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Chronic Disease Outcomes And Enhanced Primary Care In Seniors: A Cross-Jurisdictional Linkage Project
Funder
National Health and Medical Research Council
Funding Amount
$1,077,766.00
Summary
This project will provide evidence on how best to use the efforts of Australian GPs to obtain better outcomes in patients aged 65+ years who suffer from chronic diseases such as diabetes, heart disease and high blood pressure, asthma and emphysema, seizures and stomach disorders. It will also examine the best way that GP visits can promote healthier ageing in all older seniors, aged 75+ years. For each disease and in older seniors, the study will be able to detect which of the following factors ....This project will provide evidence on how best to use the efforts of Australian GPs to obtain better outcomes in patients aged 65+ years who suffer from chronic diseases such as diabetes, heart disease and high blood pressure, asthma and emphysema, seizures and stomach disorders. It will also examine the best way that GP visits can promote healthier ageing in all older seniors, aged 75+ years. For each disease and in older seniors, the study will be able to detect which of the following factors are the most important for better patient health: (i) seeing a GP more times, (ii) seeing a GP at more even intervals, (iii) seeing the same GP, or (iv) seeing a GP with a lot of experience in chronic diseases. Separate investigations will be made in older people living in hostels and nursing homes, because their needs may be different. The study will also evaluate the benefits of a major change that occurred to Medicare in 1999, when GPs were paid to perform health assessments and to prepare health plans (with other health workers) for patients with chronic health problems. The results will enable this important initiative to be further improved. The study will use a unique and new Australian research facility, which has brought together health data on the entire population of WA from both the State and Commonwealth levels, including information on Medicare use, pharmaceuticals, hospital stays and deaths. The facility works in such a way as to preserve patient and GP privacy. A strong feature of this research will be the degree of involvement of a representative and voluntary group of older Australian patients who attend GP clinics, and the GPs themselves, in advising the researchers on what's important to consumers and GPs.Read moreRead less
Being 'fat' in today's world: A socio-cultural investigation of overweight and obesity. What does it feel like to constantly struggle with your weight? Over 60% of Australians are overweight or obese, and many of these have battled with their weight for most of their adult lives. In an innovative approach to obesity, researchers at Monash University, the University of Melbourne, the University of Canberra and Deakin University are investigating the poignancy of experience of living with obesity ....Being 'fat' in today's world: A socio-cultural investigation of overweight and obesity. What does it feel like to constantly struggle with your weight? Over 60% of Australians are overweight or obese, and many of these have battled with their weight for most of their adult lives. In an innovative approach to obesity, researchers at Monash University, the University of Melbourne, the University of Canberra and Deakin University are investigating the poignancy of experience of living with obesity in Australia. The aim of the study, which also includes a review of how obesity is represented by Australian newspapers, will use narratives to provide public health, health promotion and media strategies which resonate with the lived reality of obese and overweight people.Read moreRead less
Developing methods for benefit measurement in health-related economic analyses and their use in selecting public health promotional programs. The program involves the creation, validation and use of a suite of instruments for evaluating outcomes of health promotional programs, including adult and childhood obesity, depression and smoking - areas that are universally recognised as being of importance for the Australian community. The program will provide multiple scoring algorithms for each of th ....Developing methods for benefit measurement in health-related economic analyses and their use in selecting public health promotional programs. The program involves the creation, validation and use of a suite of instruments for evaluating outcomes of health promotional programs, including adult and childhood obesity, depression and smoking - areas that are universally recognised as being of importance for the Australian community. The program will provide multiple scoring algorithms for each of the instruments in order to test the sensitivity of results to assumptions made about social values, and will produce Australian estimates of the person trade-off weights used in the Australian and Victorian Burden of Disease studies (which presently use Dutch PTO weights). Read moreRead less
PSA Testing: A Population-based Longitudinal Study Of Decision Making, Psychological Effects And Patterns Of Care
Funder
National Health and Medical Research Council
Funding Amount
$576,977.00
Summary
Prostate cancer is the most commonly diagnosed cancer in Australian men and the second most common cancer- related cause of death. Since being introduced into Australia in 1988 the Prostate Specific Antigen (PSA) blood test has been widely adopted as a method for detecting early-stage asymptomatic prostate cancer. However there is controversy about the potential benefits and harms of testing for prostate cancer. Little has been documented in Australia about the information men receive when consi ....Prostate cancer is the most commonly diagnosed cancer in Australian men and the second most common cancer- related cause of death. Since being introduced into Australia in 1988 the Prostate Specific Antigen (PSA) blood test has been widely adopted as a method for detecting early-stage asymptomatic prostate cancer. However there is controversy about the potential benefits and harms of testing for prostate cancer. Little has been documented in Australia about the information men receive when considering a PSA test, what happens to men after having an abnormal PSA test and the consequences of PSA testing (including physical and psychological effects). The aim of this study is to interview a representative community sample of men aged 50 to 84 years and resident in NSW to describe: (1) the decision-making process regarding PSA testing; (2) the psychological consequences of men's PSA testing experiences; and (3) patterns of care for men who have had an abnormal PSA test. The main outcomes from this study will include substantial information on the experiences of men regarding patterns of PSA participation (frequency of, and reasons for, testing), the clinical management of men who have had an abnormal PSA test, the psychological effects of PSA testing (both positive and negative) and how decisions about testing are being made. This will provide important information to assist GPs, urologists and Australian men make decisions about PSA testing. It will highlight areas of need regarding the information required by men for informed decision-making and the support they require when undergoing PSA testing to ensure positive psychological outcomes.Read moreRead less
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
Using Clinical And Economic Evidence To Infrom Local Decision Making In Cancer Care
Funder
National Health and Medical Research Council
Funding Amount
$1,836,745.00
Summary
Medicines used to treat cancer often come with a high price tag. Many countries, including Australia, are no longer able to provide free access to all medicines. For this reason, patients and their families, public hospitals and private health insurers are often asked to pay for these treatments. Currently, health professionals and patients are ill-equipped to make informed treatment choices, since both cost and efficacy must be considered. Our proposed research will address this important gap i ....Medicines used to treat cancer often come with a high price tag. Many countries, including Australia, are no longer able to provide free access to all medicines. For this reason, patients and their families, public hospitals and private health insurers are often asked to pay for these treatments. Currently, health professionals and patients are ill-equipped to make informed treatment choices, since both cost and efficacy must be considered. Our proposed research will address this important gap in current knowledge. We will use a unique web-based resource (Cancer Institute NSW Standard Cancer Treatment Program; CI-SCaT) to communicate the economic evidence needed to make informed decisions about cancer treatments. Our project will provide public access to information about the effectiveness and costs of cancer drugs. This is a world first. CI-SCaT is already the main vehicle of communication about cancer drug treatments in NSW and is widely used by cancer health professionals and patients to inform point-of-care decisions. Our project we will also identify the factors which influence the ability of cancer treatment centres to make best use of their drug budgets. By achieving this goal, we hope to demonstrate how to best use scarce resources for the benefit of all cancer patients.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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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