The Impact Of Household Infrastructure Improvements On Child Health In Remote Aboriginal Communities
Funder
National Health and Medical Research Council
Funding Amount
$413,350.00
Summary
The impact of the living environment on health has been well documented in the last 150 years and it is widely acknowledged that improvements in the living, working and social conditions of industrial countries have resulted in dramatic improvements in health. In Australia the close correlation between an unhealthy environment and the poor health of the Indigenous population has been clearly recognised. In 1993-94 the Federal Government established infrastructure projects as a component in the i ....The impact of the living environment on health has been well documented in the last 150 years and it is widely acknowledged that improvements in the living, working and social conditions of industrial countries have resulted in dramatic improvements in health. In Australia the close correlation between an unhealthy environment and the poor health of the Indigenous population has been clearly recognised. In 1993-94 the Federal Government established infrastructure projects as a component in the implementation of the National Aboriginal Health Strategy. The selection of communities for funding has been based on need, and the Northern Territory has attracted funding support disproportionate to its total population, but consistent with the level of need. While there is wide acceptance of the relationship between the household environment and health status, and evidence to support this general relationship, there is a need at an international and local level for research that informs specific social policy decisions. The aim of the proposed study is to determine the impact of improvements in household infrastructure on the health of children living in remote Aboriginal communities with a view to informing the development of infrastructure projects. The outcomes of this project will be a significant advance in the understanding of the relationship between the household environment and health status, and of the improvements in health that can be achieved through improvement in household infrastructure. The relationship between specific components of household infrastructure and the ability to conduct each of a number of healthy living practices will be defined, to our knowledge, for the first time. There is a unique opportunity in the Northern Territory to conduct world class research in this area. The new information will be of value in the planning of infrastructure projects in remote Indigenous communities across Australia and in similar settings internationallyRead moreRead less
Economic Evaluation Of The Costs And Benefits Of Options For Publicly Funded Dental Care Provision In Australia
Funder
National Health and Medical Research Council
Funding Amount
$219,135.00
Summary
Governments and administrators of public dental services (PDS) currently address resource allocation problems with little guidance from the public. This project will provide evidence of population priorities that can underpin planning for public dental care and provide direction for priorities in PDS A cost-benefit analysis of dental care, to guide future decisions, will be conducted by comparing the community's willingness to pay for dental services and the cost of providing those services.
Consumer Co-payments For Subsidised Medicines: Impact On Access And Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$465,838.00
Summary
Expenditure on pharmaceuticals subsidised under the Pharmaceutical Benefits Scheme (PBS) in Australia was >$6.5b in 2003-04. In efforts to ensure that medicine costs remain affordable, the government instituted cost-effectiveness assessments for listing, brand premium policies and generic substitution and consumer copayments. International research suggests copayments may affect vulnerable populations(1-4) and impact adversely on medicine use(10). In Australia, dispensings of essential and di ....Expenditure on pharmaceuticals subsidised under the Pharmaceutical Benefits Scheme (PBS) in Australia was >$6.5b in 2003-04. In efforts to ensure that medicine costs remain affordable, the government instituted cost-effectiveness assessments for listing, brand premium policies and generic substitution and consumer copayments. International research suggests copayments may affect vulnerable populations(1-4) and impact adversely on medicine use(10). In Australia, dispensings of essential and discretionary medicines fell immediately after the introduction of copayments for concessional card holders in 1991(5). Subsequent analysis found that low income general beneficiaries bore the greatest burden of copayments, with PBS expenditure accounting for 7.4% of their income, compared with 2.4% for those with high incomes(6). Costs appear to be becoming a barrier to medicine use in Australia, with a 2005 survey of 702 Australian adults who required regular medications finding 22% did not fill a prescription because of cost in the last 2 years(7). Similar results were reported in 2002 for 23% of 844 sicker Australian adults(8). A regional survey of 420 households found 20% reported they did not purchase all of their prescription medicines due to costs(9). Apart from the initial analysis of medication changes in 1991 as a result of copayment introduction(5), no Australian study has assessed the impact of these on medication use, nor on the impact of any changes in medication use on health outcomes. While copayments may effectively reduce the cost burden of the PBS to government, they may have an unintended negative effect if costs are generated elsewhere in the health system through increased hospitalisations or emergency department attendances as a result of omission of medicines. This research will explore the association between increasing copayments, medication and health service utilisation, information critical for informing policy on increasing consumer copayments.Read moreRead less
Building Best Practice In Child Protection At The Intersection Of Child Protection And Adult Mental Health Services
Funder
National Health and Medical Research Council
Funding Amount
$294,590.00
Summary
This research is an investigation of child protection practices with families where at least one parent has been diagnosed with a serious mental illness (affective or non-affective psychosis), and where child abuse or neglect has been substantiated or children are at risk of significant harm. It is specifically concerned to understand processes of interagency collaboration between workers in state government child protection and mental health service systems. The research has several aims. These ....This research is an investigation of child protection practices with families where at least one parent has been diagnosed with a serious mental illness (affective or non-affective psychosis), and where child abuse or neglect has been substantiated or children are at risk of significant harm. It is specifically concerned to understand processes of interagency collaboration between workers in state government child protection and mental health service systems. The research has several aims. These are, first, to identify and examine the current practices of child protection and mental health workers where protective concerns have been identified in relation to children whose parent-s have been diagnosed with a mental illness. Practice will be examined at the assessment, child protection follow-up and post-order phases. Second, to identify and examine any barriers to effective collaboration between child protection and mental health organisations; and third, to develop inductively derived descriptions of 'best practice' in relation to these cases. The research will be conducted in four stages, including a survey of child protection and mental health workers, tracking of cases through the child protection system, in-depth interviews with child protection workers, mental health workers and parents, and group discussions with highly experienced child protection and mental health workers. The expected outcomes of the study are: the development of child protection practice guidelines for working with families where children have been harmed or at risk of harm by a parent who has a mental illness, including practice guidelines for interagency collaboration in this field; and identification of supervisional, training, administrative and policy responses to this issue.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
Identifying Risk For Second And Subsequent Pregnancies: A Longitudinal Record Linkage Study
Funder
National Health and Medical Research Council
Funding Amount
$586,129.00
Summary
Interventions (eg. induction of labour) or conditions (eg bleeding) in one pregnancy may affect outcomes in the next pregnancy (eg. risk of complications). These relationships are under-investigated. Using population data on over 194,000 women we can look at repeat pregnancies experienced by individual women. We will use this data to investigate whether interventions in one pregnancy affect subsequent birth outcomes (for mother or baby) and whether particular conditions are likely to recur.