Electronic Portable Health File (PHF) To Promote Quality Of Care And Workflow Through Continuity Of Care
Funder
National Health and Medical Research Council
Funding Amount
$694,745.00
Summary
The medical of older individuals with chronicdiseases and with multiple doctors is complex and burdensome for the patient. We have done work where the patient is given charge of a portable personal health record that he-she can update as needed and care givers update at ofiice visits. The preliminary work is positive. Two types have been investigated, an electronic patient health file (on a data stick) and a wallet size booklet. Both have been found accceptable. The goal of this project is to se ....The medical of older individuals with chronicdiseases and with multiple doctors is complex and burdensome for the patient. We have done work where the patient is given charge of a portable personal health record that he-she can update as needed and care givers update at ofiice visits. The preliminary work is positive. Two types have been investigated, an electronic patient health file (on a data stick) and a wallet size booklet. Both have been found accceptable. The goal of this project is to see if short term acceptability and satisfaction will translate into later improved outcomes such as a reduced rate of hospitalizations.Read moreRead less
Does Place Of Birth Influence A Healthy Start To Life?
Funder
National Health and Medical Research Council
Funding Amount
$343,050.00
Summary
There are over 255,000 births in Australia each year and a major challenge in terms of planning and provision is to ensure that these babies are born in hospitals with the appropriate facilities to care for them. International studies suggest that transferring the mother before birth results in better infant outcomes than transferring the baby after birth. In Australia births occur in a range of hospitals, from small rural hospitals to tertiary obstetric and neonatal centres. However, few Austra ....There are over 255,000 births in Australia each year and a major challenge in terms of planning and provision is to ensure that these babies are born in hospitals with the appropriate facilities to care for them. International studies suggest that transferring the mother before birth results in better infant outcomes than transferring the baby after birth. In Australia births occur in a range of hospitals, from small rural hospitals to tertiary obstetric and neonatal centres. However, few Australian studies have looked at infant outcomes based on place of birth. This study will use existing population health data sets to evaluate the provision of care prior to and at birth and the impact it has on infant outcomes up to one year of age. It will also describe for the first time the hospital care utilisation associated with birth and infant health. Information will be obtained from routinely-collected birth, death and birth defect registers, and hospital, midwives and perinatal death review data. Variations in health outcomes for babies may be due to factors that occur before or during pregnancy, or may be due to differences in the care provided at birth. We need to take account of maternal factors to comprehensively assess the role of level of care at birth. We will use statistical techniques to 'predict' infant health outcomes and see if differences between places of birth are real or not. If variations are explained by different levels of care then there is enormous potential for improvement in the provision of pregnancy and newborn services. We will also compare the benefits and consequences of maternal versus neonatal transfer, and assess hospital costs. The results of this study could be applied to direct health services policy and organisational changes to improve pregnancy care and optimise infant outcomes for a healthy start to life.Read moreRead less
Determining Critical Points In The Potential Palliative Care Pathway In The Last Year Of Life
Funder
National Health and Medical Research Council
Funding Amount
$356,461.00
Summary
People with serious illnesses who are approaching the end of their lives undergo a journey where, along the way, they experience several critical points. Although we know these critical points are crucial to how they might access the best kind of care, we are unsure exactly when these points may occur and how they may vary for different kinds of people. We need to know when is the best time to start withdrawing invasive and purely curative treatments, when are discussions about approaching death ....People with serious illnesses who are approaching the end of their lives undergo a journey where, along the way, they experience several critical points. Although we know these critical points are crucial to how they might access the best kind of care, we are unsure exactly when these points may occur and how they may vary for different kinds of people. We need to know when is the best time to start withdrawing invasive and purely curative treatments, when are discussions about approaching death best introduced and how we can care for people from a diverse range of backgrounds and beliefs within our current health care system. We also need to identify and promote the best possible ways of supporting patients at the end of life and their families as they negotiate the often complex path towards a good death. With this kind of information, health care practitioners, particularly those involved in palliative care, can design better services that put in place pathways where assessment of patient and family needs, referral to the most appropriate services and coordination of all the aspects of care are easy to understand and access for all people. This kind of care can be expensive so we need to use the money allocated to palliative care wisely. This can be achieved with thoughtful research that identifies those most in need, at the time of most need and investigates the best approaches to alleviating pain in suffering in the weeks and months before death. A fair and equitable health care system is not just about keeping people healthy, but also about dealing humanely with the inevitability of deathRead moreRead less
Regionalised Maternity Care - Is There Room For Improvement?
Funder
National Health and Medical Research Council
Funding Amount
$467,752.00
Summary
A central dilemma in the provision of maternity care is that some mothers and babies need access to expertise and sophisticated technologies, but most do not. In Australia regionalised maternity care aims to ensure the provision of the appropriate level of care to all women, via antenatal identification of at-risk pregnancies and subsequent transfer to risk-appropriate settings, should the need arise. Furthermore, delayed childbearing and increasing rates of caesarean section are increasing the ....A central dilemma in the provision of maternity care is that some mothers and babies need access to expertise and sophisticated technologies, but most do not. In Australia regionalised maternity care aims to ensure the provision of the appropriate level of care to all women, via antenatal identification of at-risk pregnancies and subsequent transfer to risk-appropriate settings, should the need arise. Furthermore, delayed childbearing and increasing rates of caesarean section are increasing the pool of women with existing medical conditions and risk factors for adverse pregnancy outcomes. There is an urgent need to identify risk-appropriate levels of maternity care based on women's antenatal conditions and risk factors that can be identified early or during pregnancy. The project will use existing population health data sets to determine to what extent regionalised maternity care is delivering women and their babies in risk-appropriate settings or whether there is room for improvement through increased transfer of at-risk pregnancies to higher levels of care. Variations in outcomes for mothers and babies may be due to factors that occur before or during pregnancy, or may be due to differences in the level of maternity care provided. We need to take account of maternal factors to fairly assess the role of the level of maternity care. To do this our project will develop and utilise innovative statistical techniques to look at the risk factors associated with poor outcomes (severe illness or death) for mothers and their babies. We will then be able to 'predict' outcomes and see if differences between levels of maternity care are real or not. If variations are explained by different levels of care then there is enormous potential for improvement in the provision of maternity services. Results could be applied to direct health services policy and organisational changes to improve maternity care and optimise pregnancy outcomes for a healthy start to life.Read moreRead less
1+1- A Healthy Start To Life:Targeting The Year Before And The Year After Birth In Aboriginal Children In Remote Areas
Funder
National Health and Medical Research Council
Funding Amount
$587,272.00
Summary
Indigenous Australians in remote communities are less healthy and more socially disadvantaged than other Australians. This influences the quality of the intrauterine environment. Babies often suffer malnutrition and recurring infections during infancy which are exacerbated by their less than optimal birth status and contribute to chronic conditions (diabetes, cardiovascular disease, renal failure) in adulthood. Existing health services are costly to Government and do not achieve their potential ....Indigenous Australians in remote communities are less healthy and more socially disadvantaged than other Australians. This influences the quality of the intrauterine environment. Babies often suffer malnutrition and recurring infections during infancy which are exacerbated by their less than optimal birth status and contribute to chronic conditions (diabetes, cardiovascular disease, renal failure) in adulthood. Existing health services are costly to Government and do not achieve their potential for promoting health and providing quality care. Evidence suggests redesigned models based on continuity of care, focused, proactive family support and workload reform will improve maternal and infant outcomes. New models need to be developed, costed, implemented and evaluated providing governments with the evidence base to initiate service improvement. Such models will have applicability elsewhere in Australia. Professor Lesley Barclay and her team of researchers from Charles Darwin University will conduct research into developing such a model. The project aims to improve the quality of care for remote dwelling Aboriginal women and infants in the year before, during and the year after birth by providing evidence for, and facilitating changes to, service delivery. This will enhance the potential for the development of resilience and well-being of their children. It will also test if service improvements can improve the health of women and reduce childhood disease and therefore reduce the impact of health conditions occurring in adulthood which have their origins in the early stages of life.Read moreRead less
Spatial analysis of a linked environmental, health and social data base. Extensive environmental, health and socio-demographic data are routinely collected by various agencies throughout Australia. To date, it has been difficult to link separate databases and investigate possible associations between the different parameters within them. In this proposal we plan to link routinely collected health, environment and socio-demographic data from a number of databases. We then plan to develop tools fo ....Spatial analysis of a linked environmental, health and social data base. Extensive environmental, health and socio-demographic data are routinely collected by various agencies throughout Australia. To date, it has been difficult to link separate databases and investigate possible associations between the different parameters within them. In this proposal we plan to link routinely collected health, environment and socio-demographic data from a number of databases. We then plan to develop tools for geo-referencing the data. Finally we plan to perform spatial analysis of the linked data, specifically investigating associations between environmental and social factors and childhood leukaemia, deliberate self harm and adverse birth outcomes. Linking separate databases and performing spatial analysis of georeferenced data will substantially improve the quality of public health surveillance and research in NSW. In addition, it will enable more detailed analysis of the effects of environmental exposures on health, using routine data.Read moreRead less
Needs Based Palliative Care: Evaluation Of The Palliative Care Needs Assessment Guidelines And Palliative Care Needs Ass
Funder
National Health and Medical Research Council
Funding Amount
$32,799.00
Summary
People with cancer and their caregivers may have a range of unmet physical, emotional, social and spiritual needs. Unfortunately, not everybody receives the type of help they need with these issues, or at the time they most need it. In this study, we will assess the extent to which recently developed Palliative Care Needs Assessment Guidelines and a Needs Assessment Tool help to a) identify those advanced cancer patients and caregivers who have unmet needs and b) ensure they are offered the care ....People with cancer and their caregivers may have a range of unmet physical, emotional, social and spiritual needs. Unfortunately, not everybody receives the type of help they need with these issues, or at the time they most need it. In this study, we will assess the extent to which recently developed Palliative Care Needs Assessment Guidelines and a Needs Assessment Tool help to a) identify those advanced cancer patients and caregivers who have unmet needs and b) ensure they are offered the care that best matches their levels and types of need at the time they most need it.Read moreRead less
Understanding middle-aged women’s responses to alcohol/breast cancer risks. This project aims to identify the nature of alcohol consumption patterns by Australian women aged 45-64 in different socio-economic status groups, and how these are shaped in response to considerations of trust and future health risks. The project will focus on the known risk of alcohol for the development of breast cancer, which is particularly important given that Australian culture is saturated by alcohol use, marketi ....Understanding middle-aged women’s responses to alcohol/breast cancer risks. This project aims to identify the nature of alcohol consumption patterns by Australian women aged 45-64 in different socio-economic status groups, and how these are shaped in response to considerations of trust and future health risks. The project will focus on the known risk of alcohol for the development of breast cancer, which is particularly important given that Australian culture is saturated by alcohol use, marketing and social acceptability. This project aims to identify new strategies to transform behaviour change initiatives, which may differ by socio-economic status group. The project will be a model for national and global initiatives that seek to develop highly effective alcohol reduction messages and reduce alcohol-related harms.Read moreRead less
An investigation of the nature and effects of point-of-sale promotions for alcohol beverages. There is increasing evidence that alcohol consumption is influenced by alcohol advertising, pricing, and marketing activities. However, the current lack of clear evidence on the effect of different promotions (such as reduced-price drinks, competitions etc) means that the current guidelines are unclear and unenforceable. This project will provide clear guidance for policy makers on the effects of the di ....An investigation of the nature and effects of point-of-sale promotions for alcohol beverages. There is increasing evidence that alcohol consumption is influenced by alcohol advertising, pricing, and marketing activities. However, the current lack of clear evidence on the effect of different promotions (such as reduced-price drinks, competitions etc) means that the current guidelines are unclear and unenforceable. This project will provide clear guidance for policy makers on the effects of the different forms of alcohol promotions, allowing for better monitoring and regulation of alcohol marketing. The key benefit of this project lies in the potential to develop a clear strategy to reduce alcohol-related harm by addressing inappropriate marketing and promotion of alcohol. Read moreRead less
Chronic Disease Outcomes And Enhanced Primary Care In Seniors: A Cross-Jurisdictional Linkage Project
Funder
National Health and Medical Research Council
Funding Amount
$1,077,766.00
Summary
This project will provide evidence on how best to use the efforts of Australian GPs to obtain better outcomes in patients aged 65+ years who suffer from chronic diseases such as diabetes, heart disease and high blood pressure, asthma and emphysema, seizures and stomach disorders. It will also examine the best way that GP visits can promote healthier ageing in all older seniors, aged 75+ years. For each disease and in older seniors, the study will be able to detect which of the following factors ....This project will provide evidence on how best to use the efforts of Australian GPs to obtain better outcomes in patients aged 65+ years who suffer from chronic diseases such as diabetes, heart disease and high blood pressure, asthma and emphysema, seizures and stomach disorders. It will also examine the best way that GP visits can promote healthier ageing in all older seniors, aged 75+ years. For each disease and in older seniors, the study will be able to detect which of the following factors are the most important for better patient health: (i) seeing a GP more times, (ii) seeing a GP at more even intervals, (iii) seeing the same GP, or (iv) seeing a GP with a lot of experience in chronic diseases. Separate investigations will be made in older people living in hostels and nursing homes, because their needs may be different. The study will also evaluate the benefits of a major change that occurred to Medicare in 1999, when GPs were paid to perform health assessments and to prepare health plans (with other health workers) for patients with chronic health problems. The results will enable this important initiative to be further improved. The study will use a unique and new Australian research facility, which has brought together health data on the entire population of WA from both the State and Commonwealth levels, including information on Medicare use, pharmaceuticals, hospital stays and deaths. The facility works in such a way as to preserve patient and GP privacy. A strong feature of this research will be the degree of involvement of a representative and voluntary group of older Australian patients who attend GP clinics, and the GPs themselves, in advising the researchers on what's important to consumers and GPs.Read moreRead less