Publisher: Elsevier BV
Date: 2016
Informal caring for back pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 24-12-2020
DOI: 10.1097/J.PAIN.0000000000001788
Abstract: This study models the economic costs of informal caring for people with back pain, using a microsimulation model, Care& WorkMOD, from 2015 to 2030. Care& WorkMOD was based on 3 national Australian Surveys of Disability, Ageing and Carers (2003, 2009, 2012) data sets for in iduals aged 15 to 64 years. Estimated national income loss due to caring for people with back pain was AU$258 million in 2015, increasing to $398 million in 2030 (54% increase). Lost income tax revenue to the Australian government due to informal care of people with back pain was estimated to be AU$78 million in 2015, increasing to AU$118 million in 2030 (50% increase), and additional welfare payments were estimated to rise from $132 million in 2015 to AU$180 in 2030 (36% increase). Larger growth in lost income, compared with the increase in welfare payments, means that there would be an increasing income gap between those out of the labour force providing informal care and noncarers who are in the labour force, leading to increased inequality. Informal carers are defined as providers of informal, unpaid assistance to someone with a health condition, for at least 6 months. Informal carers of people with back pain who are out of the labour force incur substantial economic costs. Furthermore, back pain is a large economic burden on national governments. Policies addressing back pain prevention and treatment, and supporting carers, may offset government welfare expenditure, while improving the socioeconomic well-being of carers and patients.
Health and functional capacity - Capturing capability limitations in measures of health
Publisher: Informa UK Limited
Date: 09-2012
Economic impacts of illness in older workers: Quantifying the impact of illness on income, tax revenue and government spending
Publisher: Springer Science and Business Media LLC
Date: 06-2011
The impact of diabetes on the labour force participation and income poverty of workers aged 45-64 years in Australia
Publisher: Public Library of Science (PLoS)
Date: 20-02-2014
The impact of co-morbidities on the wealth of people with heart disease
Publisher: Elsevier BV
Date: 10-2013
Economic Evaluation of Interventions for Treatment of Neonatal Opioid Withdrawal Syndrome: A Review
Publisher: MDPI AG
Date: 23-06-2021
Abstract: This study assessed the economic evidence on the pharmacological and non-pharmacological management of infants with neonatal opioid withdrawal syndrome (NOWS). Six databases were searched up to October 2020 for peer-reviewed studies. After titles and abstracts were screened, 79 studies remained for full-text review, and finally, 8 studies were eligible for inclusion in the review. The methodological quality of included studies was assessed using the Drummond checklist. The review showed significant limitations in these studies, with one study being rated as good and the remaining seven studies as of poor quality. There are methodological issues that require addressing, including a lack of detail on cost categories, a robust investigation of uncertainty, and extending the time horizon to consider longer-term outcomes beyond the initial birth hospitalization. Despite these limitations, existing evidence suggests non-pharmacological strategies such as rooming-in were associated with a shorter hospital stay and a decreased need for pharmacological treatment, thereby lowering hospitalization costs. The review highlights the paucity of high-quality studies assessing the cost-effectiveness of intervention strategies for NOWS. There is also a lack of evidence on long-term outcomes associated with NOWS and the treatment of NOWS. The inclusion of economic analyses in future studies will provide evidence to inform policymakers on resource allocation decisions for this patient population.
Health, social and economic implications of adolescent risk behaviours/states: protocol for Raine Study Gen2 cohort data linkage study
Publisher: Bristol University Press
Date: 07-02-2022
DOI: 10.1332/175795921X16424353247247
Abstract: Risk-taking behaviours are a major contributor to youth morbidity and mortality. Vulnerability to these negative outcomes is constructed from in idual behaviour including risk-taking, and from social context, ecological determinants, early life experience, developmental capacity and mental health, contributing to a state of higher risk. However, although risk-taking is part of normal adolescent development, there is no systematic way to distinguish young people with a high probability of serious adverse outcomes, hindering the capacity to screen and intervene. This study aims to explore the association between risk behaviours/states in adolescence and negative health, social and economic outcomes through young adulthood. The Raine Study is a prospective cohort study which recruited pregnant women in 1989–91, in Perth, Western Australia. The offspring cohort (N = 2,868) was followed up at regular intervals from 1 to 27 years of age. These data will be linked to State government health and welfare administrative data. We will empirically examine relationships across multiple domains of risk (for ex le, substance use, sexual behaviour, driving) with health and social outcomes (for instance, road-crash injury, educational underachievement). Microsimulation models will measure the impact of risk-taking on educational attainment and labour force outcomes. Comprehensive preventive child health programmes and policy prioritise a healthy start to life. This is the first linkage study focusing on adolescence to adopt a multi-domain approach, and to integrate health economic modelling. This approach captures a more complete picture of health and social impacts of risk behaviour/states in adolescence and young adulthood.
Intellectual disability and autism
Publisher: Royal College of Psychiatrists
Date: 16-09-2019
DOI: 10.1192/BJP.2019.204
Abstract: Intellectual disability and autism spectrum disorder (ASD) influence the interactions of a person with their environment and generate economic and socioeconomic costs for the person, their family and society. To estimate costs of lost workforce participation due to informal caring for people with intellectual disability or autism spectrum disorders by estimating lost income to in iduals, lost taxation payments to federal government and increased welfare payments. We used a microsimulation model based on the Australian Bureau of Statistics' Surveys of Disability, Ageing and Carers (population surveys of people aged 15–64), and projected costs of caring from 2015 in 5-year intervals to 2030. The model estimated that informal carers of people with intellectual disability and/or ASD in Australia had aggregated lost income of AU$310 million, lost taxation of AU$100 million and increased welfare payments of AU$204 million in 2015. These are projected to increase to AU$432 million, AU$129 million and AU$254 million for income, taxation, and welfare respectively by 2030. The income gap of carers for people with intellectual disability and/or ASD is estimated to increase by 2030, meaning more financial stress for carers. Informal carers of people with intellectual disability and/or ASD experience significant loss of income, leading to increased welfare payments and reduced taxation revenue for governments these are all projected to increase. Strategic policies supporting informal carers wishing to return to work could improve the financial and psychological impact of having a family member with intellectual disability and/or ASD. None.
Labour force participation and the influence of having arthritis on financial status
Publisher: Springer Science and Business Media LLC
Date: 29-01-2015
DOI: 10.1007/S00296-015-3224-2
Abstract: The objective of this study was to quantify the impact that having arthritis has on income poverty status and accumulated wealth in Australia. Cross-sectional analysis of Health&WealthMOD, a microsimulation model built on data from the Australian Bureau of Statistics' Survey of Disability, Ageing and Carers and STINMOD, an income and savings microsimulation model. Across all categories of labour force participation status (employed full time, part time or not in the labour force at all), those with arthritis were significantly more likely to be in poverty. Those employed full time with no health condition had 0.82 times the odds of being in income poverty (95 % CI 0.80-0.84) compared with those employed full time with arthritis. Those not in the labour force with no chronic health conditions had 0.36 times the odds of being in income poverty compared with those not in the labour force due to arthritis (95 % CI 0.36-0.37). For people not in the labour force with no long-term health condition, the total value of their wealth was 211 % higher (95 % CI 38-618 %) than the amount of wealth accumulated by those not in the labour force due to arthritis. Similarly, those employed part time with no chronic health condition had 50 % more wealth than those employed part time with arthritis (95 % CI 3-116 %). Arthritis has a profound impact upon the economic circumstances of in iduals, which adds a further dimension to the detrimental living standards of older in iduals suffering from the condition.
The economic impacts of using adalimumab (Humira®) for reducing pain in people with ankylosing spondylitis
Publisher: Wiley
Date: 03-04-2018
Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis: Protocol for the PARTNER STUDY
Publisher: Springer Science and Business Media LLC
Date: 30-04-2018
Labour force participation and the influence of having CVD on income poverty of older workers
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1016/J.IJCARD.2011.03.020
Abstract: In addition to being the leading cause of death, cardiovascular disease (CVD) also impacts upon the ability of in iduals to function normally in everyday activities, which is likely to affect in iduals' employment. This paper will quantify the relationship between labour force participation, CVD and being in poverty. The 2003 Survey of Disability, Ageing and Carers (SDAC) data were used to assess the impact of having CVD on being in poverty amongst the older working aged (aged 45 to 64) population in Australia. Those not in the labour force with no chronic health condition are 93% less likely to be in poverty than those not in the labour force due to CVD (OR 0.07, 95%CI: 0.07-0.07, p<.0001). The likelihood of being in poverty varies with labour force status for those with CVD: those who were either in full time (OR 0.04, 95% CI: 0.04-0.05, p<.0001) or part time (OR 0.19, 95% CI: 0.18-0.19) employment are significantly less likely to be in poverty than those who have had to retire because of the condition. The efforts to increase the labour force participation of in iduals with CVD, or ideally prevent the onset of the condition will likely improve their living standards. This study has shown that having CVD and not being in the labour force because of the condition drastically increases the chances of living in poverty.
The potential for poverty to lower the self-efficacy of adults with asthma: An Australian longitudinal study
Publisher: The Korean Academy of Asthma, Allergy and Clinical Immunology and The Korean Academy of Pediatric Al
Date: 2016
The cost effectiveness of bevacizumab when added to capecitabine, with or without mitomycin-C, in first line treatment of metastatic colorectal cancer: Results from the Australasian phase III MAX study
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.EJCA.2013.09.028
Abstract: Based on the clinical data, bevacizumab has been approved in Australia and globally for the treatment of advanced colorectal cancer. However, limited evidence exists for its cost-effectiveness. The purpose of this study was to evaluate the cost effectiveness of adding bevacizumab to capecitabine monotherapy in patients with metastatic colorectal cancer, using data from the prospective economic evaluation conducted alongside the MAX trial. In idual patient level data on resource use and progression free survival were prospectively collected in the phase III MAX trial. Resource use data were collected for the period between randomisation and disease progression, and unit costs were assigned from the perspective of the Australian health care funder. Effectiveness was measured in quality adjusted progression free survival years, with utility scores obtained from both the community valued EQ-5D questionnaire and the patient valued UBQ-C questionnaire. Progression free survival was used as a secondary effectiveness measure. The addition of bevacizumab to capecitabine monotherapy cost approximately $192,156 (95% confidence interval [CI], $135,619 to $326,894) per quality adjusted progression free survival year gained when using publicly listed pharmaceutical prices and utility values from the EQ-5D questionnaire. This decreased to $149,455 (95% CI, $100,356 to $245,910) when values from the UBQ-C questionnaire were applied. The incremental cost per progression free survival year was $145,059 (95% CI, $106,703 to $233,225). Bevacizumab was not found to be cost effective at its listed price, based on results from the MAX trial.
Protocol for the process and feasibility evaluations of a new model of primary care service delivery for managing pain and function in patients with knee osteoarthritis (PARTNER) using a mixed methods approach
Publisher: BMJ
Date: 02-2020
DOI: 10.1136/BMJOPEN-2019-034526
Abstract: This protocol outlines the rationale, design and methods for the process and feasibility evaluations of the primary care management on knee pain and function in patients with knee osteoarthritis (PARTNER) study. PARTNER is a randomised controlled trial to evaluate a new model of service delivery (the PARTNER model) against ‘usual care’. PARTNER is designed to encourage greater uptake of key evidence-based non-surgical treatments for knee osteoarthritis (OA) in primary care. The intervention supports general practitioners (GPs) to gain an understanding of the best management options available through online professional development. Their patients receive telephone advice and support for OA management by a centralised, multidisciplinary ‘Care Support Team’. We will conduct concurrent process and feasibility evaluations to understand the implementation of this new complex health intervention, identify issues for consideration when interpreting the effectiveness outcomes and develop recommendations for future implementation, cost effectiveness and scalability. The UK Medical Research Council Framework for undertaking a process evaluation of complex interventions and the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) frameworks inform the design of these evaluations. We use a mixed-methods approach including analysis of survey data, administrative records, consultation records and semistructured interviews with GPs and their enrolled patients. The analysis will examine fidelity and dose of the intervention, observations of trial setup and implementation and the quality of the care provided. We will also examine details of ‘usual care’. The semistructured interviews will be analysed using thematic and content analysis to draw out themes around implementation and acceptability of the model. The primary and substudy protocols have been approved by the Human Research Ethics Committee of The University of Sydney (2016/959 and 2019/503). Our findings will be disseminated to national and international partners and stakeholders, who will also assist with wider dissemination of our results across all levels of healthcare. Specific findings will be disseminated via peer-reviewed journals and conferences, and via training for healthcare professionals delivering OA management programmes. This evaluation is crucial to explaining the PARTNER study results, and will be used to determine the feasibility of rolling-out the intervention in an Australian healthcare context. ACTRN12617001595303 Pre-results.
A Closing Window of Opportunity—When Does Multidimensional Poverty Become Chronic? A Longitudinal Study of Australians
Publisher: Springer International Publishing
Date: 2017
Working beyond the traditional retirement age
Publisher: Informa UK Limited
Date: 12-10-2017
DOI: 10.1080/08959420.2016.1246319
Abstract: This article examines the relationship between health and workforce participation beyond the age of 65 years in Australia. This study found that people with a chronic health condition were less likely to be employed than those without a health condition (OR, 0.59 95% CI [0.38, 0.92]). Among those with a chronic health condition, those in income quartile 2 (OR, 0.27 95% CI [0.11, 0.67]) and 3 (OR, 0.38 95% CI, [0.15-0.93]) were significantly less likely to be employed relative to those in income quartile 4. Older workers with a chronic health condition were less likely to work beyond the age of 65 however, among those with a chronic health condition, those with very high income and those with very low income were the most likely to keep working.
Back problems, comorbidities, and their association with wealth
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.SPINEE.2014.06.018
Abstract: Studies assessing the economic burden of back problems have given little consideration to the presence of comorbidities. To assess the difference in the value of wealth held by Australians who have back problems and varying numbers of chronic comorbidities. A cross-sectional study. In iduals aged 45 to 64 years in 2009: 4,388 with no chronic health conditions, 1,405 with back problems, and 3,018 with other health conditions. Total wealth (cash, shares, superannuation, investment property, and owner occupied home). Using a microsimulation model (Health&WealthMOD), logistic regression models were used to assess the odds of having any wealth. Linear regression models were used to assess the difference in the value of this wealth. Those with back problems and two comorbidities had 0.16 (95% confidence interval [CI]: 0.06-0.42) times the odds and those with back problems and three or more comorbidities had 0.20 (95% CI: 0.11-0.38) times the odds of having accumulated some wealth than those with no chronic health conditions. Those with back problems and three or more comorbidities had a median value of total wealth of around $150,000, whereas those with back problems only and back problems and one comorbidity had a median value of total wealth of around $250,500. There was no significant difference in the amount of wealth accumulated by those with back problems and at least one comorbidity and those with other health conditions and the same number of comorbidities. However, those with only one health condition (excluding back problems) had 65% more wealth than those with back problems only (95% CI: 5.1-161.2). This study highlights the importance of considering multiple morbidities when discussing the relationship between back problems and economic circumstances.
Clinically Responsive Genomic Analysis Pipelines
Publisher: Elsevier BV
Date: 07-2021
DOI: 10.1016/J.JMOLDX.2021.04.007
Abstract: Massively parallel sequencing has markedly improved mendelian diagnostic rates. This study assessed the effects of custom alterations to a diagnostic genomic bioinformatic pipeline in response to clinical need and derived practice recommendations relative to diagnostic rates and efficiency. The Genomic Annotation and Interpretation Application (GAIA) bioinformatics pipeline was designed to detect panel, exome, and genome s le integrity and prioritize gene variants in mendelian disorders. Reanalysis of selected negative cases was performed after improvements to the pipeline. GAIA improvements and their effect on sensitivity are described, including addition of a PubMed search for gene-disease associations not in the Online Mendelian Inheritance of Man database, inclusion of a process for calling low-quality variants (known as QPatch), and gene symbol nomenclature consistency checking. The new pipeline increased the diagnostic rate and reduced staff costs, resulting in a saving of US$844.34 per additional diagnosis. Recommendations for genomic analysis pipeline requirements are summarized. Clinically responsive bioinformatics pipeline improvements increase diagnostic sensitivity and increase cost-effectiveness.
Long-term economic impacts of exome sequencing for suspected monogenic disorders
Publisher: Elsevier BV
Date: 11-2019
The Population Cost-Effectiveness of Weight Watchers with General Practitioner Referral Compared with Standard Care.
Publisher: Wiley
Date: 08-2018
DOI: 10.1002/OBY.22216
Abstract: This study aimed to assess population-level cost-effectiveness of the Weight Watchers (WW) program with doctor referral compared with standard care (SC) for Australian adults with overweight and obesity. The target population was Australian adults ≥ 20 years old with BMI ≥ 27 kg/m The WW intervention resulted in 60,445 averted cases of obesity in 2025 (2,311 more cases than for SC), extra intervention costs of A$219 million, and cost savings within the health system of A$17,248 million (A$82 million more than for SC) for 2015 to 2025 compared with doing nothing. The modeled WW had an incremental cost-effectiveness ratio of A$35,195 in savings per case of obesity averted in 2025. WW remained dominant over SC for the different scenarios in the sensitivity analysis. The WW intervention represents good value for money. The WW intervention needs serious consideration in a national package of obesity health services.
Use of Whole-Genome Sequencing for Mitochondrial Disease Diagnosis
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 16-08-2022
DOI: 10.1212/WNL.0000000000200745
Abstract: Mitochondrial diseases (MDs) are the commonest group of heritable metabolic disorders. Phenotypic ersity can make molecular diagnosis challenging, and causative genetic variants may reside in either mitochondrial or nuclear DNA. A single comprehensive genetic diagnostic test would be highly useful and transform the field. We applied whole-genome sequencing (WGS) to evaluate the variant detection rate and diagnostic capacity of this technology with a view to simplifying and improving the MD diagnostic pathway. Adult patients presenting to a specialist MD clinic in Sydney, Australia, were recruited to the study if they satisfied clinical MD (Nijmegen) criteria. WGS was performed on blood DNA, followed by clinical genetic analysis for known pathogenic MD-associated variants and MD mimics. Of the 242 consecutive patients recruited, 62 participants had “definite,” 108 had “probable,” and 72 had “possible” MD classification by the Nijmegen criteria. Disease-causing variants were identified for 130 participants, regardless of the location of the causative genetic variants, giving an overall diagnostic rate of 53.7% (130 of 242). Identification of causative genetic variants informed precise treatment, restored reproductive confidence, and optimized clinical management of MD. Comprehensive bigenomic sequencing accurately detects causative genetic variants in affected MD patients, simplifying diagnosis, enabling early treatment, and informing the risk of genetic transmission.
Changes in CO2 diffuse degassing induced by the passing of seismic waves
Publisher: Elsevier BV
Date: 06-2016
Health models
Publisher: Emerald Group Publishing Limited
Date: 29-10-2014
Economic costs of informal care for people with chronic diseases in the community: Lost income, extra welfare payments, and reduced taxes in Australia in 2015-2030
Publisher: Hindawi Limited
Date: 30-10-2019
DOI: 10.1111/HSC.12670
Abstract: We estimated the economic costs of informal care in the community from 2015 to 2030, using an Australian microsimulation model, Care&WorkMOD. The model was based on data from three Surveys of Disability, Ageing, and Carers (SDACs) for the Australian population aged 15-64 years old. Estimated national income lost was AU$3.58 billion in 2015, increasing to $5.33 billion in 2030 (49% increase). Lost tax payments were estimated at AU$0.99 billion in 2015, increasing to AU$1.44 billion in 2030 (45% increase), and additional welfare payments were expected to rise from $1.45 billion in 2015 to AU$1.94 in 2030 (34% increase). There are substantial economic costs both to informal carers and the government due to carers being out of the labour-force to provide informal care for people with chronic diseases. Health and social policies supporting carers to remain in the labour force may allow governments to make substantial savings, while improving the economic situation of carers.
Application of next‐generation sequencing to improve cancer management: A review of the clinical effectiveness and cost‐effectiveness
Publisher: Wiley
Date: 08-02-2018
DOI: 10.1111/CGE.13199
Abstract: Uptake of next-generation sequencing (NGS) has increased dramatically due to significant cost reductions and broader community acceptance of NGS. To systematically review the evidence on both the clinical effectiveness and the cost-effectiveness of applying NGS to cancer care. A systematic search for full-length original research articles on the clinical effectiveness and cost-effectiveness of NGS in MEDLINE and EMBASE. Articles that focussed on cancer care and involved the application of NGS were included for the review of clinical effectiveness. For the cost-effectiveness review, we only included the articles with economic evaluations of NGS in cancer care. We report the rate of successfully detecting mutations from the clinical studies. The incremental cost-effectiveness ratio and sensitivity analysis outcomes are reported for the cost-effectiveness articles. Fifty-six articles reported that sequencing patient s les using targeted gene panels, and 83% of the successfully sequenced patients harboured at least 1 mutation. Only 6 studies reported on the cost-effectiveness of the application of NGS in cancer care. NGS is an effective tool for identifying mutation in cancer patients. However, more rigorous cost-effectiveness studies of NGS applied to cancer management are needed to determine whether NGS can improve patient outcomes cost-effectively.
Cost effectiveness of primary care referral to a commercial provider for weight loss treatment, relative to standard care: a modelled lifetime analysis
Publisher: Springer Science and Business Media LLC
Date: 04-12-2013
DOI: 10.1038/IJO.2013.227
Effects of delayed versus immediate umbilical cord clamping in reducing death or major disability at 2 years corrected age among very preterm infants (APTS): a multicentre, randomised clinical trial.
Publisher: Elsevier BV
Date: 03-2021
IDMOD: An Australian microsimulation model of lifetime economic and social factors in familial intellectual disability
Publisher: International Microsimulation Association
Date: 2020
DOI: 10.34196/IJM.00212
The long-term economic impacts of arthritis through lost productive life years
Publisher: Springer Science and Business Media LLC
Date: 24-05-2018
ANCILLARY AND SPECIALIST HEALTH SERVICES: THE RELATIONSHIP BETWEEN INCOME, USER RATES AND EQUITY OF ACCESS
Publisher: Wiley
Date: 02-1999
Are we getting healthier as we grow older? Implications for babyboomer labor force participation
Publisher: Wiley
Date: 10-2007
Abstract: The Intergenerational Report (IGR) released by the Department of the Treasury of the Commonwealth of Australia in 2002 highlighted pressures that in the future would threaten the sustainability of the Australian government's budget balance. These pressures result from the growing needs of an aging population and labor shortages that will limit economic growth and taxation revenue. The IGR has become a driving force in planning government policy. The Treasurer has recently said that "the whole economic agenda of the government at the moment is drawn from the IGR." In response, the Prime Minster and Treasurer have promoted deferred or gradual retirement as part of the solution. However, about 50% of men and 20% of women retire early as a result of ill health, indicating that poor health is potentially a limiter of economic growth. This paper reports lower labor force participation among persons with poorer health and that these persons move out of the labor force at a faster rate as they age. A range of measures suggests some decline in health in the pre-retirement age group (those aged from 40 to 64 years). This indicates that better health may be a facilitator of greater labor force participation in the baby boomer cohort. However, there is evidence that improving economic conditions in Australia leading to low unemployment has created an environment more favorable to the employment of older workers with health problems as there has been a rise in labor force participation in these groups, and measures to prevent chronic disease may further increase the employment prospects.
Mercury Sorption and Desorption on Gold: A Comparative Analysis of Surface Acoustic Wave and Quartz Crystal Microbalance-Based Sensors
Publisher: American Chemical Society (ACS)
Date: 23-07-2015
DOI: 10.1021/ACS.LANGMUIR.5B01858
Abstract: Microelectromechanical sensors based on surface acoustic wave (SAW) and quartz crystal microbalance (QCM) transducers possess substantial potential as online elemental mercury (Hg(0)) vapor detectors in industrial stack effluents. In this study, a comparison of SAW- and QCM-based sensors is performed for the detection of low concentrations of Hg(0) vapor (ranging from 24 to 365 ppbv). Experimental measurements and finite element method (FEM) simulations allow the comparison of these sensors with regard to their sensitivity, sorption and desorption characteristics, and response time following Hg(0) vapor exposure at various operating temperatures ranging from 35 to 75 °C. Both of the sensors were fabricated on quartz substrates (ST and AT cut quartz for SAW and QCM devices, respectively) and employed thin gold (Au) layers as the electrodes. The SAW-based sensor exhibited up to ∼111 and ∼39 times higher response magnitudes than did the QCM-based sensor at 35 and 55 °C, respectively, when exposed to Hg(0) vapor concentrations ranging from 24 to 365 ppbv. The Hg(0) sorption and desorption calibration curves of both sensors were found to fit well with the Langmuir extension isotherm at different operating temperatures. Furthermore, the Hg(0) sorption and desorption rate demonstrated by the SAW-based sensor was found to decrease as the operating temperature increased, while the opposite trend was observed for the QCM-based sensor. However, the SAW-based sensor reached the maximum Hg(0) sorption rate faster than the QCM-based sensor regardless of operating temperature, whereas both sensors showed similar response times (t90) at various temperatures. Additionally, the sorption rate data was utilized in this study in order to obtain a faster response time from the sensor upon exposure to Hg(0) vapor. Furthermore, comparative analysis of the developed sensors' selectivity showed that the SAW-based sensor had a higher overall selectivity (90%) than did the QCM counterpart (84%) while Hg(0) vapor was measured in the presence of ammonia (NH3), humidity, and a number of volatile organic compounds at the chosen operating temperature of 55 °C.
Loss of income and levels of scholarship support for students on rural clinical placements: A survey of medical, nursing and allied health students
Publisher: Wiley
Date: 21-05-2009
DOI: 10.1111/J.1440-1584.2009.01057.X
Abstract: To quantify the financial impact of rural clinical placements on medical, nursing and allied health students in rural Australia. The Careers in Health Tracking Survey provided data on whether students were employed, usual weekly hours of employment and a range of covariates, such as age, sex, course of study, marital status, dependents and rural or urban origin. A total of 121 students from a range of health professions completed the Careers in Health Tracking Survey while on rural placement at the Northern Rivers University Department of Rural Health. Survey data. Forty-one per cent of respondents were working immediately before their clinical placements. Nursing students worked the longest hours by far and were significantly more financially disadvantaged than both medical and allied health students (P < 0.01). Scholarship support was unevenly distributed, with nursing and allied health students being relatively under-supported in relation to lost earnings. Recruitment of students can be an effective strategy to address the rural health workforce shortage throughout Australia. However, there are a number of financial disincentives for students to undertake rural clinical placements. Additional support for some disciplines is needed to provide equitable distribution of scholarship support to offset this financial burden. Establishing an employment scheme for students on rural clinical placements and a scholarship for income replacement where employment is not available would also alleviate income loss.
Multi-dimensional poverty in Australia and the barriers ill health imposes on the employment of the disadvantaged
Publisher: Elsevier BV
Date: 12-2011
A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 25-08-2023
DOI: 10.1097/J.PAIN.0000000000003010
Abstract: Graded exposure treatment (GET) is a theory-driven pain treatment that aims to improve functioning by exposing patients to activities previously feared and avoided. Combining key elements of GET with acceptance-based exposure, GET Living (GL) was developed for adolescents with chronic pain (GL). Based on robust treatment effects observed in our single-case experimental design pilot trial of GL (NCT01974791), we conducted a 2-arm randomized clinical trial comparing GL with multidisciplinary pain management (MPM) comprised of cognitive behavioral therapy and physical therapy for pain management (NCT03699007). A cohort of 68 youth with chronic musculoskeletal pain (M age 14.2 years 81% female) were randomized to GL or MPM. Owing to COVID-19 restrictions, 54% of participants received zoom video delivered care. Assessments were collected at baseline, discharge, as well as at 3-month and 6-month follow-up. Primary outcomes were self-reported pain-related fear and avoidance. Secondary outcomes were child functional disability and parent protective responses to child pain. As hypothesized, GL improved in primary and secondary outcomes at 3-month follow-up. Contrary to our superiority hypothesis, there was no significant difference between GL and MPM. Patients reported both GL and MPM (in person and video) as credible and were highly satisfied with the treatment experience. Next steps will involve examining the single-case experimental design data embedded in this trial to facilitate an understanding of in idual differences in treatment responses (eg, when effects occurred, what processes changed during treatment within the treatment arm). The current findings support GET Living and MPM for youth with chronic pain.
Does genomic sequencing early in the diagnostic trajectory make a difference? A follow-up study of clinical outcomes and cost-effectiveness
Publisher: Elsevier BV
Date: 2019
Changes within the central stalk of E. coli F1Fo ATP synthase observed after addition of ATP
Publisher: Springer Science and Business Media LLC
Date: 11-01-2023
DOI: 10.1038/S42003-023-04414-Z
Abstract: F 1 F o ATP synthase functions as a biological generator and makes a major contribution to cellular energy production. Proton flow generates rotation in the F o motor that is transferred to the F 1 motor to catalyze ATP production, with flexible F 1 /F o coupling required for efficient catalysis. F 1 F o ATP synthase can also operate in reverse, hydrolyzing ATP and pumping protons, and in bacteria this function can be regulated by an inhibitory ε subunit. Here we present cryo-EM data showing E. coli F 1 F o ATP synthase in different rotational and inhibited sub-states, observed following incubation with 10 mM MgATP. Our structures demonstrate how structural transitions within the inhibitory ε subunit induce torsional movement in the central stalk, thereby enabling its rotation within the F ο motor. This highlights the importance of the central rotor for flexible coupling of the F 1 and F o motors and provides further insight into the regulatory mechanism mediated by subunit ε.
Freedom poverty: A new tool to identify the multiple disadvantages affecting those with CVD
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.IJCARD.2011.10.088
Abstract: It is recognised that CVD affects an in idual's financial situation, placing them in income poverty. However, recent developments in poverty measurement practice recognises other forms of disadvantage other than low income, such as poor health and insufficient education also affect living standards. Using the Freedom Poverty Measure, the multiple forms of disadvantage experienced by those with no health condition, heart disease, other diseases of the circulatory system, and all other health conditions was assessed using data on the adult Australian population contained in the 2003 Survey of Disability, Ageing and Carers. 24% of those with heart disease and 23% of those with other diseases of the circulatory system were in freedom poverty, suffering from multiple forms of disadvantage. Those with heart disease and those with other diseases of the circulatory system were around three times more likely to be in freedom poverty (OR 3.02, 95% CI: 2.29-3.99, p<.0001 OR 2.78, 95% CI: 1.94-3.98, p<.0001) than those with no health condition. Recognising the multiple forms of disadvantage suffered by those with CVD provides a clearer picture of their living standards than just looking at their income alone and the high proportion of in iduals with CVD that are suffering from multiple forms of disadvantage should make them a target for policy makers wishing to improve living standards.
Projecting the radiation oncology workforce in Australia
Publisher: Asian Pacific Organization for Cancer Prevention
Date: 30-04-2012
DOI: 10.7314/APJCP.2012.13.4.1159
Abstract: Research on radiation oncologists has indicated that there is a shortage in supply of specialist workers in this field internationally, and also within Australia. However, there are no current estimates as to what the future Australian radiotherapy workforce will look like. This paper aims to review the current status and capacity of the three main disciplines that make up the radiation oncology workforce in Australia and project the workforce supply and demand for 2014 and 2019. Using data on the workforce from a survey of all radiotherapy facilities operating in Australia in 2008 a workforce model was constructed. This study found that there will be a future shortfall of radiation oncologists, radiation therapists and radiation oncology medical physicists working in radiation oncology treatment. By 2014 there will be 109 fewer radiation oncologists than what will be demanded, and by 2019 this figure will increase to a shortfall of 155 radiation oncologists. There was a projected shortfall of 612 radiation therapists by 2014, with this figure slightly decreasing to a shortfall of 593 radiation therapists in 2019. In 2014, there was projected to be a deficit of 104 radiation oncology medical physicists with a persisting shortfall of 78 in 2019. This future projected shortage highlights the need for radiation oncology workforce planning.
The long term financial impacts of CVD: Living standards in retirement
Publisher: Elsevier BV
Date: 03-2012
DOI: 10.1016/J.IJCARD.2010.10.046
Abstract: Cardiovascular disease (CVD) has significant economic costs, however these are generally estimated for the present-time and little consideration is given to the long term economic consequences. This study estimates the value of savings those who retire early due to CVD will have accumulated by the time they reach the traditional retirement age of 65 years, and how much lower the value of these savings are compared to those who remained healthy and in the workforce. Using Health&WealthMOD - a microsimulation model of Australians aged 45 to 64 years, regression models were used to analyse the differences between the projected savings and the retirement incomes of people by the time they reach age 65 for those currently working with no chronic condition, and people not in the labour force due to CVD. Over 99% of in iduals who are employed full-time will have accumulated some savings at age 65 whereas only 77% of those who are out of the labour force due to CVD will have done so. Those who retire early due to CVD will have a median value of total savings by the time they are 65 of $1833. This is far lower than the expected median value of savings for those who remained in the labour force full-time, who will have $281841 of savings. Not only will early retirement due to cardiovascular disease limit the immediate income and wealth available to in iduals, but also reduce their long term financial capacity by reducing their savings.
Prospective comparison of the cost-effectiveness of clinical whole-exome sequencing with that of usual care overwhelmingly supports early use and reimbursement
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1038/GIM.2016.221
Abstract: To undertake the first prospective cost-effectiveness study of whole-exome sequencing (WES) as an early, routine clinical test for infants with suspected monogenic disorders. Cost data for diagnosis-related investigations and assessments were collected for a prospective, sequential clinical cohort of infants (N = 40) who underwent singleton WES in parallel to usual diagnostic care. We determined costs per patient, costs per diagnosis, and incremental costs per additional diagnosis for three alternative strategies for integrating WES into the diagnostic trajectory. We performed a sensitivity analysis to examine the robustness of estimates and bootstrapping (500 replications) to examine their distributions. Standard care achieved an average cost per diagnosis of AU$27,050 (US$21,099) compared with AU$5,047 (US$3,937) for singleton WES. If WES had been performed after exhaustive standard investigation, then there would have been an incremental cost per additional diagnosis of AU$8,112 (US$ 6,327). Using WES to replace some investigations decreases this incremental cost to AU$2,622 (US$2,045), whereas using it to replace most investigations results in a savings per additional diagnosis of AU$2,182 (US$1,702). Use of WES early in the diagnostic pathway more than triples the diagnostic rate for one-third the cost per diagnosis, providing strong support for reimbursement as a clinical test.Genet Med advance online publication 26 January 2017.
Type 2 diabetes mellitus and the risk of falling into poverty: an observational study
Publisher: Wiley
Date: 18-01-2016
DOI: 10.1002/DMRR.2771
Abstract: Diabetes is known to be associated with low income however, no longitudinal studies have documented whether developing type 2 diabetes mellitus (T2DM) is a risk factor for later falling into poverty. This paper aims to determine whether Australians who are diagnosed with type 2 diabetes have an elevated risk of falling into income poverty or multidimensional poverty. Data from a nationally representative, longitudinal survey conducted annually since 2001 are utilized. It identifies adults aged 21 years and over who were diagnosed with type 2 diabetes between 2007 and 2009 and compares their risk of falling into income poverty and multidimensional poverty between 2007 and 2012 relative to those who had never been diagnosed with type 2 diabetes using survival analysis with Cox regression models. After adjusting for confounding factors, for men who were diagnosed with T2DM, the hazard ratio for falling into income poverty was 1.89 (95% CI: 1.03-3.44) and 2.52 (95% CI: 1.24-5.12) for falling into multidimensional poverty, relative men who had never been diagnosed with T2DM. There was no significant difference in the hazard ratio for falling into income poverty (p = 0.6554) or multidimensional poverty (p = 0.9382) for women who were diagnosed with T2DM compared with women who had never been diagnosed with T2DM. Being diagnosed with type 2 diabetes increases the risk of men falling into poverty. The risk is higher for multidimensional poverty than income poverty. Copyright © 2015 John Wiley & Sons, Ltd.
Capacity for freedom-a new way of measuring poverty amongst Australian children
Publisher: Springer Science and Business Media LLC
Date: 16-09-2012
The impact of back problems on retirement wealth
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2012
DOI: 10.1016/J.PAIN.2011.10.018
Abstract: This study undertook an economic analysis of the costs of early retirement due to back problems, with the aim of quantifying how much lower the value of accumulated wealth of in iduals who exit the workforce early due to back problems is by the time they reach the traditional retirement age of 65 years--compared to those who remained in the workforce. This was done using the output dataset of the microsimulation model Health&WealthMOD. It was found that over 99% of in iduals who are employed full time will have accumulated some wealth at age 65 years, whereas as little as 74% of those who are out of the labour force due to back problems will have done so. Those who retire from the labour force early due to back problems will have a median value of total accumulated wealth by the time they are 65 of as little as $3708 (for women aged 55-64 years). This is far lower than the median value of accumulated wealth for those women aged 55-64 years who remained in the labour force full time, who will have $214,432 of accumulated wealth at age 65 years. Not only will early retirement due to back problems limit the immediate income available to in iduals, but it will also reduce their long-term financial capacity by reducing their wealth accumulation. Maintaining the labour force participation of those with back problems, or preventing the onset of the disease, should be a priority in order to maintain living standards comparable with others who do not suffer from this condition.
A within-trial cost-effectiveness analysis of primary care referral to a commercial provider for weight loss treatment, relative to standard care—an international randomised controlled trial
Publisher: Springer Science and Business Media LLC
Date: 28-08-2012
DOI: 10.1038/IJO.2012.139
The financial vulnerability of individuals with diabetes
Publisher: SAGE Publications
Date: 11-2010
Abstract: To quantify the impact of early retirement due to diabetes on the level and type of savings among those aged 45–64 years in Australia, the output dataset of the microsimulation model, Health& WealthMOD was analysed. Compared with those who are in full-time employment with no health condition, those who have retired early due to diabetes have significantly lower odds of owning any wealth (odds ratio 0.03, 95% confidence interval 0.00–0.30). Among those with any accumulated wealth, the value of this wealth is 90% less for people who are out of the labour force due to diabetes relative to those in full-time employment, after adjusting for age, sex and education (p=0.037). Retiring from the labour force early due to diabetes is likely to cause large financial stress in the future as not only have retired in iduals lost an income stream from paid employment, but they also have little or no savings to draw upon.
Optimising primary care management of knee osteoarthritis (partner): protocol for a randomised controlled trial
Publisher: Elsevier BV
Date: 04-2018
The personal and national costs of lost labour force participation due to arthritis: An economic study
Publisher: Springer Science and Business Media LLC
Date: 03-03-2013
Abstract: The costs of arthritis to the in iduals and the state are considerable. Cross-sectional analysis of the base population of Health& WealthMOD, a microsimulation model of 45 to 64 year old Australians built on data from the Australian Bureau of Statistics’ Survey of Disability, Ageing and Carers and STINMOD, an income and savings microsimulation model. In iduals aged 45 to 64 years who had retired early due to arthritis had a median value of AU$260 in total weekly income whereas those who were employed full time were likely to average more than five times this. The large national aggregate impact of early retirement due to arthritis includes AU$9.4 billion in lost GDP, attributable to arthritis through its impact on labour force participation. When looking at the ongoing impact of being out of the labour force those who retired from the labour force early due to arthritis were estimated to have a median value of total savings by the time they are 65 of as little as $300 (for males aged 45–54). This is far lower than the median value of savings for those males aged 45–54 who remained in the labour force full time, who would have an estimated $339 100 of savings at age 65. The costs of arthritis to the in iduals and the state are considerable. The impacts on the state include loss of productivity from reduced workforce participation, lost income taxation revenue, and increased government support payments – in addition to direct health care costs. In iduals bear the economic costs of lost income and the reduction of their savings over the long term.
Capacity for Freedom - Using a New Poverty Measure to Look at Regional Differences in Living Standards within Australia
Publisher: Wiley
Date: 08-03-2012
Economic evaluation of genomic sequencing in the paediatric population: a critical review
Publisher: Springer Science and Business Media LLC
Date: 24-05-2018
The indirect costs of back problems (dorsopathies) in Australians aged 45 to 64 years from 2015 to 2030
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 15-09-2016
DOI: 10.1097/J.PAIN.0000000000000715
Abstract: This study projected the indirect costs of back problems through lost productive life years (PLYs) from the in idual's perspective (lost disposable income), the governmental perspective (reduced taxation revenue, greater welfare spending), and the societal perspective (lost gross domestic product, GDP) from 2015 to 2030, using Health& WealthMOD2030—Australia's first microsimulation model on the long-term impacts of ill-health. Quantile regression analysis was used to examine differences in median weekly income, welfare payments, and taxes of people unable to work due to back problems with working full-time without back problems as comparator. National costs and lost GDP resulting from missing workers due to back problems were also projected. We projected that 90,000 people have lost PLYs due to back problems in 2015, increasing to 104,600 in 2030 (16.2% increase). People with lost PLYs due to back problems are projected to receive AU$340.91 less in total income and AU$339.77 more in welfare payments per week than full-time workers without back problems in 2030 and pay no income tax on average. National costs consisted of a loss of AU$2931 million in annual income in 2015, increasing to AU$4660 million in 2030 (60% increase). For government, extra annual welfare payments are projected to increase from AU$1462 million in 2015 to AU$1709 million in 2030 (16.9% increase), and lost annual taxation revenue to increase from AU$671 million in 2015 to $961 million in 2030 (43.2% increase). We projected losses in GDP of AU$10,543 million in 2015, increasing to AU$14,522 million in 2030 due to back problems.
An evaluation of the quality of evidence underpinning diabetes management models: a review of the literature
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/AH14018
Abstract: Objective There is a paucity of research on the quality of evidence relating to primary care workforce models. Thus, the aim of the present study was to evaluate the quality of evidence on diabetes primary care workforce models in Australia. Methods The National Health and Medical Research Council of Australia’s (National Health and Medical Reseach Council 2000, 2001) frameworks for evaluating scientific evidence and economic evaluations were used to assess the quality of studies involving primary care workforce models for diabetes care involving Australian adults. A search of medical databases (MEDLINE, AMED, RURAL, Australian Indigenous HealthInfoNet and The Cochrane Institute), journals for diabetes care (Diabetes Research and Clinical Practice, Diabetes Care, Diabetic Medicine, Population Health Management, Rural and Remote Health, Australian Journal of Primary Health, PLoS Medicine, Medical Journal of Australia, BMC Health Services Research, BMC Public Health, BMC Family Practice) and Commonwealth and state government health websites was undertaken to acquire Australian studies of diabetes workforce models published 2005–13. Various diabetes workforce models were examined, including ‘one-stop shops’, pharmacy care, Aboriginal services and telephone-delivered interventions. The quality of evidence was evaluated against several criteria, including relevance and replication, strength of evidence, effect size, transferability and representativeness, and value for money. Results Of the14 studies found, four were randomised controlled trials and one was a systematic review (i.e. Level II and I (best) evidence). Only three provided a replicable protocol or detailed intervention delivery. Eleven lacked a theoretical framework. Twelve reported significant improvements in clinical (patient) outcomes, commonly HbA1c, cholesterol and blood pressure only four reported changes in short- and long-term outcomes (e.g. quality of life). Most studies used a small or targeted population. Only two studies assessed both benefits and costs of their intervention compared with usual care and cost effectiveness. Conclusions More rigorous studies of diabetes workforce models are needed to determine whether these interventions improve patient outcomes and, if they do, represent value for money. What is known about the topic? Although health systems with strong primary care orientations have been associated with enhanced access, equity and population health, the primary care workforce is facing several challenges. These include a mal-distribution of resources (supply side) and health outcomes (demand side), inconsistent support for teamwork care models, and a lack of enhanced clinical inter-professional education and/or training opportunities. These challenges are exacerbated by an ageing health workforce and general population, as well as a population that has increased prevalence of chronic conditions and multi-morbidity. Although several policy directions have been advocated to address these challenges, there is a lack of high-quality evidence about which primary care workforce models are best (and which models represent better value for money than current practice) and what the health effects are for patients. What does this paper add? This study demonstrated several strengths and weaknesses of Australian diabetes models of care studies. In particular, only five of the 14 studies assessed were designed in a way that enabled them to achieve a Level II or I rating (and hence the ‘best’ level of evidence), based on the NHMRC’s (2000, 2001) frameworks for assessing scientific evidence. The majority of studies risked the introduction of bias and thus may have incorrect conclusions. Only a few studies described clearly what the intervention and the comparator were and thus could be easily replicated. Only two studies included cost-effectiveness studies of their interventions compared with usual care. What are the implications for practitioners? Although there has been an increase in the number of primary care workforce models implemented in Australia, there is a need for more rigorous research to assess whether these interventions are effective in producing improved health outcomes and represent better value for money than current practice. Researchers and policymakers need to make decisions based on high-quality evidence it is not obvious what effect the evidence is having on primary care workforce reform.
The work environment and its effect on engagement and retention of nuclear medicine technologists
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2010
Impacts of genomics on the health and social costs of intellectual disability
Publisher: BMJ
Date: 24-01-2020
DOI: 10.1136/JMEDGENET-2019-106445
Abstract: This study provides an integrated assessment of the economic and social impacts of genomic sequencing for the detection of monogenic disorders resulting in intellectual disability (ID). Multiple knowledge bases were cross-referenced and analysed to compile a reference list of monogenic disorders associated with ID. Multiple literature searches were used to quantify the health and social costs for the care of people with ID. Health and social expenditures and the current cost of whole-exome sequencing and whole-genome sequencing were quantified in relation to the more common causes of ID and their impact on lifespan. On average, in iduals with ID incur annual costs in terms of health costs, disability support, lost income and other social costs of US$172 000, accumulating to many millions of dollars over a lifetime. The diagnosis of monogenic disorders through genomic testing provides the opportunity to improve the diagnosis and management, and to reduce the costs of ID through informed reproductive decisions, reductions in unproductive diagnostic tests and increasingly targeted therapies.
Individual and national financial impacts of informal caring for people with mental illness in Australia, projected to 2030
Publisher: Royal College of Psychiatrists
Date: 07-2022
DOI: 10.1192/BJO.2022.540
Abstract: Mental illness has a significant impact not only on patients, but also on their carers’ capacity to work. To estimate the costs associated with lost labour force participation due to the provision of informal care for people with mental illness in Australia, such as income loss for carers and lost tax revenue and increased welfare payments for government, from 2015 to 2030. The output data of a microsimulation model Care& WorkMOD were analysed to project the financial costs of informal care for people with mental illness, from 2015 to 2030. Care& WorkMOD is a population-representative microsimulation model of the Australian population aged between 15 and 64 years, built using the Australian Bureau of Statistics Surveys of Disability, Ageing and Carers data and the data from other population-representative microsimulation models. The total annual national loss of income for all carers due to caring for someone with mental illness was projected to rise from AU$451 million (£219.6 million) in 2015 to AU$645 million (£314 million) in 2030 in real terms. For the government, the total annual lost tax revenue was projected to rise from AU$121 million (£58.9 million) in 2015 to AU$170 million (£82.8 million) in 2030 and welfare payments to increase from AU$170 million (£82.8 million) to AU$220 million (£107 million) in 2030. The costs associated with lost labour force participation due to the provision of informal care for people with mental illness are projected to increase for both carers and government, with a widening income gap between informal carers and employed non-carers, putting carers at risk of increased inequality.
The Impact of Illness on Retirement Finances
Publisher: Wiley
Date: 03-10-2012
Health economics of exome sequencing for rare disorders
Publisher: Elsevier BV
Date: 02-2016
Early retirement and the financial assets of individuals with back problems
Publisher: Springer Science and Business Media LLC
Date: 05-12-2011
The association between labour force participation and being in income poverty amongst those with mental health problems
Publisher: Informa UK Limited
Date: 03-2013
DOI: 10.1080/13607863.2012.727381
Abstract: Mental health conditions are associated with lower standards of living. This study quantifies the relationship between employment, depression and other mental health conditions and being in income poverty. Cross-sectional analysis was undertaken using the 2003 Survey of Disability, Ageing and Carers data for Australians aged 45-64 years. Those not in the labour force due to depression and other mental health conditions are significantly more likely (odds ratio (OR) 12.53, 95% CI: 12.20-12.86, p < 0.0001 OR 20.10, 95% CI: 19.67-20.54, p < 0.0001) to be in income poverty than those not in the labour force with no chronic health condition. Amongst those with depression and other mental health conditions, those who were in employment were significantly less likely to be in income poverty than those who have had to retire because of the condition. Due to the association between leaving the workforce due to mental health problems and poverty status, efforts to increase the employment of in iduals with mental health conditions, or prevent the onset of the conditions, will likely improve living standards.
Diagnostic impact and cost-effectiveness of whole-exome sequencing for ambulant children with suspected monogenic conditions
Publisher: American Medical Association (AMA)
Date: 09-2017
Multiple chronic health conditions and their link with labour force participation and economic status
Publisher: Public Library of Science (PLoS)
Date: 11-2013
Graded exposure treatment for adolescents with chronic pain (GET Living): Protocol for a randomized controlled trial enhanced with single case experimental design
Publisher: Elsevier BV
Date: 12-2019
A crisis in the making? Education, ageing populations and the future of the medical research workforce
Publisher: Wiley
Date: 05-01-2011
DOI: 10.1111/J.1365-2923.2010.03785.X
Abstract: this study aims to project attrition from the Australian health and medical research workforce for those aged > 40 years in 2009, through to 2019, and to draw conclusions about the future of this workforce and the international implications of ageing workforce populations. the study uses recently collected unpublished demographic data on the 2009 health and medical research workforce drawn from an Australian Society for Medical Research survey of health and medical research organisations. about 6250 members of the health and medical research workforce aged > 40 years in 2009 are expected to leave the workforce during 2009-2019 the bulk of these will be aged 50-69 years. It is estimated that 35% of women and 49% of men aged 40-49 years in 2009 will retire by the age of 50-59 years, and 85% of women and 70% of men aged 50-59 years in 2009 are also projected to retire over the next 10 years. Of the 6250 members who are expected to leave the workforce by 2019, about 4000 hold a PhD. As a result of population growth, a further 1700 persons with a PhD will be required if Australia is to maintain its current ratio of PhD-qualified persons in the health and medical research workforce: working population to 2019, at a cost of about AU$240 million. there is a need to plan for the replacement of the retiring generation of the health and medical research workforce and for the growth required to match that of the working population. If Australia is to fulfil its ambition for a highly educated, optimally skilled and highly trained health and medical research sector, it must heighten its focus on the higher education of young medical researchers. As population ageing is an emerging phenomenon worldwide, all first world nations are likely to face the challenges involved in replacing a rapidly retiring generation of the health and medical research workforce.
Ageing medical workforce in Australia - where will the medical educators come from?
Publisher: Springer Science and Business Media LLC
Date: 05-11-2009
Indirect economic impacts of comorbidities on people with heart disease
Publisher: Japanese Circulation Society
Date: 2014
Abstract: Few studies have assessed the effect of multiple health conditions among patients with heart disease, particularly the economic implications of having multiple conditions. This study used a microsimulation model, Health&WealthMOD, to assess the effect of comorbidities on the labor force participation of 45-64-year-old Australians with heart disease, and the indirect economic costs to these in iduals and government. For most comorbid conditions, there is a significant increase in the chance of an in idual being out of the labor force, relative to those with heart disease alone. For ex le, in iduals with heart disease and arthritis have more than 6-fold the odds of being out of the labor force relative to those with heart disease alone (OR 6.64, 95% CI: 2.46-17.95). People with heart disease and ≥1 comorbidities also receive a significantly lower income, pay less in taxation and receive more in government transfer payments than those with heart disease alone. It is important to consider whether an in idual with heart disease also has other health conditions, as in iduals with comorbidities have inferior financial situations and are a greater burden on government finances than those with only heart disease. (Circ J 2014 78: 644-648).
The productivity gains associated with a junk food tax and their impact on cost-effectiveness
Publisher: Public Library of Science (PLoS)
Date: 22-07-2019
The MTA1 subunit of the nucleosome remodeling and deacetylase complex can recruit two copies of RBBP4/7
Publisher: Wiley
Date: 18-05-2016
DOI: 10.1002/PRO.2943
Costs of being a carer: Labour force participation and lost earnings among older working-aged Australians
Publisher: Elsevier BV
Date: 04-2013
Estimating the costs of genomic sequencing in cancer control
Publisher: Springer Science and Business Media LLC
Date: 03-06-2020
DOI: 10.1186/S12913-020-05318-Y
Abstract: Despite the rapid uptake of genomic technologies within cancer care, few studies provide detailed information on the costs of sequencing across different applications. The objective of the study was to examine and categorise the complete costs involved in genomic sequencing for a range of applications within cancer settings. We performed a cost-analysis using gross and micro-costing approaches for genomic sequencing performed during 2017/2018 across different settings in Brisbane, Australia. Sequencing was undertaken for patients with lung, breast, oesophageal cancers, melanoma or mesothelioma. Aggregated resource data were captured for a total of 1433 patients and point estimates of per patient costs were generated. Deterministic sensitivity analyses addressed the uncertainty in the estimates. Estimated costs to the public health system for resources were categorised into seven distinct activities in the sequencing process: s ling, extraction, library preparation, sequencing, analysis, data storage and clinical reporting. Costs were also aggregated according to labour, consumables, testing, equipment and ‘other’ categories. The per person costs were AU$347–429 (2018 US$240–297) for targeted panels, AU$871–$2788 (2018 US$604–1932) for exome sequencing, and AU$2895–4830 (2018 US$2006-3347) for whole genome sequencing. Cost proportions were highest for library preparation/sequencing materials (average 76.8% of total costs), s le extraction (8.1%), data analysis (9.2%) and data storage (2.6%). Capital costs for the sequencers were an additional AU$34–197 (2018 US$24–67) per person. Total costs were most sensitive to consumables and sequencing activities driven by commercial prices. Per person sequencing costs for cancer are high when tumour/blood pairs require testing. Using the natural steps involved in sequencing and categorising resources accordingly, future evaluations of costs or cost-effectiveness of clinical genomics across cancer projects could be more standardised and facilitate easier comparison of cost drivers.
Response to Ferket et al.
Publisher: Elsevier BV
Date: 11-2020
The personal and national costs of early retirement because of spinal disorders: Impacts on income, taxes, and government support payments
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.SPINEE.2012.09.036
Abstract: Spinal disorders can reduce an in idual's ability to participate in the labor force, and this can lead to considerable impacts on both the in idual and the state. This study was aimed to quantify the personal cost of lost income and the cost to the state from lost income taxation, increased benefits payments, and lost gross domestic product (GDP) as a result of early retirement because of spinal disorders in Australians aged 45 to 64 years in 2009. This was done using cross-sectional analysis of the base population of Health&WealthMOD, a microsimulation model built on data from the Australian Bureau of Statistics' Survey of Disability, Ageing and Carers, and STINMOD, an income and savings microsimulation model. Linear regression models were used to examine the relationship between spinal disorders, labor force participation, income, taxation, and government support payments. It was found that in iduals aged 45 to 64 years who have retired early because of spinal disorders have significantly lower income (79% less 95% confidence interval [CI], -84.7, -71.1 p<.0001), pay significantly less taxation (100% less 95% CI, -100.0, 99.9 p<.0001), and receive significantly more in government support payments (21,000% more 95% CI, 12,767.0, 35,336.4 p<.0001) than those employed full time with no health condition. In iduals who have retired early because of spinal disorders have a median value of total weekly income of only AU$310, whereas those who are employed full time are likely to receive four times this. This has a large national aggregate impact, with AU$4.8 billion lost in annual in idual earnings, AU$622 million in additional welfare payments, AU$497 million lost in taxation revenue for governments, and AU$2.9 billion in lost GDP: all attributable to spinal disorders through their impact on labor force participation. Although the in idual has to bear the economic costs of lost income in addition to the burden of the condition itself, the state experiences the impacts of loss of productivity from reduced workforce participation, lost income taxation revenue, and increasing government support payments.
Chronic health conditions and poverty: A cross-sectional study using a multidimensional poverty measure
Publisher: BMJ
Date: 11-2013
Optimising management of knee osteoarthritis in primary care (Partner)
Publisher: Elsevier BV
Date: 03-2023
Retiring early with cardiovascular disease - Impact on individual's financial assets
Publisher: Elsevier BV
Date: 2011
Labor force participation and the influence of having back problems on income poverty in Australia
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2012
Protocol for the Lactoferrin Infant Feeding Trial (LIFT): A randomised trial of adding lactoferrin to the feeds of very-low birthweight babies prior to hospital discharge
Publisher: BMJ
Date: 10-2018
DOI: 10.1136/BMJOPEN-2018-023044
Abstract: Very-low birthweight (VLBW, g) infants comprise about 1%–1.4% of all births in high-income countries. Every year, about 3000 VLBW babies in Australia and New Zealand receive intensive care. Many die or else survive with severe brain injury, retinopathy, late-onset sepsis or necrotising enterocolitis (NEC), each of which carries substantial risk of disability. This trial tests whether adding bovine lactoferrin (bLF) to feeds in VLBW infants improves (1) survival to hospital discharge free from brain injury, late-onset sepsis, NEC and treated retinopathy of prematurity (primary composite end point) (2) each component of the primary composite end point and (3) time to reach full enteral feeds, number of blood transfusions, chronic lung disease and length of hospital stay. It includes a cost-effectiveness analysis of bLF in improving survival free from major morbidity, and evaluates the effect of bLF on survival and developmental outcomes at 24 to 36 months corrected gestational age. This is a multicentre, two-arm, randomised trial comparing the treatment group receiving bLF added to breast milk or formula milk daily (up to 250 mg/kg/day bLF) versus the control group receiving no bLF supplementation. The intervention is administered until 34 completed weeks corrected gestation or for 2 weeks, whichever is longer, or until discharge home, if earlier. The target s le size of 1500 participants yields 85% power, at the two-sided 5% level significance, to detect a difference in proportions meeting the primary outcome assuming the true probability is 74% in controls and 80.5% in the bLF group. This protocol was approved by Northern Sydney Local Human Research Ethics Committee in January 2017 (Version 2.0, Reference 1003-118M) and other relevant ethics committees. The findings of the trial will be disseminated through peer-reviewed journals and conference presentations. ACTRN12611000247976 Pre-results.
Patient-reported health-related quality of life in individuals with inherited retinal diseases
Publisher: Elsevier BV
Date: 03-2022
Replacing the projected retiring baby boomer nursing cohort 2001 – 2026
Publisher: Springer Science and Business Media LLC
Date: 16-06-2007
Abstract: The nursing population in Australia is ageing. However, there is little information on the rate and timing of nursing retirement. Specifically designed health workforce extracts from the Australian Bureau of Statistics (ABS) censuses from 1986 to 2001 are used to estimate the rate of nursing retirement. The 2001 nursing data are then "aged" and retirement of the nursing workforce projected through to 2026. ABS population projections are used to examine the future age structure of the population and the growth and age distribution of the pool of labour from which future nurses will be drawn. Attrition rates for nurses aged 45 and over are projected to be significantly higher between the base year of 2006 and 2026, than they were between 1986 and 2001 (p 0.001). Between 2006 and 2026 the growth in the labour force aged 20 to 64 is projected to slow from 7.5 per cent every five years to about 2 per cent, and over half of that growth will be in the 50 to 64 year age group. Over this period Australia is projected to lose almost 60 per cent of the current nursing workforce to retirement, an average of 14 per cent of the nursing workforce every five years and a total of about 90,000 nurses. The next 20 years will see a large number of nursing vacancies due to retirement, with ageing already impacting on the structure of the nursing workforce. Retirement income policies are likely to be a key driver in the retirement rate of nurses, with some recent changes in Australia having some potential to slow retirement of nurses before the age of 60 years. However, if current trends continue, Australia can expect to have substantially fewer nurses than it needs in 2026.
Towards a holistic understanding of poverty: A new multidimensional measure of poverty for Australia
Publisher: Informa UK Limited
Date: 2012
Pathways into chronic multidimensional poverty amongst older people: a longitudinal study.
Publisher: Springer Science and Business Media LLC
Date: 07-03-2016
Where do students in the health professions want to work?
Publisher: Springer Science and Business Media LLC
Date: 18-08-2009
Economic evaluation of population-based, expanded reproductive carrier screening for genetic diseases in Australia
Publisher: Elsevier BV
Date: 05-2023
The long-term productivity impacts of all cause premature mortality in Australia
Publisher: Elsevier BV
Date: 04-2017
Abstract: To estimate the long-term productivity impacts of all-cause premature mortality in Australia by age, sex and cause of death. Using a human capital approach, a model was developed to estimate both the working years and present value of lifetime income (PVLI) lost due to premature deaths that occurred in 2003. Outcomes were modelled on in idual level data to the year 2030. A discount rate of 3% was applied and results are presented in 2015 Australian dollars. Premature deaths occurring in 2003 accounted for about 284,000 working years lost and $13.8 billion in PVLI lost when modelled to 2030. Deaths from cancer and cardiovascular disease accounted for more than half the total PVLI impact. Injuries and mental disorders were associated with the highest average PVLI loss per death. The productivity-related impacts of premature mortality are substantial. This study provides an assessment of relative impact of these costs across specific age, sex and cause of death categories. Policies and interventions that prevent premature mortality would improve both health and economic outcomes. An awareness of the productivity costs associated with all-cause mortality may assist decision makers in identifying population and disease subgroups where cost-effective health care investment can achieve the greatest economic gains to society.
Return to work and productivity loss after surgery
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2021
The physiotherapy workforce is ageing, becoming more masculinised, and is working longer hours: A demographic study
Publisher: Elsevier BV
Date: 2007
DOI: 10.1016/S0004-9514(07)70045-4
Abstract: Is the physiotherapy workforce significantly older in 2001 than 1986? What is the cumulative attrition of the workforce to 2001 and what is the predicted attrition by 2026? Is the workforce becoming masculinised? Is the workforce working longer hours? Observational study using Australian Bureau of Statistics census data from 1986 to 2001 to predict workforce characteristics in 2026. All physiotherapists who responded to the 1986, 1991, 1996 and 2001 censuses: 5928, 7106, 8788 and 10039 respondents in each year respectively. The physiotherapy workforce has aged significantly since 1986 (p < 0.001), and women are older than men (p < 0.001). Forty-one percent of the 2001 physiotherapy workforce is predicted to retire by 2026, although around one-third of physiotherapists continue working after age 65. While physiotherapy remains a female-dominated profession, the proportion of males is increasing and has risen from 16% in 1986 to 27% in 2001. Physiotherapists are working longer hours than they did in the past, and while this is partly due to the increasing proportion of males in the workforce, generation X and Y females are also more likely to work longer hours than their predecessors. The retirement of older, mostly female, physiotherapists may exacerbate existing workforce shortages, particularly in the public and aged care sectors. However, the growing proportion of male physiotherapists and their generally higher workforce participation may go some way to improving labour force capacity overall.
Impact of multidimensional poverty on the self-efficacy of older people: Results from an Australian longitudinal study
Publisher: Wiley
Date: 23-12-2017
DOI: 10.1111/GGI.12689
Abstract: Self-efficacy has numerous benefits for active and healthy aging, including giving the people the ability to make positive changes to their living standards and lifestyles. The present study aims to determine whether falling into multidimensional poverty lowers self-efficacy. Longitudinal analysis of waves 7-11 (2007-2011) of the nationally representative Household, Income and Labor Dynamics in Australia survey using linear regression models. The analysis focused on the Australian population aged 65 years and older. The Freedom Poverty Measure was used to identify those in multidimensional poverty. Those who fell into multidimensional poverty for 3 or 4 years between 2007 and 2011 had their self-efficacy scores decline by an average of 27 points (SD 21.2). Those who fell into poverty had significantly lower self-efficacy scores in 2011 - up to 57% lower (-66.6%, -45.7% P < 0.0001) after being in multidimensional poverty for 3 or 4 years between 2007 and 2011 than those who were never in poverty. Falling into multidimensional poverty lowers the self-efficacy scores of older people. In order to improve the chances of older people making long-term changes to improve their living standards, feelings of self-efficacy should first be assessed and improved. Geriatr Gerontol Int 2017 17: 308-314.
Economic analysis of patient-related effects of an interdisciplinary pain self-management program
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 15-06-2023
The impact of diabetes prevention on labour force participation and income of older Australians: An economic study
Publisher: Springer Science and Business Media LLC
Date: 06-01-2012
The relationship between employment and social participation among australians with a disabling chronic health condition: A cross-sectional analysis
Publisher: BMJ
Date: 2013
Baby boomer pharmacists: Ageing and projections of retirement
Publisher: Oxford University Press (OUP)
Date: 09-2007
Abstract: To identify ageing and retirement patterns of the pharmacy workforce since 1986 and the implications of those changes for future workforce planning. Australian Bureau of Statistics census data from 1986 to 2001 were used to examine ageing of the pharmacy workforce and attrition of pharmacists aged 50 years and over. The number of pharmacists to retire was projected over the next 20 years. The Australian pharmacy workforce has aged significantly since 1986 (P & 0.01). Forty-one per cent of pharmacists practising in 2001 are predicted to retire by 2026. Baby boomer pharmacists were more likely to work long hours (49+ per week) in 2001 than in 1986, and than generation X pharmacists in 2001. The proportion of women in pharmacy has increased from 39% in 1986 to over 50% in 2001. Women are still more likely to work part-time than males, although they are less likely to do so than they were in 1986. Conversely, the proportion of male pharmacists working part-time is rising. With baby boomer and older cohorts currently making up 65% of the pharmacy workforce, their retirement will place increased pressure on a profession already facing severe shortages. The growing proportion of female pharmacists and their generally lower workforce participation mean the potential for continued pharmacy shortages.
Multiple Disadvantages Among Older Citizens: What a Multidimensional Measure of Poverty Can Show
Publisher: Informa UK Limited
Date: 10-2012
DOI: 10.1080/08959420.2012.735177
Abstract: Using the newly created Freedom Poverty Measure, a multidimensional measure of poverty, it can be seen that there were 534,700 in iduals who were in freedom poverty, who had either poor health or poor education in addition to having low incomes. This multidimensional disadvantage would not normally be captured by single measures of poverty, such as income poverty measures. Men were significantly less likely to be in freedom poverty than women (OR = 0.63, 95% CI: 0.54-0.74, p < .0001), and the proportion of in iduals in freedom poverty increased with age, with those older than 85 being 2.3 times more likely to be in freedom poverty than those aged 65 to 69 years (95% CI: 1.73-3.11, p < .0001). Policy responses to address the marginalization of disadvantaged older people should take a multidisciplinary approach, addressing health inequalities in particular, not just low income.
The risk of falling into poverty after developing heart disease: A survival analysis
Publisher: Springer Science and Business Media LLC
Date: 15-07-2016
Psychological distress and the increased risk of falling into poverty: a longitudinal study of Australian adults
Publisher: Springer Science and Business Media LLC
Date: 21-05-2015
DOI: 10.1007/S00127-015-1074-6
Abstract: To identify whether psychological distress is associated with an increased risk of falling into poverty, giving a more complete picture of how psychological distress affects living standards. Longitudinal analysis of the nationally representative Household Income and Labour Dynamics in Australian (HILDA) survey using Poisson regression models to estimate relative risk of falling into income poverty and multidimensional poverty between 2007 and 2012. The s le was limited to those who were not already in income poverty in 2007. Psychological distress was identified using the Kessler-10 (K10) scale. After adjusting for confounding factors, having moderate psychological distress increased the risk of falling into income poverty by 1.62 (95% CI 1.31-2.01, p < 0.0001) and the risk of falling into multidimensional poverty by 1.85 (95% CI 1.37-2.48, p < 0.0001) having very high psychological distress increased the risk of falling into income poverty by 2.40 (95% CI 1.80-3.20, p < 0.0001) and the risk of falling into multidimensional poverty by 3.68 (95% CI 2.63-5.15, p < 0.0001), compared to those with low psychological distress. Those who did experience income poverty (RR: 1.29, 95% CI 1.04-1.61, p = 0.0210) and those who experienced multidimensional poverty (RR: 1.69, 95% CI 1.32-2.17, p < 0.0001) had an increased risk of having their level of psychological distress increase further compared to those who did not experience poverty. To date, the increased risk of falling into poverty that is associated with elevated levels of psychological distress has been an overlooked burden of the condition.
Productivity costs of cardiovascular disease mortality across disease types and socioeconomic groups
Publisher: BMJ
Date: 02-2019
DOI: 10.1136/OPENHRT-2018-000939
Abstract: Cardiovascular disease (CVD) is the single largest contributor to global mortality. Premature mortality due to CVD results in a loss of productivity, with associated economic and policy implications that are often overlooked. A human capital approach was adopted to project the long-term impacts of Australian CVD deaths in 2003 on labour force participation and the present value of lifetime income (PVLI) forgone. Impacts were modelled to the year 2030 and accounted for in idual characteristics at the time of death including age, sex and socioeconomic status. Premature deaths due to CVD in 2003 accounted for 51 659 working years and $2.69 billion in PVLI forgone when modelled to 2030 (95% CI $2.63 billion to $2.75 billion). The labour force impacts were highest for in iduals aged between 35 and 64 at the time of death, and male deaths accounted for 87% of the total PVLI loss. The most costly disease type was ischaemic heart disease, followed by stroke and inflammatory heart disease. Deaths occurring in in iduals residing in the most socioeconomically disadvantaged areas at the time of death had a disproportionately large impact on the total PVLI loss. This study quantifies the relative productivity costs of CVD mortality across a range of disease types and socioeconomic groups. The magnitude of these costs highlights the scope for investments in effective healthcare interventions to provide positive economic returns and may assist decision makers in allocating resources among competing priorities.
Modelling the economic impact of next generation sequencing and precision medicine on childhood cancer management—a microsimulation approach
Publisher: International Microsimulation Association
Date: 30-04-2021
DOI: 10.34196/IJM.00230
How should we measure the impact of chronic pain? Limitations of utility measurement using the EQ-5D and SF-6D
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2014
The impact of diabetes on the labour force participation, savings and retirement income of workers aged 45-64 years in Australia
Publisher: Public Library of Science (PLoS)
Date: 23-02-2015
The productivity costs of premature mortality due to cancer in Australia
Publisher: Public Library of Science (PLoS)
Date: 12-12-2016
A decision model to estimate the cost-effectiveness of intensity modulated radiation therapy (IMRT) compared to three dimensional conformal radiation therapy (3DCRT) in patients receiving radiotherapy to the prostate bed
Publisher: Elsevier BV
Date: 08-2014
DOI: 10.1016/J.RADONC.2014.03.020
Abstract: Intensity modulated radiation therapy (IMRT) is a radiation therapy technology that facilitates the delivery of an improved dose distribution with less dose to surrounding critical structures. This study estimates the longer term effectiveness and cost-effectiveness of IMRT in patients post radical prostatectomy. A Markov decision model was developed to calculate the incremental quality adjusted life years (QALYs) and costs of IMRT compared with three dimensional conformal radiation therapy (3DCRT). Costs were estimated from the perspective of the Australian health care system. IMRT was both more effective and less costly than 3DCRT over 20 years, with an additional 20 QALYs gained and over $1.1 million saved per 1000 patients treated. This result was robust to plausible levels of uncertainty. IMRT was estimated to have a modest long term advantage over 3DCRT in terms of both improved effectiveness and reduced cost. This result was reliant on clinical judgement and interpretation of the existing literature, but provides quantitative guidance on the cost effectiveness of IMRT whilst long term trial evidence is awaited.
Depression prevention, labour force participation and income of older working aged Australians
Publisher: SAGE Publications
Date: 25-11-2015
Abstract: Depression has economic consequences not only for the health system, but also for in iduals and society. This study aims to quantify the potential economic impact of five-yearly screening for sub-syndromal depression in general practice among Australians aged 45-64 years, followed by a group-based psychological intervention to prevent progression to depression. We used an epidemiological simulation model to estimate reductions in prevalence of depression, and a microsimulation model, Health& WealthMOD2030, to estimate the impact on labour force participation, personal income, savings, taxation revenue and welfare expenditure. Group therapy is estimated to prevent around 5,200 prevalent cases of depression (2.2%) and add about 520 people to the labour force. Private incomes are projected to increase by $19 million per year, tax revenues by $2.4 million, and transfer payments are reduced by $2.6 million. Group-based psychological intervention to prevent depression could result in considerable economic benefits in addition to its clinical effects.
How depression and other mental health problems can affect future living standards of those out of the labour force
Publisher: Informa UK Limited
Date: 07-2011
DOI: 10.1080/13607863.2011.556599
Abstract: To estimate the extent to which those who exit the workforce early due to mental health problems have less savings by the time they reach retirement age. Using Health & WealthMOD--a microsimulation model of Australians aged 45-64 years that predicts accumulated savings at age 65, regression models were used to analyse the differences between the projected savings and the retirement incomes of people at age 65 for those currently working with no chronic condition, and people not in the labour force due to mental health problems. Females who retire early due to depression have a median value of total savings by the time they are 65 of $300. For those with other mental health problems the median figure was $0. This is far lower than the median value of $227,900 for females with no chronic condition who remained employed full-time. Males showed similar differences. Both males and females who were out of the labour force due to depression or other mental health problems had at least 97% (95% CI: -99.9% to -68.7%) less savings and retirement income by age 65 that those who remained employed full-time. People who retire from the labour force early due to mental health problems will face long term financial disadvantage compared to people who are able to remain in employment.
The impact of chronic conditions of care recipients on the labour force participation of informal carers in Australia: Which conditions are associated with higher rates of non-participation in the labour force?
Publisher: Springer Science and Business Media LLC
Date: 05-06-2014
The impact of generational change and retirement on psychiatry to 2025
Publisher: Springer Science and Business Media LLC
Date: 04-09-2007
Abstract: Australia is currently experiencing widespread shortages of psychiatrists. The changing nature of the workforce and increasing demand mean that these shortages are unlikely to ease. This study aims to identify demographic change and retirement patterns of the Australian psychiatry workforce from 1995 to 2003, and the implications of those changes for future workforce planning. Data from the Australian Institute of Health and Welfare (AIHW) Medical Labour Force Survey from 1995 to 2003 is used to examine ageing of the psychiatry workforce and attrition of psychiatrists aged 50 years and over. Future attrition from the workforce is projected to 2025. Sixty two percent of psychiatrists practicing in the year 2000 are predicted to have retired by 2025. Most psychiatrists continue to work until late in life, with only 18 per cent retiring before age 65. The psychiatry workforce aged significantly between 1995 and 2003 (p 0.001), with men older than women in both years. A reduction in hours worked by psychiatrists reflects both the increasing proportion of females and the older members of the profession reducing their hours in preparation for retirement. The impact of ageing of the workforce may be more immediate for psychiatry than for some other health professions. With the growing proportion of females and their typically lower workforce participation, more than one younger psychiatrist will be required to replace each of the mostly male retirees.
Arthritis and the Risk of Falling into Poverty: A Survival Analysis Using Australian Data
Publisher: Wiley
Date: 23-12-2016
DOI: 10.1002/ART.39277
Abstract: Low income is known to be associated with having arthritis. However, no longitudinal studies have documented the relationship between developing arthritis and falling into poverty. The purpose of this study was to evaluate Australians who developed arthritis to determine if they had an elevated risk of falling into poverty. Survival analysis using Cox regression models was applied to nationally representative, longitudinal survey data obtained between January 1, 2007 and December 31, 2012 from Australian adults who were ages 21 years and older in 2007. The hazard ratio for falling into income poverty was 1.08 (95% confidence interval [95% CI] 1.06-1.09) in women who were diagnosed as having arthritis and 1.15 (95% CI 1.13-1.16) in men who were diagnosed as having arthritis, as compared to those who were never diagnosed as having arthritis. The hazard ratio for falling into multidimensional poverty was 1.15 (95% CI 1.14-1.17) in women who were diagnosed as having arthritis and 1.88 (95% CI 1.85-1.91) in men who were diagnosed as having arthritis. Developing arthritis increases the risk of falling into income poverty and multidimensional poverty. The risk of multidimensional poverty is greater than the risk of income poverty. Given the high prevalence of arthritis, the condition is likely an overlooked driver of poverty.
The impact of weight-loss interventions on health expenditure in Australia
Publisher: Elsevier BV
Date: 2019
Emergency Department Workforce Models: What the literature can tell us
Publisher: Wiley
Date: 02-2011
DOI: 10.1111/J.1742-6723.2010.01378.X
Abstract: The present study looks at what the literature can tell us about ex les of innovative ED staffing. Numerous medical databases, journals specific to emergency care, and key government agency sites were searched to obtain Australian and relevant international literature between 1995 and the present. Studies which discussed appropriate staffing arrangements in the EDs were assessed with preference given to those which gathered evidence about the staff mix. There is little literature available which looks at the entire staffing profile of an ED and assesses its effectiveness. The few papers that do exist conclude that senior staffing, matching peak staffing levels with peak patient demand, having appropriately skilled staff mixes and designing the staff profile based upon in idual hospital needs produces the most effective outcomes. Although there are some lessons to be learnt from the success of the staffing of various teams, and the introduction of new roles in the EDs, there are still significant gaps within the literature. There is a need for assessment of the effectiveness of various ED-wide staffing profiles (rather than just in idual teams within an ED).
The health consequences of unemployment: the evidence
Publisher: AMPCo
Date: 08-1998
Trans Tasman Radiation Oncology Group: Development of the Assessment of New Radiation Oncology Technology and Treatments (ANROTAT) Framework
Publisher: Wiley
Date: 27-10-2015
Abstract: The study aim was to develop a generic framework to derive the parameters to populate health-economic models for the rapid evaluation of new techniques and technologies in radiation oncology. A draft framework was developed through horizon scanning for relevant technologies, literature review to identify framework models, and a workshop program with radiation oncology professionals, biostatisticians, health economists and consumers to establish the Framework's structure. It was tested using four clinical protocols, comparing intensity modulated with 3D conformal therapy (post-prostatectomy, anal canal and nasopharynx) and image-guided radiation therapy techniques with off-line review of portal imaging (in the intact prostate). The draft generic research framework consisted of five sequential stages, each with a number of components, and was assessed as to its suitability for deriving the evidence needed to populate the decision-analytic models required for the health-economic evaluations. A final Framework was established from this experience for use by future researchers to provide evidence of clinical efficacy and cost-utility for other novel techniques. The four clinical treatment sites tested during the project were considered suitable to use in future evaluations. Development of a generic research framework to predict early and long-term clinical outcomes, combined with health-economic data, produced a generally applicable method for the rapid evaluation of new techniques and technologies in radiation oncology. Its application to further health technology assessments in the radiation oncology sector will allow further refinement and support its generalisability.
Access to general practitioner services amongst underserved Australians: A microsimulation study
Publisher: Springer Science and Business Media LLC
Date: 22-01-2012
The personal and national costs of mental health conditions: Impacts on income, taxes, government support payments due to lost labour force participation
Publisher: Springer Science and Business Media LLC
Date: 28-04-2011
An economic analysis of the cost of survival of micro preemies: A systematic review
Publisher: Elsevier BV
Date: 06-2022
DOI: 10.1016/J.SINY.2022.101336
Abstract: This study aimed to systematically review the current literature on the economic costs of micro preemie as well as evidence on the cost-effectiveness of interventions to improve outcomes for micro preemie babies with a birth weight of ≤500 g. We searched MEDLINE, CINAHL, Scopus, ECONLIT, Business Source Premier and Cochrane Library for studies reporting costs of micro preemie from January 2000. Costs were inflated to 2019 United States dollars (US$). All full-text articles were assessed for eligibility and a quality assessment of included articles was conducted using the Drummond and the Larg and Moss checklists. The search identified three studies that met the inclusion criteria two cost-of-illness studies and one cost-effectiveness study. Across studies, the mean healthcare spending per micro preemie survivor (in 2019 US$) ranged from US$61,310 (birth admission) to US$263,958 (inpatient and outpatient for the first six months of life). One modelling study reported exclusive human milk diet for micro preemies at birth was more cost-effective compared to the standard approach with cow milk diet from the third-party payer and societal perspectives. Despite significant advances in perinatal care and expanded access to life-saving equipment to improve survival outcomes of micro preemie, there remains a paucity of research on economic costs associated with these babies. No study has utilised quality-adjusted life-years as an outcome measure. Given the chronic conditions and long-term neurologic disability associated with micro preemie survivors, an estimate of the lifetime cost to the in idual, healthcare providers and society would provide a benchmark of the potential cost-savings that could accrue from cost-effective interventions to improve the survival rate of micro preemies.
Premature retirement due to ill health and income poverty: A cross-sectional study of older workers
Publisher: BMJ
Date: 2013
The individual and socioeconomic impact of osteoarthritis
Publisher: Springer Science and Business Media LLC
Date: 25-03-2014
Abstract: Osteoarthritis (OA) is a highly prevalent, disabling disease, with a commensurate tremendous in idual and socioeconomic burden. This Perspectives article focuses on the burden of OA for the in idual, the health-care system and society, to draw attention to the magnitude of the current problem with some reference to projected figures. We have an urgent opportunity to make fundamental changes to the way we care for in iduals with OA that will have an effect upon the direct and indirect costs of this disease. By focusing on the burden of this prevalent, disabling, and costly disease, we hope to highlight the opportunity for shifts in health-care policy towards prevention and chronic-disease management.
The Development of a microsimulation model (MitoMOD) to estimate the economic impact of mitochondrial disease in adults
Publisher: International Microsimulation Association
Date: 31-08-2022
DOI: 10.34196/IJM.00265
Lost productive life years caused by chronic conditions in Australians aged 45–64 years, 2010–2030
Publisher: AMPCo
Date: 09-2015
DOI: 10.5694/MJA15.00132
Abstract: To estimate (1) productive life years (PLYs) lost because of chronic conditions in Australians aged 45-64 years from 2010 to 2030, and (2) the impact of this loss on gross domestic product (GDP) over the same period. A microsimulation model, Health&WealthMOD2030, was used to project lost PLYs caused by chronic conditions from 2010 to 2030. The base population consisted of respondents aged 45-64 years to the Australian Bureau of Statistics Survey of Disability, Ageing and Carers 2003 and 2009. The national impact of lost PLYs was assessed with Treasury's GDP equation. Lost PLYs due to chronic disease at 2010, 2015, 2020, 2025 and 2030 (ie, whole life years lost because of chronic disease) the national impact of lost PLYs at the same time points (GDP loss caused by PLYs) the effects of population growth, labour force trends and chronic disease trends on lost PLYs and GDP at each time point. Using Health&WealthMOD2030, we estimated a loss of 347,000 PLYs in 2010 this was projected to increase to 459,000 in 2030 (32.28% increase over 20 years). The leading chronic conditions associated with premature exits from the labour force were back problems, arthritis and mental and behavioural problems. The percentage increase in the number of PLYs lost by those aged 45-64 years was greater than that of population growth for this age group (32.28% v 27.80%). The strongest driver of the increase in lost PLYs was population growth (accounting for 89.18% of the increase), followed by chronic condition trends (8.28%). Our study estimates an increase of 112 000 lost PLYs caused by chronic illness in older workers in Australia between 2010 and 2030, with the most rapid growth projected to occur in men aged 55-59 years and in women aged 60-64 years. The national impact of this lost labour force participation on GDP was estimated to be $37.79 billion in 2010, increasing to $63.73 billion in 2030.
Clinical and Economic Outcomes of Genome Sequencing Availability on Containing a Hospital Outbreak of Resistant Escherichia coli in Australia
Publisher: Elsevier BV
Date: 08-2020
Integrating exome sequencing into a diagnostic pathway for epileptic encephalopathy: Evidence of clinical utility and cost effectiveness
Publisher: Wiley
Date: 17-06-2216
DOI: 10.1002/MGG3.355
How co-morbidities magnify the effect of arthritis on labour force participation and economic status: A costs of illness study in Australia
Publisher: Springer Science and Business Media LLC
Date: 22-02-2014
DOI: 10.1007/S00296-014-2967-5
Abstract: Few studies have assessed the impact of co-morbid conditions amongst patients with arthritis. This study will quantify the impact co-morbid health conditions have on the labour force status and economic circumstances of people with arthritis. This study uses a microsimulation model, Health&WealthMOD, to quantify the impact of co-morbidities on the labour force participation and economic circumstances of 45- to 64-year-old Australians with arthritis. The results show that the probability of being out of the labour force increases with increasing number of co-morbidities. However, there was no statistically significant difference in the amount of weekly private income received by people with arthritis and no co-morbidities, and people with arthritis and one or two co-morbidities. However, those with arthritis and three or more co-morbidities received a weekly private income 72 % lower than people with arthritis alone (95 % CI -82, -57). People with arthritis and co-morbidities paid less in tax and received more in government transfer payments. As such, it is important to consider the co-morbid conditions an in idual has when assessing the impact of arthritis on labour force participation and economic circumstances. People with arthritis that have multiple co-morbid conditions are likely to have their labour force participation and economic circumstances interrupted much more than those with arthritis only.
The effects of technological developments on nuclear medicine technologist productivity: A systematic review
Publisher: Cambridge University Press (CUP)
Date: 07-2009
DOI: 10.1017/S0266462309990195
Abstract: Objectives: Nuclear medicine has changed rapidly as a result of technological developments. Very little is reported on the effects these developments may have on technologist productivity. This study aims to determine whether advances have created a workplace where more patient studies can be performed with fewer technologists. The level of change in automation or time taken to perform a routine task by the nuclear medicine technologist as a result of technological development over the past decade is reported. Methods: A systematic review was conducted using Embase.com, Medline, INSPEC, and Cinahl. Two authors reviewed each article for eligibility. Technological developments in routine areas over the past decade were reviewed. The resultant automation or time effects on data acquisition, data processing, and image processing were summarized. Results: Sixteen articles were included in the areas of myocardial perfusion, information technology, and positron emission tomography (PET). Gamma camera design has halved the acquisition time for myocardial perfusion studies, automated analysis requires little manual intervention and information technologies and filmless departments are more efficient. Developments in PET have reduced acquisition to almost one-fifth of the time. Conclusions: Substantial efficiencies have occurred over the decade thereby increasing productivity, but whether staffing levels are appropriate for safe, high quality practice is unclear. Future staffing adequacy is of concern given the anticipated increasing service needs.
Whole exome and genome sequencing in mendelian disorders
Publisher: Springer Science and Business Media LLC
Date: 15-08-2022
DOI: 10.1038/S41431-022-01162-2
Abstract: Whole genome sequencing (WGS) improves Mendelian disorder diagnosis over whole exome sequencing (WES) however, additional diagnostic yields and costs remain undefined. We investigated differences between diagnostic and cost outcomes of WGS and WES in a cohort with suspected Mendelian disorders. WGS was performed in 38 WES-negative families derived from a 64 family Mendelian cohort that previously underwent WES. For new WGS diagnoses, contemporary WES reanalysis determined whether variants were diagnosable by original WES or unique to WGS. Diagnostic rates were estimated for WES and WGS to simulate outcomes if both had been applied to the 64 families. Diagnostic costs were calculated for various genomic testing scenarios. WGS diagnosed 34% (13/38) of WES-negative families. However, contemporary WES reanalysis on average 2 years later would have diagnosed 18% (7/38 families) resulting in a WGS-specific diagnostic yield of 19% (6/31 remaining families). In WES-negative families, the incremental cost per additional diagnosis using WGS following WES reanalysis was AU$36,710 (£19,407 US$23,727) and WGS alone was AU$41,916 (£22,159 US$27,093) compared to WES-reanalysis. When we simulated the use of WGS alone as an initial genomic test, the incremental cost for each additional diagnosis was AU$29,708 (£15,705 US$19,201) whereas contemporary WES followed by WGS was AU$36,710 (£19,407 US$23,727) compared to contemporary WES. Our findings confirm that WGS is the optimal genomic test choice for maximal diagnosis in Mendelian disorders. However, accepting a small reduction in diagnostic yield, WES with subsequent reanalysis confers the lowest costs. Whether WES or WGS is utilised will depend on clinical scenario and local resourcing and availability.
Prioritising the application of genomic medicine
Publisher: Springer Science and Business Media LLC
Date: 21-11-2017
DOI: 10.1038/S41525-017-0037-0
Abstract: The clinical translation of genomic sequencing is h ered by the limited information available to guide investment into those areas where genomics is well placed to deliver improved health and economic outcomes. To date, genomic medicine has achieved its greatest successes through applications to diseases that have a high genotype–phenotype correlation and high penetrance, with a near certainty that the in idual will develop the condition in the presence of the genotype. It has been anticipated that genomics will play an important role in promoting population health by targeting at-risk in iduals and reducing the incidence of highly prevalent, costly, complex diseases, with potential applications across screening, prevention, and treatment decisions. However, where primary or secondary prevention requires behavioural changes, there is currently very little evidence to support reduction in disease incidence. A better understanding of the relationship between genomic variation and complex diseases will be necessary before effective genomic risk identification and management of the risk of complex diseases in healthy in iduals can be carried out in clinical practice. Our recommended approach is that priority for genomic testing should focus on diseases where there is strong genotype–phenotype correlation, high or certain penetrance, the effects of the disease are serious and near-term, there is the potential for prevention and/or treatment, and the net costs incurred are acceptable for the health gains achieved.
Preimplantation genetic diagnosis for retinoblastoma survivors
Publisher: Elsevier BV
Date: 06-2020
Effectiveness of a New Service Delivery Model for Management of Knee Osteoarthritis in Primary Care: A Cluster Randomized Controlled Trial
Publisher: Wiley
Date: 29-12-2023
DOI: 10.1002/ACR.25037
Abstract: To evaluate the effectiveness and health costs of a new primary care service delivery model (the Optimising Primary Care Management of Knee Osteoarthritis [PARTNER] model) to improve health outcomes for patients with knee osteoarthritis (OA) compared to usual care. This study was a 2‐arm, cluster, superiority, randomized controlled trial with randomization at the general practice level, undertaken in Victoria and New South Wales, Australia. We aimed to recruit 44 practices and 572 patients age ≥45 years with knee pain for months. Professional development opportunities on best practice OA care were provided to intervention group general practitioners (GPs). All recruited patients had an initial GP visit to confirm knee OA diagnosis. Control patients continued usual GP care, and intervention patients were referred to a centralized care support team (CST) for 12‐months. Via telehealth, the CST provided OA education and an agreed OA action plan focused on muscle strengthening, physical activity, and weight management. Primary outcomes were patient self‐reported change in knee pain (Numerical Rating Scale [range 0–10 higher score = worse]) and physical function (Knee Injury and Osteoarthritis Outcome Score activities of daily living subscale [range 0–100 higher score = better] at 12 months. Health care cost outcomes included costs of medical visits and prescription medications over the 12‐month period. Recruitment targets were not reached. A total of 38 practices and 217 patients were recruited. The intervention improved pain by 0.8 of 10 points (95% confidence interval [95% CI] 0.2, 1.4) and function by 6.5 of 100 points (95% CI 2.3, 10.7), more than usual care at 12 months. Total costs of medical visits and prescriptions were $3,940 (Australian) for the intervention group versus $4,161 for usual care. This difference was not statistically significant. The PARTNER model improved knee pain and function more than usual GP care. The magnitude of improvement is unlikely to be clinically meaningful for pain but is uncertain for function.
Economic costs of chronic disease through lost productive life years (PLYs) among Australians aged 45–64 years from 2015 to 2030
Publisher: BMJ
Date: 09-2016
Cost-effectiveness of Multidisciplinary Interventions for Chronic Low Back Pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 22-11-2021
DOI: 10.1097/AJP.0000000000001009
Abstract: Chronic musculoskeletal pain in adults is a global health and economic problem. The aim of this paper was to systematically review and determine what proportion of multidisciplinary approaches to managing chronic musculoskeletal pain are cost-effective. The EconLit, Embase, and PubMed electronic databases were searched for randomized and nonrandomized economic evaluation studies of nonpharmaceutical multidisciplinary chronic pain management interventions published from inception through to August 2019. Seven studies comprising 2095 patients were included. All studies involved erse multidisciplinary teams in one or more of the study arms. All studies involved chronic (both chronic and subacute) low back pain and were economic evaluations from either a societal or health care perspective. Two of the 3 studies that reported on a multidisciplinary pain intervention compared with nonmultidisciplinary intervention concluded favorable cost-effectiveness based on cost per quality adjusted life years gained, 1 study was not found to be cost-effective. Cost-effectiveness of the multidisciplinary intervention of interest was also not established by another 3-arm study. Two studies compared 2 multidisciplinary interventions neither of these could definitively declare cost-effectiveness. The remaining study indicated the intervention by a multidisciplinary team was more effective but at a higher cost. None of the included studies used decision models to estimate long-term health outcomes and cost-effectiveness of multidisciplinary programs. There are few studies on the cost-effectiveness of multidisciplinary chronic pain management interventions. This study encourages additional rigorous economic evaluations of multidisciplinary models for chronic pain management. Economic evaluations that enable extrapolating costs and effects of multidisciplinary programs beyond the time horizon of clinical trials may be more informative for clinicians and health administrators.
Cost-effectiveness of massively parallel sequencing for diagnosis of paediatric muscle diseases
Publisher: Springer Science and Business Media LLC
Date: 03-03-2017
DOI: 10.1038/S41525-017-0006-7
Abstract: Childhood-onset muscle disorders are genetically heterogeneous. Diagnostic workup has traditionally included muscle biopsy, protein-based studies of muscle specimens, and candidate gene sequencing. High throughput or massively parallel sequencing is transforming the approach to diagnosis of rare diseases however, evidence for cost-effectiveness is lacking. Patients presenting with suspected congenital muscular dystrophy or nemaline myopathy were ascertained over a 15-year period. Patients were investigated using traditional diagnostic approaches. Undiagnosed patients were investigated using either massively parallel sequencing of a panel of neuromuscular disease genes panel, or whole exome sequencing. Cost data were collected for all diagnostic investigations. The diagnostic yield and cost effectiveness of a molecular approach to diagnosis, prior to muscle biopsy, were compared with the traditional approach. Fifty-six patients were analysed. Compared with the traditional invasive muscle biopsy approach, both the neuromuscular disease panel and whole exome sequencing had significantly increased diagnostic yields (from 46 to 75% for the neuromuscular disease panel, and 79% for whole exome sequencing), and reduced the cost per diagnosis from USD$16,495 (95% CI: $12,413–$22,994) to USD$3706 (95% CI: $3086–$4453) for the neuromuscular disease panel and USD$5646 (95% CI: $4501–$7078) for whole exome sequencing. The neuromuscular disease panel was the most cost-effective, saving USD$17,075 (95% CI: $10,654–$30,064) per additional diagnosis, over the traditional diagnostic pathway. Whole exome sequencing saved USD$10,024 (95% CI: $5795–$17,135) per additional diagnosis. This study demonstrates the cost-effectiveness of investigation using massively parallel sequencing technologies in paediatric muscle disease. The findings emphasise the value of implementing these technologies in clinical practice, with particular application for diagnosis of Mendelian diseases, and provide evidence crucial for government subsidy and equitable access.
Baby boomer retirement and the future of dentistry
Publisher: Wiley
Date: 06-2007
DOI: 10.1111/J.1834-7819.2007.TB00479.X
Abstract: The dental workforce, like the Australian population, is ageing. As the large baby boomer cohort retires dental shortages will likely increase. Australian Bureau of Statistics census data from 1986 to 2001 were used to examine ageing of the dental workforce and attrition of dentists aged 50 years and over. The number of dentists to retire was projected over the next 20 years. Since 1986, the dental workforce has aged significantly (p < 0.01). About half of the current dental workforce is projected to retire by 2026. Generation X dentists are significantly less likely to work long hours than the baby boomer cohort of dentists (p 41 per week) than male baby boomer dentists (p < 0.01). Ageing of the workforce will have an impact on dentistry later than on some other professions due to the 35 per cent of dentists who work beyond 65 years of age. Nonetheless, existing dental shortages are likely to be exacerbated over the short term by the 22 per cent of dentists projected to retire over the next 10 years.
The personal and national costs of CVD: Impacts on income, taxes, government support payments and GDP due to lost labour force participation
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.IJCARD.2011.09.066
Abstract: CVD has the ability to interrupt an in idual's ability to participate in the labour force, and this can have considerable follow-up on impacts to both the in idual and the state. This study aimed to quantify the personal cost of lost income and the cost to the state from lost income taxation, increased benefit payments and lost GDP as a result of early retirement due to CVD in Australians aged 45-64 in 2009. Cross-sectional analysis of the base population of Health&WealthMOD, a microsimulation model built on data from the Australian Bureau of Statistics' Survey of Disability, Ageing and Carers and STINMOD, an income and savings microsimulation model. In iduals aged 45 to 64 years who have retired early due to CVD have a median value of total weekly income of only $268 whereas those who are employed full time are likely to have almost five times this. The national aggregate impact of CVD through the loss of labour force participation amongst 45 to 64 year olds, equated to around AU$1.1 billion in lost income, $AU225 million in lost income taxation revenue, AU$85 million in additional government benefit payments, and AU$748 million in lost GDP, in 2009 alone. The costs of CVD to both in iduals and the state are considerable. Whilst in iduals bear the economic costs of lost income in addition to the burden of the condition itself, the state impacts are loss of productivity from reduced workforce participation, lost income taxation revenue, and increasing government support payments - in addition to direct health care costs.
Multiple chronic health conditions and their link with wealth assets
Publisher: Oxford University Press (OUP)
Date: 05-09-2015
Abstract: There has been little research on the economic status of those with multiple health conditions, particularly on the relationship between multiple health conditions and wealth. This paper will assess the difference in the value and type of wealth assets held by Australians who have multiple chronic health conditions. Using Health&WealthMOD, a microsimulation model of the 45-64-year-old Australian population in 2009, a counterfactual analysis was undertaken. The actual proportion of people with different numbers of chronic health conditions with any wealth, and the value of this wealth was estimated. This was compared with the counterfactual values had the in iduals had no chronic health conditions. There was no change in the proportion of people with one health condition who actually had any wealth, compared to the counterfactual proportion had they had no chronic health conditions. Ninety-four percent of those with four or more health conditions had some accumulated wealth however, under the counterfactual, 100% would have had some accumulated wealth. There was little change in the value of non-income-producing assets under the counterfactual, regardless of number of health conditions. Those with four or more chronic health conditions had a mean value of $17 000 in income-producing assets under the counterfactual, the average would have been $78 000. This study has highlighted the variation in the value of wealth according to number of chronic health conditions, and hence the importance of considering multiple morbidities when discussing the relationship between health and wealth.
Whole-exome sequencing reanalysis at 12 months boosts diagnosis and is cost-effective when applied early in Mendelian disorders
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1038/GIM.2018.39
Abstract: Whole-exome sequencing (WES) has revolutionized Mendelian diagnostics, however, there is no consensus on the timing of data review in undiagnosed in iduals and only preliminary data on the cost-effectiveness of this technology. We aimed to assess the utility of WES data reanalysis for diagnosis in Mendelian disorders and to analyze the cost-effectiveness of this technology compared with a traditional diagnostic pathway. WES was applied to a cohort of 54 patients from 37 families with a variety of Mendelian disorders to identify the genetic etiology. Reanalysis was performed after 12 months with an improved WES diagnostic pipeline. A comparison was made between costs of a modeled WES pathway and a traditional diagnostic pathway in a cohort with intellectual disability (ID). Reanalysis of WES data at 12 months improved diagnostic success from 30 to 41% due to interim publication of disease genes, expanded phenotype data from referrer, and an improved bioinformatics pipeline. Cost analysis on the ID cohort showed average cost savings of US$586 (AU$782) for each additional diagnosis. Early application of WES in Mendelian disorders is cost-effective and reanalysis of an undiagnosed in idual at a 12-month time point increases total diagnoses by 11%.
Chapter 7 Projections of Commonwealth Health Expenditure in Australia's First Intergenerational Report
Publisher: Elsevier
Date: 2007
Truncated careers in nuclear medicine technology: increased job control may improve retention
Publisher: CSIRO Publishing
Date: 2011
DOI: 10.1071/AH09822
Abstract: Objectives. The aim of the study was to gain understanding of why nuclear medicine technologists (NMTs) leave and to compare workforce and service provision trends with diagnostic imaging professionals. Design and setting. A survey of all NMT professional body members in New South Wales, the Australian Capital Territory and Queensland was conducted. This paper reports on survey findings of those no longer working as a NMT. Analysis of 1996, 2001 and 2006 Australian Census data and Medicare statistics was made for NMTs, sonographers and radiographers. Main outcome measures. The five most influential reasons for leaving nuclear medicine were measured by survey. Census data measured workforce characteristics size, sex, age. Medicare statistics measured national service provision. Results. Primarily, limited career pathways and professional plateau influence retention of NMTs, with sonography a common career move. Nuclear medicine technologists are young (44.3% years) compared with radiography (52.3% years) or sonography (52.8% years). From 2001 to 2006, service provision in nuclear medicine grew by 11.8% compared with 36% in ultrasound but the workforce size decreased by 4.9% whereas sonographers increased by 51.1%. Conclusions. Increasing the level of job control is the most likely factor in creating a positive change to the NMT job characteristics and improving retention. What is known about the topic? The early and high level of attrition of NMTs with an overall decrease in workforce size from 2001 to 2006 and a corresponding increase in service provision has been reported by the authors of this paper. A comparison of age distribution patterns between NMTs, diagnostic radiographers and radiation therapists from the 1996 and 2001 Australian Bureau of Statistics Census showed NMTs to have a much younger workforce, indicating that workers do not remain long in the field. A direct career pathway to sonography exists for NMTs, with an indication that there is movement to this field. The levels of work engagement and job satisfaction in private and public NMTs have been reported, with factors influencing these levels identified. What does this paper add? This paper reports findings of a survey of NMTs who have left the workforce, providing insight into the most influential reasons for leaving and the type of position to which the in idual moves. The NMT and sonography workforce age distribution patterns from the 2006 Census data are compared with those for diagnostic radiography to determine whether the previously reported NMT downward trend remains. A comparison of ultrasound, radiography and nuclear medicine service provision between 2001 and 2006 is made to explore factors that may affect changes to workforce size. This paper builds on findings of the NMT’s levels of work engagement and satisfaction to more fully understand why such high levels of attrition occur. What are the implications for practitioners? This paper highlights the need for a change of structure to the NMT job in order to keep more experienced workers in the field. The NMT attrition, in conjunction with the anticipated national population trends with an increasing elderly population, places the quality of nuclear medicine services at risk. The present rapid turnover leads to a workforce in which the majority are young with limited experience.
Healthcare resource utilization of patients with mitochondrial disease in an outpatient hospital setting
Publisher: Springer Science and Business Media LLC
Date: 29-05-2023
DOI: 10.1186/S13023-023-02746-X
Abstract: Mitochondrial diseases present as multi-system disorders requiring a comprehensive multidisciplinary approach. The data on healthcare resource utilization associated with mitochondrial diseases and the clinical drivers of these costs are limited including for the out-patient setting where the majority of the clinical care for mitochondrial disease patients occurs. We performed a cross-sectional retrospective study of out-patient healthcare resource utilization and costs for patients with a confirmed diagnosis of mitochondrial disease. We recruited participants from the Mitochondrial Disease Clinic in Sydney and stratified them into three groups: those with mitochondrial DNA (mtDNA) mutations (Group 1), those with nuclear DNA (nDNA) mutations and the predominant phenotype of chronic progressive external ophthalmoplegia (CPEO) or optic atrophy (Group 2) and those without a confirmed genetic diagnosis but clinical criteria and muscle biopsy findings supportive of a diagnosis of mitochondrial disease (Group 3). Data was collected through retrospective chart review and out-patient costs were calculated using the Medicare Benefits Schedule. We analyzed the data from 91 participants and found that Group 1 had the greatest average out-patient costs per person per annum ($838.02 SD 809.72). Neurological investigations were the largest driver of outpatient healthcare costs in all groups (average costs per person per annum:—Group 1: $364.11 SD 340.93, Group 2: $247.83 SD 113.86 and Group 3: $239.57 SD 145.69) consistent with the high frequency (94.5%) of neurological symptoms. Gastroenterological and cardiac-related out-patient costs were also major contributors to out-patient healthcare resource utilization in Groups 1 and 3. In Group 2, ophthalmology was the second-most resource intensive specialty ($136.85 SD 173.35). The Group 3 had the greatest average healthcare resource utilization per person over the entire duration of out-patient clinic care ($5815.86 SD 3520.40) most likely due to the lack of a molecular diagnosis and a less customized management approach. The drivers of healthcare resource utilization are dependent on the phenotype–genotype characteristics. Neurological, cardiac, and gastroenterological costs were the top three drivers in the out-patient clinics unless the patient had nDNA mutations with predominant phenotype of CPEO and/or optic atrophy wherein ophthalmological-related costs were the second most resource intensive driver.
The health care and societal costs of inherited retinal diseases in Australia
Publisher: Wiley
Date: 10-06-2023
DOI: 10.5694/MJA2.51997
Abstract: To estimate the health care and societal costs of inherited retinal diseases (IRDs) in Australia. Microsimulation modelling study based on primary data — collected in interviews of people with IRDs who had ophthalmic or genetic consultations at the Children's Hospital at Westmead or the Save Sight Institute (both Sydney) during 1 January 2019 – 31 December 2020, and of their carers and spouses — and linked Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Schedule (PBS) data. Annual and lifetime costs for people with IRDs and for their carers and spouses, grouped by payer (Australian government, state governments, in iduals, private health insurance) and type (health care costs societal costs: social support, National Disability Insurance Scheme (NDIS), income and taxation, costs associated with caring for family members with IRDs) estimated annual national cost of IRDs. Ninety‐four people (74 adults, 20 people under 18 years 55 girls and women [59%]) and 30 carers completed study surveys (participation rate: adults, 66% children, 66% carers, 63%). Total estimated lifetime cost was $5.2 million per person with an IRD, of which 87% were societal and 13% health care costs. The three highest cost items were lost income for people with IRDs ($1.4 million), lost income for their carers and spouses ($1.1 million), and social spending by the Australian government (excluding NDIS expenses: $1.0 million). Annual costs were twice as high for people who were legally blind as for those with less impaired vision ($83 910 v $41 357 per person). The estimated total annual cost of IRDs in Australia was $781 million to $1.56 billion. As the societal costs associated with IRDs are much larger than the health care costs, both contributors should be considered when assessing the cost‐effectiveness of interventions for people with IRDs. The increasing loss of income across life reflects the impact of IRDs on employment and career opportunities.
Psychological distress increases the risk of falling into poverty amongst older Australians: The overlooked costs-of-illness
Publisher: Springer Science and Business Media LLC
Date: 17-04-2018
Effect of asthma on falling into poverty: The overlooked costs of illness
Publisher: Elsevier BV
Date: 05-2015
DOI: 10.1016/J.ANAI.2015.02.017
Abstract: Studies on the indirect costs of asthma have taken a narrow view of how the condition affects the living standards of patients by examining only the association with employment and income. To build on the current cost-of-illness literature and identify whether having asthma is associated with an increased risk of poverty, thus giving a more complete picture of the costs of asthma to in iduals and society. Longitudinal analysis of the nationally representative Household Income and Labour Dynamics in Australian survey to estimate the relative risk of income poverty, multidimensional poverty, and long-term multidimensional poverty between 2007 and 2012 and population attributable risk method to estimate the proportion of poverty between 2007 and 2012 directly attributable to asthma. No significant difference was found in the risk of falling into income poverty between those with and without asthma (P = .07). Having asthma increased the risk of falling into multidimensional poverty by 1.35 (95% confidence interval [CI], 1.01-1.83) and the risk of falling into chronic multidimensional poverty by 2.22 (95% CI, 1.20-4.10). Between 2007 and 2012, a total of 5.2% of income poverty cases (95% CI, 5.1%-5.4%), 7.8% of multidimensional poverty cases (95% CI, 7.7%-8.0%), and 19.6% of chronic multidimensional poverty cases (95% CI, 19.2%-20.0%) can be attributed to asthma. Asthma is associated with an increased risk of falling into poverty. This should be taken into consideration when considering the suitability of different treatment options for patients with asthma.
The economic impact of diabetes through lost labour force participation on individuals and government: Evidence from a microsimulation model
Publisher: Springer Science and Business Media LLC
Date: 04-03-2014
The impact of poverty on self-efficacy: An australian longitudinal study
Publisher: Oxford University Press (OUP)
Date: 03-03-2016
Abstract: People with strong feelings of 'self-efficacy', i.e. how much a person feels they have control over their life, perform better in the workplace. However, little is known about negative influences on feelings of self-efficacy. In view of the increasing number of people whose income places them below the poverty line despite being in employment, poverty may negatively influence feelings of self-efficacy and hence workplace productivity. To assess whether falling into poverty lowers self-efficacy. Longitudinal analysis of waves 7 to 11 of the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) survey, using linear regression models. Those who fell into multidimensional poverty (income poverty plus poor health or insufficient level of education attainment) had significantly lower self-efficacy scores (up to 18% lower (95% CI -31% to -1%, P < 0.05)) than those never in poverty, after accounting for initial self-efficacy score and other confounding factors. Income uniquely accounted for 3% of the variance in self-efficacy scores, physical health for 10%, mental health for 78% and education for 1%. Given the known links between self-efficacy and workplace productivity, workers who are below the poverty line may be at risk of poor productivity due to the experience of poverty. In addition to the poor outcomes from the employer's perceptive, this may also lead to a negative spiral for the employee.
Will the Australian nuclear medicine technologist workforce meet anticipated health care demands?
Publisher: CSIRO Publishing
Date: 2008
DOI: 10.1071/AH080282
Abstract: Determination of national nuclear medicine technologist workforce size was made from census data in 2001 and 1996 and from the professional body in 2004. A survey conducted by the authors in 2005 provided retention patterns in north-eastern Australia and suggested causes. Utilisation of nuclear medicine diagnostic services was established through the Medicare Benefits Schedule group statistics. More than half the nuclear medicine technologist workforce is under 35 years of age. Attrition commences from age 30, with very few workers over 55 years. In 2005 there was a 12% attrition of the survey workforce. In the past decade, service provision increased while workforce size decreased and the nuclear medicine technologist workforce is at risk of failing to meet the anticipated rise in health service needs.
Related Organisations
Department Of Health And Ageing, Australian Government
Location: No location found
National Centre For Social And Economic Modelling
Location: Australia
Department Of Family And Community Services, Australian Government
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Department Of Health And Ageing, Australian Government
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