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
This proposal aims to build research capacity and methodological sophistication in economic evaluation and priority setting in health. An unprecedented critical mass of Australian experts in economic evaluation will be created who can then train a new generation of researchers. The proposal covers the following topics: Assessing the impact of economic evaluation and priority setting methods on resource allocation in Australia to better understand the methodological, conceptual, practical and pol ....This proposal aims to build research capacity and methodological sophistication in economic evaluation and priority setting in health. An unprecedented critical mass of Australian experts in economic evaluation will be created who can then train a new generation of researchers. The proposal covers the following topics: Assessing the impact of economic evaluation and priority setting methods on resource allocation in Australia to better understand the methodological, conceptual, practical and political barriers to its use ('policy analysis'); Developing appropriate, valid and reliable utility measures that are culturally appropriate for Indigenous populations, children and carers ('utility measures'); Developing methods and tools for measuring non-health sector costs and benefits from a social perspective ('cost benefit'); Refining methods for adjusting cost-effectiveness results to reflect other values such as equity, applicability and feasibility ('second filter'); Exploring the usefulness and appropriateness of different modeling approaches used in economic evaluation ('modeling'); and Developing techniques to measure gains in overall health system efficiency from the adoption of cost-effective interventions ('efficiency'). The proposed outcomes are: An increased number of independent researchers with expertise in economic evaluation-priority setting who develop their own research programs; Establish a critical mass of researchers who can improve the standard and acceptance of economic evaluation and priority setting methods in health, including priority setting for Indigenous Australians and other groups with special needs; Value-adding to existing priority setting and economic evaluation projects by validating methods and developing new approaches; Effective linkages between researchers and policy makers, advocates and other stakeholders to increase appreciation of the use of economic evaluation and priority setting in health policy and clinical practice; and Research transfer through workshops, presentations and peer-reviewed publications.Read moreRead less
A screening human health risk assessment for developing coal seam gas water resources in Queensland, Australia. Due to its rich coal seam deposits, Queensland is projected to become Australia's leading coal seam gas (CSG) producer, contributing significantly to the State's economy and national "clean" energy targets. Over a 30 year period, it is estimated that Queensland's CSG industry could also create by-product water of sufficient volume to beneficially augment the State's future water supply ....A screening human health risk assessment for developing coal seam gas water resources in Queensland, Australia. Due to its rich coal seam deposits, Queensland is projected to become Australia's leading coal seam gas (CSG) producer, contributing significantly to the State's economy and national "clean" energy targets. Over a 30 year period, it is estimated that Queensland's CSG industry could also create by-product water of sufficient volume to beneficially augment the State's future water supply demands. The proposed screening Health Risk Assessment will evaluate the relative risks associated with human exposure to raw and treated CSG by-product water contaminants, informing public debate on this matter, and guide policy development within the complex multi-sector regulatory framework in place for CSG water resource development in Queensland.Read moreRead less
What will it take to decrease socio-economic inequalities in obesity? There is little understanding of how the increasing prevalence of obesity, and its prevention and management, may contribute to socio-economic inequalities in health. This project aims to identify policies that are most likely to both decrease the prevalence of obesity and decrease associated inequalities in health.
Population Based Estimates Of MBS, PBS And Hospital Utilisation Rates Using Prevalent Chronic Disease Denominators
Funder
National Health and Medical Research Council
Funding Amount
$246,000.00
Summary
This project will use hospital morbidity and mortality data from the WA Data Linkage System, linked to the Medicare Benefits Scheme and Pharmaceutical Benefits Scheme databases to produce measures of disease occurrence and health service utilisation within the Western Australian population according to indices of social and geographical disadvantage. The first objective will involve establishing teams of clinicians and researchers who will work together to develop and validate lists of MBS and P ....This project will use hospital morbidity and mortality data from the WA Data Linkage System, linked to the Medicare Benefits Scheme and Pharmaceutical Benefits Scheme databases to produce measures of disease occurrence and health service utilisation within the Western Australian population according to indices of social and geographical disadvantage. The first objective will involve establishing teams of clinicians and researchers who will work together to develop and validate lists of MBS and PBS item numbers that are indicative of specified chronic diseases. This information will then be used to identify patients with these conditions from the MBS and PBS databases during the period 1990-2003 and this method of case ascertainment will be compared with the use of the Hospital morbidity data system alone. Once groups of patients have been identified, their utilisation rates of MBS, PBS and hospital services will be calculated. The effect of social and geographical indices on the occurrence of disease and the utilisation of services will also be studied. Trends over time in health status and health service utilisation are vital to the evidence-based planning and evaluation of health services and to the provision of an equitable and accessible health service which is based on the needs of the community. The work will represent the first time that the utilisation of Australian MBS and PBS itemised services is measured in diagnostically defined groups of patients with chronic diseases.Read moreRead less
Blue Mountains Cohort Study: Long-term (15-year) Incidence Of Eye Disease, Hearing Loss And Other Public Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$837,919.00
Summary
The Blue Mountains Eye Study 15-year study will re-examine survivors of the 3,654 persons who participated in baseline BMES exams, to determine the long-term development and progression of sensory problems, including vision and hearing loss and eye diseases like macular degeneration, glaucoma, cataract or diabetic eye damage. The project will assess whether vascular conditions like high blood pressure, chronic medical conditions, medications, smoking, diet, blood, family and genetic factors pred ....The Blue Mountains Eye Study 15-year study will re-examine survivors of the 3,654 persons who participated in baseline BMES exams, to determine the long-term development and progression of sensory problems, including vision and hearing loss and eye diseases like macular degeneration, glaucoma, cataract or diabetic eye damage. The project will assess whether vascular conditions like high blood pressure, chronic medical conditions, medications, smoking, diet, blood, family and genetic factors predict the risk or age at onset of eye disease or hearing loss. We will assess impacts of vision and hearing loss on independence, falls, quality of life and development of memory loss and depression. This information will help to develop services, and to plan interventions to prevent and treat these conditions. Because of the exponential age-related increase in frequency of these diseases, this long follow-up will provide more disease events, and a longer interval to assess impacts from the exposures we measured when we started the BMES in 2002. It will enable us to estimate the strength of risk factors for eye disease and hearing loss with greater precision, essential to understand their evolution. Surviving participants from the original BMES will be invited to attend follow-up exams at our Katoomba clinic, or to attend mobile- nursing home exams. We will conduct similar exams to those previously to detect new or worsened eye disease or hearing loss. In 2002-4, we saw 82% of the population of 2 Blue Mountains postcodes aged 50 or older. At the 5- and 10-year exams we saw 75% of people still living. We expect the same proportion to participate this time. The BMES is one of Australia's main cohort studies with over 200 publications. It has yielded key findings on the frequency and causes of the major diseases threatening vision and hearing. Longer follow-up will greatly increase our power to detect predictors of these key age-dependent conditions.Read moreRead less
Strengthening community responses to hepatitis B. Australians who have been born overseas often have high rates of chronic hepatitis B. In this project people with hepatitis B and people who provide them with health and social services will be interviewed to understand individual responses to the infection, and to identify barriers to effective health care delivery.
Examining A Core Assumption Of Policy And Services For Older Indigenous Australians
Funder
National Health and Medical Research Council
Funding Amount
$133,387.00
Summary
In aged care service planning, the age 50 years or over is used for the Indigenous Australian population in the same way as the age 70 years is used for the non-Indigenous population. This is based on the lower life expectancy of the Indigenous population which is presumed to result in a need for aged care services at younger ages. The underlying assumption is that Australia's Indigenous population aged over 50 has the same set of age-associated conditions and care needs as the non-Indigenous po ....In aged care service planning, the age 50 years or over is used for the Indigenous Australian population in the same way as the age 70 years is used for the non-Indigenous population. This is based on the lower life expectancy of the Indigenous population which is presumed to result in a need for aged care services at younger ages. The underlying assumption is that Australia's Indigenous population aged over 50 has the same set of age-associated conditions and care needs as the non-Indigenous population aged over 70. The evidence for this assumption is not established. It is well documented that the Indigenous population has worse health outcomes across all age groups relative to non-Indigenous Australians. However, our understanding of the details of the observed pattern is far from complete. This project seeks to compare the health status of the Indigenous population aged 50 years or over to the health status of the non-Indigenous population aged 70 years or over. The project will analyse a number of data sets to inform future directions in policy and service provision. A better understanding of these issues is fundamental to informed planning and allocation of resources, to identification of areas amenable to prevention strategies and to the development of approaches to care that meet the needs of Indigenous people.Read moreRead less
From science to policy: quantifying and managing the risk of mosquito borne disease in the context of climate change. It is important to assess and manage the health risks of climate change. This research will create fundamental knowledge and practical skills on the interdisciplinary assessment and management of health risks of climate change, and explore policy ramifications of research outcomes in this study.