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Towards Evidence-based Adoption And Scale-up Of Cost-saving Primary Health Care Innovations
Funder
National Health and Medical Research Council
Funding Amount
$408,768.00
Summary
What innovations like service integration, care coordination and information technology (e.g. text message reminders, remote video consultations, remote monitoring) have in common is that they alter the patient-provider interface, more reliably and consistently than improving clinical outcomes. So, to determine their true costs and benefits, how to select among them and how to scale them up, this research program will assess them based on measures of how they alter patient-provider transactions.
Evaluating The Effectiveness Of Comprehensive Primary Health Care In Local Communities
Funder
National Health and Medical Research Council
Funding Amount
$1,635,268.00
Summary
This research will develop and implement a program logic evaluation in order to assess the effectiveness of various models of primary heatlh care service delivery. Although comprehensive primary health care holds considerable promise to meet the growing demands on the health system, it has not been thoroughly evaluated. Comprehensive primary health care is a large and complex area, therefore part of the project focuses on services and client experiences in two chromic diseases: diabetes and depr ....This research will develop and implement a program logic evaluation in order to assess the effectiveness of various models of primary heatlh care service delivery. Although comprehensive primary health care holds considerable promise to meet the growing demands on the health system, it has not been thoroughly evaluated. Comprehensive primary health care is a large and complex area, therefore part of the project focuses on services and client experiences in two chromic diseases: diabetes and depressionRead moreRead less
After the questions: outcomes of routine screening for domestic violence in NSW Health services. Recent research indicates that domestic violence is the leading contributor to death, disability and illness in women aged 15-44 in Australia and leads to health costs of $314 m annually (VicHealth 2004, Access Economics 2004). Routine screening is a low cost measure aimed at prevention and early intervention for domestic violence, which has been successfully introduced for women entering antenatal, ....After the questions: outcomes of routine screening for domestic violence in NSW Health services. Recent research indicates that domestic violence is the leading contributor to death, disability and illness in women aged 15-44 in Australia and leads to health costs of $314 m annually (VicHealth 2004, Access Economics 2004). Routine screening is a low cost measure aimed at prevention and early intervention for domestic violence, which has been successfully introduced for women entering antenatal, early childhood, mental health and drug and alcohol services operated by NSW Health. The research will be the first study of its size to consider the outcomes of routine screening for domestic violence in public health settings in the Australian context.Read moreRead less
The Influence Of Acupuncture On Reducing Women's Pain From Primary Dysmenorrhoea: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$310,875.00
Summary
Dysmenorrhoea refers to painful uterine cramps during menstruation. It is a common condition that affects as many as 50 percent of women. Severe menstrual pain can lead to an absence from work, or attending school, or interference with day to day lives. This condition is commonly treated with non-steroidal anti-inflammatory drugs or the oral contraceptive pill. Studies suggest that between 30-50 percent of the adult population use some form of complementary medicine. Acupuncture, the insertion o ....Dysmenorrhoea refers to painful uterine cramps during menstruation. It is a common condition that affects as many as 50 percent of women. Severe menstrual pain can lead to an absence from work, or attending school, or interference with day to day lives. This condition is commonly treated with non-steroidal anti-inflammatory drugs or the oral contraceptive pill. Studies suggest that between 30-50 percent of the adult population use some form of complementary medicine. Acupuncture, the insertion of fine needles, into specific areas of the body is increasingly being used to treat a number of conditions. It has been indicated in several non-clinical studies and two small clinical trials to be effective with treating dysmenorrhoea. Evidence from the Cochrane systematic review of acupuncture to treat primary dysmenorrhoea concluded acupuncture may be helpful. This study assesses whether women with dysmenorrhoea can be successfully treated using acupuncture. Women experiencing dysmenorrhoea with no underlying pelvic pathology will be offered the opportunity to take part in the trial. Women interested in taking part will be randomly allocated into one of two groups. One group of women will receive acupuncture, a second group will receive control (sham) acupuncture. The second study group involves the insertion of needles away from acupuncture points. Women will receive the treatment intervention for three menstrual cycles and then followed up for a further six months. Women will be asked to report on the pain they experience during menses and to report any time taken off from work or school, disruption with day to day activities, or the need for additional pain relief. In 2005 we expect to report on the effectiveness of this treatment on dysmenorrhoea and whether this treatment is acceptable to women. If the results are positive, it is hoped this will become an option available to women for the management of their dysmenorrhoea.Read moreRead less
Population Health Planning For Rural Medicare Locals: Evaluating A Community Participation Method For Delivering Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$438,587.00
Summary
The study, in six communities, will evaluate whether an evidenced based method of rural community participation from the UK translates to assist healthcare planning by Medicare Locals. Medicare Locals must involve local people in designing services to improve health, but lack methods to do this. The focus of the study is oral health, a major issue in rural areas. The study evaluates whether new services are designed and implemented and whether there is change to health knowledge and behaviours.
Pathways to healing: determining effective care pathways for chronic wounds for timely healing, prevention and cost effectiveness. Care for chronic leg ulcers is reported to cost 1-2.5% of total health budgets (>3 billion $US/year, $500 million AUD/year). Efficient use of health resources and improved health as a result of effective chronic wound management (early healing and prevention) are the most significant potential outcomes from this study. In addition to direct health care costs, chronic ....Pathways to healing: determining effective care pathways for chronic wounds for timely healing, prevention and cost effectiveness. Care for chronic leg ulcers is reported to cost 1-2.5% of total health budgets (>3 billion $US/year, $500 million AUD/year). Efficient use of health resources and improved health as a result of effective chronic wound management (early healing and prevention) are the most significant potential outcomes from this study. In addition to direct health care costs, chronic wounds are associated with significant hidden burdens on the community resulting from loss of mobility, decreased functional ability, social isolation and loss of participation in the workforce/society. This study will provide much needed information on management of this chronic disease to promote improved quality of life, health and independence in this population.Read moreRead less
An Evaluation Of Trust In A Primary Health Care System
Funder
National Health and Medical Research Council
Funding Amount
$135,550.00
Summary
Trust is a critical issue in the relationships between organisations that need to work together to achieve integrated services for consumers. As organisational representatives get to know one another trust may develop permitting a greater degree of collaboration. In Victoria, the Primary Care Partnerships Strategy process aims to strengthen the relationships between agencies in alocal areas to improve collaboration and achieve services that operate in an integrated way in the provision of servic ....Trust is a critical issue in the relationships between organisations that need to work together to achieve integrated services for consumers. As organisational representatives get to know one another trust may develop permitting a greater degree of collaboration. In Victoria, the Primary Care Partnerships Strategy process aims to strengthen the relationships between agencies in alocal areas to improve collaboration and achieve services that operate in an integrated way in the provision of services to consumers. It is about strengthening the system of care. The aim of this study is to understand how people within a primary care system build and maintain relationships of trust between individuals and between organisations. Individuals will be interviewed to learn how they experience trust and related issues, documents will be analysed to learn about the policy and organisational environments of trust relationships, and the Trust Evaluation Scale used to measure the factors associated with trust over a two year period. The outcomes of this study will be an understanding of how organisations establish the relationships that allow them to collaborate effectively. In particular it will help us understand how they can be encouraged to share the same protocols and procedures, to share information, and become more skilful at managing organisational differences, and it will provide a deeper understanding of relationships between primary health care organisations and the strategies that can help individuals and organisations create trust and collaborate.Read moreRead less
Improving maternal and child health care for women experiencing violence: collaborative development, implementation and effectiveness of a good practice model. Maternal and child health services are universal community-based national services for Australia's mothers and babies. However, they are poorly researched, supported, resourced and lack evidence for managing the challenges of addressing intimate partner violence among their client populations. Partner violence is prevalent in early parent ....Improving maternal and child health care for women experiencing violence: collaborative development, implementation and effectiveness of a good practice model. Maternal and child health services are universal community-based national services for Australia's mothers and babies. However, they are poorly researched, supported, resourced and lack evidence for managing the challenges of addressing intimate partner violence among their client populations. Partner violence is prevalent in early parenthood and imposes a heavy health burden on victims and infants and a significant cost to society. If effective, this innovative model of maternal child health nursing care for abused mothers and infants will inform the enhanced provision of early intervention services nationwide, contribute to community nursing scholarship and give children a healthier start to life.Read moreRead less
People who have experienced a previous heart attack or stroke are at greatest risk of having another cardiovascular event. Drug treatment, with aspirin and medication to lower blood pressure and cholesterol, has been shown to substantially reduce this risk. Despite good evidence that these drugs are effective, and that their use is recommended in both Australian and international guidelines, many people who should be taking these medications on a long-term basis are not. This may partly be due t ....People who have experienced a previous heart attack or stroke are at greatest risk of having another cardiovascular event. Drug treatment, with aspirin and medication to lower blood pressure and cholesterol, has been shown to substantially reduce this risk. Despite good evidence that these drugs are effective, and that their use is recommended in both Australian and international guidelines, many people who should be taking these medications on a long-term basis are not. This may partly be due to under-prescribing by doctors, but it is also likely that asymptomatic patients are discouraged by the cost and inconvenience of taking many tablets. In the first study of its kind in this country, we will determine whether a strategy based on the provision of recommended treatments in a single pill (a polypill) will result in better use of these drugs, and as a consequence, will achieve optimum practice in patients with heart disease or stroke. Under the care of their general practitioner, 1000 such patients will be randomly allocated to the polypill, or to continuing their usual treatment. At the end of 2 years, both groups will be assessed for the proportion of people still prescribed and taking all recommended treatments. We will also collect information on the attitudes and experiences of those participating in the study of prescribing (by doctors), dispensing (by pharmacists) and taking (by patients) the polypill. As cardiovascular diseases are the leading causes of illness and death in Australia, finding new ways to ensure the maximum use of known, effective preventive treatments in patients with heart disease and stroke, particularly to those who have less access to health care, is of critical importance. The polypill represents a novel strategy with the potential to achieve this objective, and to improve the clinical care and well-being of many thousands of Australians.Read moreRead less
A study of the provision of the emergency contraceptive pill over-the-counter in Australia. Australian abortion rates, especially among young women, are a major concern. The emergency contraceptive pill (ECP) is an effective method for the prevention of unwanted and unplanned pregnancy, with the potential to reduce abortions. The study aims to provide evidence of whether the rescheduling of ECP in Australia so that pharmacists as well as doctors can dispense it, has improved its accessibility ....A study of the provision of the emergency contraceptive pill over-the-counter in Australia. Australian abortion rates, especially among young women, are a major concern. The emergency contraceptive pill (ECP) is an effective method for the prevention of unwanted and unplanned pregnancy, with the potential to reduce abortions. The study aims to provide evidence of whether the rescheduling of ECP in Australia so that pharmacists as well as doctors can dispense it, has improved its accessibility and use by women at risk of abortion. It will also assess whether pharmacists feel confident, well-trained and supported to provide it and whether abortion rates have reduced. The study will provide policymakers with the evidence to assess whether this important initiative is effective and what is needed to improve its effectiveness.Read moreRead less