Supply, Demand And The Distribution Of Health Services In Australia
Funder
National Health and Medical Research Council
Funding Amount
$308,038.00
Summary
The distribution of medical services and its impact on access and equity is widely recognised as a key concern of the Australian community. Access and equity are key indicators to the public of the performance of a health system. These concerns have led to the adoption of major policy goals under Medicare relating to equitable access to medical services for the population as a whole. Furthermore, both the community and policy makers have expressed high levels of concern over the distribution of ....The distribution of medical services and its impact on access and equity is widely recognised as a key concern of the Australian community. Access and equity are key indicators to the public of the performance of a health system. These concerns have led to the adoption of major policy goals under Medicare relating to equitable access to medical services for the population as a whole. Furthermore, both the community and policy makers have expressed high levels of concern over the distribution of medical services between sub-markets and sub-populations, in particular, in the distribution of medical services between urban and rural-remote areas. This project, for the first time, comprehensively examines the performance of Medicare in terms of access to medical services over time. Australian data sets, largely untapped by economic modelling, will be used for analysis of the relationships between the distribution of, access to, and demand and fees for Australian medical services and their impact upon mortality over time. The study will result in the first comprehensive Australian description of access and supply of different medical services by social group and by geographic location over time. Furthermore it will provide evidence on the key determinants of distribution and changes in the distribution of medical services and estimates the likely effects of policy instruments designed to address the distribution of, and access to, medical services.Read moreRead less
Maximum Acceptable Risk Of Complication In Total Knee Arthroplasty (MARKA) Study: Using Discreet Choice Experiments To Elicit Patient And Surgeon Perception Of Acceptable Risk In Total Knee Arthroplasty
Funder
National Health and Medical Research Council
Funding Amount
$465,199.00
Summary
Patient expectation is the strongest predictor of satisfaction following total knee replacement. Dissatisfaction with surgery is reported in approximately 1 in 5 patients undergoing knee replacement. Unrealistic patient expectations and uninformed perceptions of potential benefits, risks and limitations of surgery lead to dissatisfaction in many cases. This study will examine the “risk-benefit” preferences in patients and surgeons considering total knee replacement as a treatment option for end- ....Patient expectation is the strongest predictor of satisfaction following total knee replacement. Dissatisfaction with surgery is reported in approximately 1 in 5 patients undergoing knee replacement. Unrealistic patient expectations and uninformed perceptions of potential benefits, risks and limitations of surgery lead to dissatisfaction in many cases. This study will examine the “risk-benefit” preferences in patients and surgeons considering total knee replacement as a treatment option for end-stage osteoarthritis.Read moreRead less
Improving Rehabilitation Outcomes Through Self-Management: My Therapy
Funder
National Health and Medical Research Council
Funding Amount
$743,438.00
Summary
We must ensure patients have enough therapy practice for the best inpatient rehabilitation outcomes. During rehabilitation, we know patients don't often receive enough therapy and actually spend most of the day sitting and lying down. My Therapy was designed to increase independent practice of therapy exercises during rehabilitation, in addition to usual care, without additional staff. Through My Therapy, patients achieved 100 extra minutes of weekly therapy participation and better function.
Harnessing Information Technology To Improve Self-management Behaviours And Health Outcome In People With Heart Failure: A Smarthome Ecosystem Living Lab Study
Funder
National Health and Medical Research Council
Funding Amount
$1,120,226.00
Summary
The burden of heart failure in Australia is substantial. Management of heart failure is complex and requires self-management of symptoms and behaviour change, which requires ongoing education and support to achieve. Current approaches for supporting self-management do not meet the needs of people with heart failure or the healthcare system. This Australian first project aims to co-design an intelligent smart home ecosystem (Smart Heart) to support the management for people with heart failure.
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.
Stroke is a medical emergency. Admission to a stroke unit; administration of clot busting therapy to eligible patients; and treatment of fever, raised blood sugar and swallowing difficulties are therapies with demonstrated evidence to reduce death and disability. Our study will rigorously evaluate an organisational intervention to deliver these initiatives in Emergency Departments. We hypothesise this will deliver further significant improvements in 90-day health outcomes and patient recovery.
A Multi-centre RCT To Prevent Secondary Falls In Older People Presenting To The Emergency Department With A Fall
Funder
National Health and Medical Research Council
Funding Amount
$1,534,471.00
Summary
Falls are a leading cause for presentation to Emergency Departments (EDs) by older patients. More than 50% who present to ED with a fall injury have fallen in the previous year. RESPOND is an innovative post-ED discharge program designed to reduce secondary falls in older people. RESPOND extends current falls prevention research and practice by incorporating patient-centred education with behaviour change strategies proven to be effective in the secondary prevention of cardiovascular events.
Testing A Tailored, Evidence-based Education Intervention To Enhance Outcomes For Patients Commencing Chemotherapy
Funder
National Health and Medical Research Council
Funding Amount
$311,250.00
Summary
This project tests an innovative education program aimed at reducing the physical and psychosocial burden experienced during a course of cancer chemotherapy. The aim of the study is to reduce the burden and distress associated with cancer chemotherapy. Cancer chemotherapy is associated with physical (nausea, fatigue, hair loss, infection) and psychosocial (fear, anxiety, worry about family) effects that cause significant distress. Patients experience a highly level of pre-treatment anxiety and f ....This project tests an innovative education program aimed at reducing the physical and psychosocial burden experienced during a course of cancer chemotherapy. The aim of the study is to reduce the burden and distress associated with cancer chemotherapy. Cancer chemotherapy is associated with physical (nausea, fatigue, hair loss, infection) and psychosocial (fear, anxiety, worry about family) effects that cause significant distress. Patients experience a highly level of pre-treatment anxiety and for many this distress lasts across the course of treatment. Over the past decade there has been a dramatic shift in chemotherapy delivery to the outpatient setting. This means that patients are now responsibile for monitoring their own health at home and may need to use self-care strategies to deal with the many adverse effects of treatment. Pre-treatment education has usually focused on providing information about the facts of treatment, i.e. likelihood of nausea, rather than preparing the patient for the experience of treatment or helping them to manage the self-care demands associated with receiving treatment in the outpatient setting. The innovative education program tested here is the first of its type to draw on high level research evidence about preparing patients for potentially threatening medical procedures, tailoring this education to the individual situation of the patient and coaching the patient to implement evidence-based self-care behaviours and to use stress reduction techniques across the course of treatment.Read moreRead less
A Centre For Research Excellence In Cerebral Palsy (CRE-CP)
Funder
National Health and Medical Research Council
Funding Amount
$2,622,042.00
Summary
Cerebral palsy is the most common physical disability in childhood. Our objective is to bring about a radical improvement in the treatment of individuals with cerebral palsy, both children and adults, and to determine better ways to assist their families. Emphasis will be placed on early detection of health issues and rigorous evaluation of management options. We will train more researchers and ensure that all the knowledge generated is made available to families and health care professionals.
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