Consumer Co-payments For Subsidised Medicines: Impact On Access And Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$465,838.00
Summary
Expenditure on pharmaceuticals subsidised under the Pharmaceutical Benefits Scheme (PBS) in Australia was >$6.5b in 2003-04. In efforts to ensure that medicine costs remain affordable, the government instituted cost-effectiveness assessments for listing, brand premium policies and generic substitution and consumer copayments. International research suggests copayments may affect vulnerable populations(1-4) and impact adversely on medicine use(10). In Australia, dispensings of essential and di ....Expenditure on pharmaceuticals subsidised under the Pharmaceutical Benefits Scheme (PBS) in Australia was >$6.5b in 2003-04. In efforts to ensure that medicine costs remain affordable, the government instituted cost-effectiveness assessments for listing, brand premium policies and generic substitution and consumer copayments. International research suggests copayments may affect vulnerable populations(1-4) and impact adversely on medicine use(10). In Australia, dispensings of essential and discretionary medicines fell immediately after the introduction of copayments for concessional card holders in 1991(5). Subsequent analysis found that low income general beneficiaries bore the greatest burden of copayments, with PBS expenditure accounting for 7.4% of their income, compared with 2.4% for those with high incomes(6). Costs appear to be becoming a barrier to medicine use in Australia, with a 2005 survey of 702 Australian adults who required regular medications finding 22% did not fill a prescription because of cost in the last 2 years(7). Similar results were reported in 2002 for 23% of 844 sicker Australian adults(8). A regional survey of 420 households found 20% reported they did not purchase all of their prescription medicines due to costs(9). Apart from the initial analysis of medication changes in 1991 as a result of copayment introduction(5), no Australian study has assessed the impact of these on medication use, nor on the impact of any changes in medication use on health outcomes. While copayments may effectively reduce the cost burden of the PBS to government, they may have an unintended negative effect if costs are generated elsewhere in the health system through increased hospitalisations or emergency department attendances as a result of omission of medicines. This research will explore the association between increasing copayments, medication and health service utilisation, information critical for informing policy on increasing consumer copayments.Read moreRead less
A Telehealth Application For The Assessment And Treatment Of Disordered Speech In Parkinson's Disease
Funder
National Health and Medical Research Council
Funding Amount
$362,875.00
Summary
People with Parkinson's disease frequently develop soft, indistinct, and monotonous speech that significantly affects the person's ability to communicate with his or her family, and the community in general. To date, the most effective treatment for the speech disturbance seen in persons with Parkinson's disease is the Lee Silverman Voice Treatment (LSVT ) program that focuses on improving the individual's vocal loudness and quality, resulting in improved speech intelligibility. For many people ....People with Parkinson's disease frequently develop soft, indistinct, and monotonous speech that significantly affects the person's ability to communicate with his or her family, and the community in general. To date, the most effective treatment for the speech disturbance seen in persons with Parkinson's disease is the Lee Silverman Voice Treatment (LSVT ) program that focuses on improving the individual's vocal loudness and quality, resulting in improved speech intelligibility. For many people with this disease, accessing this effective treatment for their speech disorder is very difficult due to their physical disabilities, the distances they are required to travel, and the availability of speech pathologists. This project aims to overcome these access issues through the development of a telehealth system that will enable speech pathologists to assess and treat people with Parkinson's disease who have a speech disorder across the Internet using videoconferencing. It is intended that this research will ultimately enable people with Parkinson's disease to be treated within their own home or local community.Read moreRead less
Use Of Innovative Mobile Telehealth Technology To Enable A New Service Delivery Solution For Dysphagia Management
Funder
National Health and Medical Research Council
Funding Amount
$207,231.00
Summary
Dysphagia, the term used to describe a swallowing difficulty, affects up to 30% of people over 65 years of age. Speech pathologists are responsible for diagnosing and managing dysphagia, however there is a shortfall between the number of clinicians available and the large number of individuals with this condition. The study aims to validate a way to assess dysphagia using telehealth, to increase access to speech pathology services particularly for patients in rural health settings.
Health Status And Development Among Aboriginal Infants In An Urban Community.
Funder
National Health and Medical Research Council
Funding Amount
$436,650.00
Summary
This research is a descriptive study of the health outcomes of Aboriginal infants, born at Campbelltown Hospital. The research will build on Centre for Health Equity's (CHETRE) work, since 1997, with the Aboriginal community, Aboriginal Medical Service (AMS) and Area Health Services (AHS) in the region to develop and advocate for services to address the needs of Aboriginal and other disadvantaged communities. CHETRE has supported the Aboriginal workers to develop additional services for Aborigin ....This research is a descriptive study of the health outcomes of Aboriginal infants, born at Campbelltown Hospital. The research will build on Centre for Health Equity's (CHETRE) work, since 1997, with the Aboriginal community, Aboriginal Medical Service (AMS) and Area Health Services (AHS) in the region to develop and advocate for services to address the needs of Aboriginal and other disadvantaged communities. CHETRE has supported the Aboriginal workers to develop additional services for Aboriginal women, such as the Aboriginal Home Visiting Team (AHV) and assisted with evaluation of these services. The AHV management comprises representatives from AMS, AHS, the Aboriginal community and CHETRE, and will provide advice and oversight for this project. The AHV developed from community concern about health status of Aboriginal infants and provides ante and postnatal care to infants and mothers. As a part of this service Aboriginal infants are systematically identified by the AHS. Further development of services is limited by lack of information on health status, use of health services, or achievement of developmental milestones by Aboriginal infants in an urban community and the assumption that outcomes are a factor of disadvantage. The researchers intend to describe in meticulous detail obstetric outcomes for 150 Aboriginal infants and their mothers born in 2004-5 and the health and development outcomes of the infants at 12 months. Baseline information on birth weight, Apgar score and obstetric history will be collected from maternal report at 2-3 week post-delivery and from routine data collections. Infants and their mothers will be followed up prospectively with further data collection points at 6 months and 12 months. Information on health status, health service use, and achievement of developmental milestones will be obtained by measurement and maternal report. An assessment by a paediatrician will be undertaken at 12 months.Read moreRead less
Re-orientating General Practice Systems Toward Youth Friendly Care: A Cluster Randomized Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,387,497.00
Summary
This project aims to improve young people's health care by helping general practice become youth friendly and measuring the effects of this on: willingness to visit for mental health and risky behaviours such as tobacco, alcohol and other drug use and unprotected sex; parents' perceptions of the care received; the sense of competence staff have in dealing with young people's issues; the practice's effectiveness in responding to young people's health risks and on the cost of general practice.
Telerehabilitation: Assessing Acquired Neurogenic Communication Disorders Online.
Funder
National Health and Medical Research Council
Funding Amount
$172,446.00
Summary
People who suffer brain damage as a result of a stroke, head injury, or a disorder such as Parkinson's disease frequently develop difficulty in either speaking, writing, reading, or understanding the spoken language. As a result, the person's ability to communicate with his or her family and friends, and the community in general is seriously affected. Individuals who experience these speech and language disorders are treated by a speech pathologist who focuses on improving the person's ability t ....People who suffer brain damage as a result of a stroke, head injury, or a disorder such as Parkinson's disease frequently develop difficulty in either speaking, writing, reading, or understanding the spoken language. As a result, the person's ability to communicate with his or her family and friends, and the community in general is seriously affected. Individuals who experience these speech and language disorders are treated by a speech pathologist who focuses on improving the person's ability to communicate. The treatment of these disorders is frequently long-term requiring speech pathology management beyond existing hospital care. For many people with these communication disorders, accessing speech pathology services after their discharge from hospital may be very difficult due to their physical difficulties, the distances they are required to travel, and the limited availability of speech pathologists in their local community. This project aims to overcome these access issues through the development of a telerehabilitation system that will enable speech pathologists to assess people with these speech and language difficulties across the Internet using videoconferencing. It is intended that this research will ultimately enable people with these types of communication difficulties to be assessed and treated within their own home or local community.Read moreRead less
Mechanism Of Signal Transduction And Receptor Activation In Ligand Gated Ion Channel Receptors
Funder
National Health and Medical Research Council
Funding Amount
$551,560.00
Summary
This project seeks to provide fundamental new information about the means by which neurotransmitter receptors, which mediate fast synaptic neurotransmission, operate. This knowledge is important since the Cys-loop family of ligand gated ion channel receptors are responsible for a wide range of neuronal signalling and the control of both excitatory and inhibitory receptors. The Cys-loop receptors are modulated by both therapeutic drugs (eg. benzodiazepines, barbiturates, antiemetics) and by recre ....This project seeks to provide fundamental new information about the means by which neurotransmitter receptors, which mediate fast synaptic neurotransmission, operate. This knowledge is important since the Cys-loop family of ligand gated ion channel receptors are responsible for a wide range of neuronal signalling and the control of both excitatory and inhibitory receptors. The Cys-loop receptors are modulated by both therapeutic drugs (eg. benzodiazepines, barbiturates, antiemetics) and by recreational drugs (eg. alcohol, nicotine). They are also targets for development of new therapeutic drugs, such as allosteric modulators of nAChR for memory enhancement, or modulating GlyR to relieve spasticity or chronic pain. The project will use a range of molecular advances made by this and other laboratories to clarify how neurotransmitters enable their receptors to activate and signal. This fundamental information is of major medical significance as defective synaptic transmission, caused by mutations in ligand gated ion channel receptors, gives rise to a number of neurological and psychiatric disease states. The ligand gated receptors are also major targets for therapeutic drugs and the information gained in this study may also provide insights into new ways in which drugs could be used to enhance or inhibit synaptic signalling.Read moreRead less