Empirical Ethics: Quantification Of Social Preferences For Economic Evaluation In The Health Sector
Funder
National Health and Medical Research Council
Funding Amount
$329,450.00
Summary
Recent studies indicate that there are significant differences between the social 'preferences'-priorities of the population and the priorities implied by health policy and embodied in health economic evaluations of the health sector. For example, members of the public give higher priority to the severely ill even when little can be done for them. The studies suggest that the public would also take into account, inter alia, a number of other factors, including prognosis, health potential and the ....Recent studies indicate that there are significant differences between the social 'preferences'-priorities of the population and the priorities implied by health policy and embodied in health economic evaluations of the health sector. For example, members of the public give higher priority to the severely ill even when little can be done for them. The studies suggest that the public would also take into account, inter alia, a number of other factors, including prognosis, health potential and the social context of the problem. They would not treat program costs in the way economic theory and practice recommends. These issues have been dramatised in the WHO's Evaluation of Health Systems (World Health Report 2000). This assigns a weight of only 0.25 to health improvement and 0.75 to issues of fairness. The proposed study will carry out three tasks. The first is to measure the importance of Australian health-related social preferences which should, potentially, be included in economic evaluation studies. Key values - parameters - including the rate of time preference and the social willingness to pay for an additional year of life will be measured precisely for immediate use. Secondly, the importance of other issues including illness severity, adaptation and prognosis will be tested to determine how these factors should be included in the economic evaluation of health programs. Finally, some general issues related to public versus private funding, egalitarianism and choice will be investigated. Results from interviews and surveys will be integrated in the Assessment of Quality of Life (AQoL) instrument and its user manual.Read moreRead less
After Hours Medical Care And Personal Safety Needs Of Urban General Practitioners
Funder
National Health and Medical Research Council
Funding Amount
$73,250.00
Summary
Experiences of violence and aggression are widespread within the health care field. Episodes of violence and aggression against general practitioners (GPs) in their working environment are not uncommon. These incidents frequently go unreported and the toll they take on GPs, on a personal as well as a professional level, is unknown. The frequency and severity of violence experienced by some health professionals is extreme. Such experiences may undermine the confidence and commitment of GPs and ma ....Experiences of violence and aggression are widespread within the health care field. Episodes of violence and aggression against general practitioners (GPs) in their working environment are not uncommon. These incidents frequently go unreported and the toll they take on GPs, on a personal as well as a professional level, is unknown. The frequency and severity of violence experienced by some health professionals is extreme. Such experiences may undermine the confidence and commitment of GPs and may inevitably have detrimental effects on health care services. Studies in the UK indicate that violence against general practitioners is increasing, violence against GPs in rural areas of Australia is also increasing but there have been no comparable studies carried out in our major cities. This research aims to ask general practitioners working in a range of different urban areas around NSW to describe their experiences of dealing with violent and aggressive patients. The study will be the first of its kind in Australia to provide an important insight into the level of violent and aggressive behaviour GPs are subjected to in city areas. One of the key areas of concern that has been reported in medical journals and the general press has been an increase in attacks on GPs making house-calls, this project will therefore be particularly focussed on GPs who provide after hours care. This study is important so in order to find out exactly what the incidence of violence against our urban general practitioners is, what type of violence is actually occurring, where it is occurring, who the perpetrators are, and also what the longer term psychological effects of abuse against general practitioners may be. The findings from this study will be used by the Commonwealth Government and Health Departments to plan better ways of providing after hours medical care. The findings may also be used to educate GPs and medical students about safety in the workplace.Read moreRead less
Contextual And Composition Determinants Of Urban Health Inequities: An Indigenous Perspective
Funder
National Health and Medical Research Council
Funding Amount
$426,317.00
Summary
This research studies the life experiences of Indigenous Australians living in suburban Australia. The project is exploring whether the characteristics of suburbs have an effect on residents' health, regardless of the make up of the resident population. In particular, this research is examining whether this locational impact is any different for Indigenous people compared to non-Indigenous people. It will specifically take into account the impact of social and economic factors on health. More pa ....This research studies the life experiences of Indigenous Australians living in suburban Australia. The project is exploring whether the characteristics of suburbs have an effect on residents' health, regardless of the make up of the resident population. In particular, this research is examining whether this locational impact is any different for Indigenous people compared to non-Indigenous people. It will specifically take into account the impact of social and economic factors on health. More particularly, the research will consider how Indigenous people's patterns of social interaction, trust and reciprocity - elements of social capital - affect their perceived health status. The research will examine the extent to which people are able to use their social networks to gain access to benefits such as assistance in daily life, access to jobs or to people with influence in ways that directly or indirectly contribute to improved health within the Indigenous population. The impact of racism on health will also be considered. The research will be conducted in two high income and three low income suburbs in Adelaide in order to allow comparisons between the suburbs and between Indigenous and non-Indigenous residents in each. Information will be collected from detailed interviews, a face-to-face survey and observation of the social environment, services and facilities available in the case study suburbs. The final stage of the research will engage policy makers and program planners to determine the implications of the research for their work. The research findings are designed to be used by policy makers and practitioners when they devise interventions aimed at improving health status and outcomes in Indigenous communities.Read 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.
The Use Of Web 2.0 Internet Sites To Undermine Tobacco Advertising Bans And To Mobilise Tobacco Control Advocates
Funder
National Health and Medical Research Council
Funding Amount
$365,531.00
Summary
With advertising bans eroding direct tobacco advertising opportunities, tobacco companies are embracing covert means of keeping their products and policies in current and potential consumers' minds. While the Internet is being used extensively to sell cigarettes, its largely unregulated status holds much potential as a vehicle for promoting smoking and tobacco products, as well as anti-smoking dialogue. This project assesses the potential of globally popular websites to promote and discourage sm ....With advertising bans eroding direct tobacco advertising opportunities, tobacco companies are embracing covert means of keeping their products and policies in current and potential consumers' minds. While the Internet is being used extensively to sell cigarettes, its largely unregulated status holds much potential as a vehicle for promoting smoking and tobacco products, as well as anti-smoking dialogue. This project assesses the potential of globally popular websites to promote and discourage smoking.Read moreRead less
Urban Locational Disadvantage And Health: Compositional And Contextual Determinants
Funder
National Health and Medical Research Council
Funding Amount
$608,050.00
Summary
Research has shown that where you live can affect your health, with poorer areas tending to have lower levels of health. Relationships have also been found between an individual's income and their health. It is not clear, however, which has the greatest influence on health difference - characteristics of the areas themselves or the type of people living in the area. Recent research has suggested that the levels of social capital (that is, links between people, the amount of voluntary community a ....Research has shown that where you live can affect your health, with poorer areas tending to have lower levels of health. Relationships have also been found between an individual's income and their health. It is not clear, however, which has the greatest influence on health difference - characteristics of the areas themselves or the type of people living in the area. Recent research has suggested that the levels of social capital (that is, links between people, the amount of voluntary community activity, and the degree to which people trust others and civic institutions) has a significant impact on health. The nature of physical environments also has an impact on peoples' lives. The study will examine how the communities in which people live influence their health and will consider both aspects of the physical and social environments of areas, and their demographic composition. The research is in three stages. The first stage involves a telephone survey of residents of metropolitan Adelaide and includes questions about social capital, area of residence and health. Existing information about areas, such as crime rates, availability of services and air and water pollution, will be collected. The second stage involves detailed case studies of four suburbs in Adelaide, two of which are more affluent than average and two of which are poorer than average. These case studies will: catalogue the facilities available; survey a random sample of residents about their health, their participation in community activities and their perceptions of their area; talk about these issues in detail with residents in each area; and assess the quality of the physical environment. In the third stage, the findings of the research will be discussed with community members and key policy makers in state and local government to determine how communities can be best structured so that they support individuals' health status.Read moreRead less
Australia has limited systems in place to identify, then reduce or withdraw (disinvest) ineffective or inappropriate health care practices. Such practices result in sub-optimal care and inefficient use of scarce resources. Disinvestment models are few and have not been tested in Australia. We will develop a novel, systematic policy framework by linking policy, clinical, patient and community members as partners in the decision process for disinvesting (or not) selected health care practices.
Investigating The Capacity Of The General Practitioner Workforce To Meet Ongoing HIV Primary Care Needs In Australia
Funder
National Health and Medical Research Council
Funding Amount
$469,552.00
Summary
The number of people living with HIV-AIDS in Australia is increasing and ageing, requiring an expert primary care workforce to provide HIV clinical care into the future. Yet the numbers of general practitioners training as s100 prescribers may be insufficient to replace those leaving to retire or change jobs. This study will provide critical and timely evidence for why and how GPs pursue or continue working in HIV medicine in different caseload and geographical settings across Australia.