Which Heart Failure Intervention Is Most Cost Effective In Reducing Hospital Care (WHICH? II) Trial: A Multicentre, Randomised Trial Of Standard Versus Intensified Management Of Metropolitan And Regional-dwelling Patients With Heart Failure
Funder
National Health and Medical Research Council
Funding Amount
$1,891,210.00
Summary
Chronic heart failure (CHF) management programs are now the gold-standard to cost-effectively care for thousands of Australians hospitalised with CHF each year. We’ve shown that home-based management is most cost-effective in reducing hospital stay in CHF. The Which Intervention is most Cost-effective in reducing Hospital care (WHICH? II) Trial, a multicentre, randomised study, will determine if more intensive care (via home visits and remote care contacts) further improves poor outcomes in CHF.
Coverage with Evidence Development: Application to pharmaceutical reimbursement decisions. Some new medicines produce only a small improvement in health but have considerable costs. When these medicines are trialled on only small numbers of people, uncertainty results about the value of the medicine, which can create problems for decision makers. Funding medicines where there is uncertainty may lead to harm when medicines are later found to be unsafe, or waste millions of dollars when they are ....Coverage with Evidence Development: Application to pharmaceutical reimbursement decisions. Some new medicines produce only a small improvement in health but have considerable costs. When these medicines are trialled on only small numbers of people, uncertainty results about the value of the medicine, which can create problems for decision makers. Funding medicines where there is uncertainty may lead to harm when medicines are later found to be unsafe, or waste millions of dollars when they are overpriced relative to effectiveness. Not funding medicines may disadvantage patients in whom the medicines are effective. Methods to enable access to medicines while reducing uncertainty will offer significant benefit to patients, clinicians and taxpayers. Read moreRead less
A new quality of life instrument with older people for economic evaluation. This project aims to develop and validate a new preference-based quality-of-life instrument with applications in aged-care. The new instrument will be developed with older people receiving aged care services, and will focus upon incorporating their values into the measurement and valuation of quality of life for economic evaluation. The new instrument will have immediate applications in quality assessment and economic ev ....A new quality of life instrument with older people for economic evaluation. This project aims to develop and validate a new preference-based quality-of-life instrument with applications in aged-care. The new instrument will be developed with older people receiving aged care services, and will focus upon incorporating their values into the measurement and valuation of quality of life for economic evaluation. The new instrument will have immediate applications in quality assessment and economic evaluation, improving the quality of life and wellbeing of older Australians, and will assist in determining the relative cost effectiveness of new and existing services.
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Determination Of Irradiation Dose Efficacy For Use In Impaction Grafting At Revision Joint Replacement
Funder
National Health and Medical Research Council
Funding Amount
$411,517.00
Summary
Primary hip replacement is a successful intervention for hip disease, but 10-15% of hip prostheses fail and require revision surgery within 10-15 years. At the time of revision, significant bone loss around the failed prosthesis is not uncommon. A bone reconstruction procedure, called impaction grafting, where donor bone is minced and placed in the areas of deficient bone before implanting the new prosthesis, has shown to give good results at more than ten years in some centres. A high incidence ....Primary hip replacement is a successful intervention for hip disease, but 10-15% of hip prostheses fail and require revision surgery within 10-15 years. At the time of revision, significant bone loss around the failed prosthesis is not uncommon. A bone reconstruction procedure, called impaction grafting, where donor bone is minced and placed in the areas of deficient bone before implanting the new prosthesis, has shown to give good results at more than ten years in some centres. A high incidence of early complications of this procedure have included loss of fixation within the bone. Fracture of the bone around prostheses has also reported in some centres. These events require more surgery, putting the patient at higher risk greater complications and longer rehabilitations. Recent improvements in surgical technique and donor bone preparation have improved results. A current debate questions whether the dose of irradiation can be reduced from 25 kGy, while maintaining sterility of allografts. The risk of bacterial contamination in allografts is low, and irradiation reduces the mechanical strength of the graft, contributing to complications when irradiated bone is used. The benefits of decontaminating the bone may be outweighed by the higher risk for failure due to poor bone quality and resulting prosthesis instability. We will use ISO standards to test the validity of radiation dose for sterilising bone ex vivo. In the absence of controlled human studies, our aim is also to compare the results of impaction grafting with non-irradiated bone versus bone irradiated at current doses used by Australian bone banks, and lower doses indicated by ex vivo testing. We will use a large animal model of revision hip replacement, with precise measures of prosthesis stability. The results of this study will guide clinical decisions regarding the efficacy of current bone graft preparation procedures and the use of irradiated bone in human hip replacement surgery.Read moreRead less
Health Impacts Of Sleep Apnea In Australian Men- A Longitudinal Population Study.
Funder
National Health and Medical Research Council
Funding Amount
$312,056.00
Summary
Obstructive sleep apnea (OSA) is very common, seen in 60-70% of men over 40 years old. OSA is linked to a number of serious conditions, e.g. heart disease and diabetes. However, we don't know which men are at risk of long term complications from OSA. Our aim is to follow-up men from a community sample of 1000 men who had sleep studies in 2010 to help identify who is at risk of poor health from OSA.
Dental Health Services Research For Improved Oral Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$2,641,484.00
Summary
This research will generate new knowledge to improve health outcomes by investigating expenditure and financing of dental care, dental practice performance, and the impact of dental services on oral health outcomes. This is needed for health policy to deliver dental care that promotes good oral health, to identify characteristics of the dental delivery system that deliver productive outputs with good outcomes, and testing oral health outcomes in relation to the type of dental care received.
Linking Place To Metabolic Syndrome Via Behavioural And Psychological Antecedents: Levers For Public Health Intervention
Funder
National Health and Medical Research Council
Funding Amount
$295,135.00
Summary
This collaboration involves the SA Health Department and community partners in analyses of local data from a 10-year biomedical cohort to (i) identify features of residential areas that are related to the metabolic syndrome and (ii) assess the mechanism by which area features influence metabolic syndrome through effects on behavioural and psychosocial mediators. The knowledge generated will inform policy intervention via urban planning and public health actions to support healthful lifestyles.
The Risks And Benefits Of Contemporary Total Hip Replacement
Funder
National Health and Medical Research Council
Funding Amount
$493,530.00
Summary
The number of hip replacements undertaken in Australia is steadily increasing. The most common complications of hip replacements are dislocation and loosening due to bone loss around the implant, requiring complex and expensive revision surgery. This study will investigate the incidence of dislocation and, using a new diagnostic imaging technique, the incidence and amount of bone loss around a relatively new prosthetic material, the outcomes of which are not known despite its increasing use.
Statistical methods for the analysis of critical care data, with application to the Australian and New Zealand Intensive Care Database. The recent inquiry into Queensland's Bundaberg Base Hospital highlights the need to monitor hospital performance. This project develops new statistical methods to account for uncertainty in the assessment of provider performance and its outcomes will provide government with institutional comparisons for policy and planning.
Health, Economic, Psychological And Social Impact Of Educating Carers Of Patients With Advanced Pulmonary Disease (APD)
Funder
National Health and Medical Research Council
Funding Amount
$605,452.00
Summary
Our study aims to understand the health, economic and social costs associated with caring for patients with advanced pulmonary disease (APD) and to determine health, economic and social impact of improving the skills of caregivers of patients with APD has on patients and their carers. Patients with APD are a large population at high risk of health resource use, unnecessary medication use and emergency admission to hospital or residential care facilities. Although previous research has identified ....Our study aims to understand the health, economic and social costs associated with caring for patients with advanced pulmonary disease (APD) and to determine health, economic and social impact of improving the skills of caregivers of patients with APD has on patients and their carers. Patients with APD are a large population at high risk of health resource use, unnecessary medication use and emergency admission to hospital or residential care facilities. Although previous research has identified difficulties experienced by caregivers of the elderly in general, very little research has been undertaken with carers of patients with APD. The study will compare the usual practice of educating patients with APD who commence home oxygen therapy (HOT), and their carers, against a more detailed and individually targeted education program that increases the skills of patients and carers. This study has the potential to reduce hospital-residential care readmission, reduce carer distress, improve patient outcomes, reduce adverse effects of oxygen therapy and medication use, and minimize inappropriate presentation to tertiary care emergency departments.Read moreRead less