Measuring The Productive Efficiency Of Hospitals - A Comparison Of Parametric And Non-parametric Approaches
Funder
National Health and Medical Research Council
Funding Amount
$61,815.00
Summary
In the face of rising health service costs, an ageing population, and falling private health insurance rates, the efficient use of scarce health service resources has become a central theme in health system reform. Productive (or technical) efficiency is a key aspect of health system reform - that given health services are produced with the minimum feasible amount of resources. Despite the importance of technical efficiency there have been few published studies in Australia which measure technic ....In the face of rising health service costs, an ageing population, and falling private health insurance rates, the efficient use of scarce health service resources has become a central theme in health system reform. Productive (or technical) efficiency is a key aspect of health system reform - that given health services are produced with the minimum feasible amount of resources. Despite the importance of technical efficiency there have been few published studies in Australia which measure technical efficiency in the health sector. This study will develop theoretical and empirical approaches to measuring technical efficiency in the production of hospital services using data from Victoria. Measures of hospital technical efficiency will be developed using two quantitative modelling approaches: stochastic frontier modelling and data envelopment analysis. Results will be used to investigate the impact of patient and hospital characteristics on efficiency, and to identify economies of scale and scope in the provision of hospital services. The robustness of results to changes in variables, the sample of hospitals studied, and model assumptions will be tested, and two techniques will be compared to assess their appropriateness in the health services context which has not previously been done. Criteria for assessing the approaches include the degree to which: assumptions affect the robustness of results; the techniques capture the salient features of health services production; and the techniques produce similar rankings and estimates of inefficiency. The methods used will represent a significant contribution to international knowledge of hospital efficiency measurement, and the relationships between hospital characteristics, casemix, and efficiency. The study wil provide improved measures of hospital efficiency in Victoria, and will inform debate on hospital funding policy.Read moreRead less
Improved electrophoretic analyser for water quality monitoring. This proposal will advance the Australian made Eco Detection portable electrophoretic analyser for autonomous monitoring of water chemistry - the Eco Sensor. We will re-design and miniaturise the fluidic manifold to reduce capital- and per-sample cost, increase the sensitivity of nutrients - nitrate and phospate - by 100-times in both fresh- and sea-waters, and develop new ultra-sensitive reagents for heavy metal detection at enviro ....Improved electrophoretic analyser for water quality monitoring. This proposal will advance the Australian made Eco Detection portable electrophoretic analyser for autonomous monitoring of water chemistry - the Eco Sensor. We will re-design and miniaturise the fluidic manifold to reduce capital- and per-sample cost, increase the sensitivity of nutrients - nitrate and phospate - by 100-times in both fresh- and sea-waters, and develop new ultra-sensitive reagents for heavy metal detection at environmentally regulated levels. This will provide a single platform for at-site near-real-time monitoring of water chemistry for agricultural, mining, water corporations and other industries that use and/or discharge water to the environment. Read moreRead less
We will seek to address an important clinical problem in orthpaedics, namely the bone loss that commonly occurs around joint replacement prostheses. Termed peri-prosthetic osteolysis (PO), this bone loss can result in the loosening and ultimate failure and need for revision of the artificial joint components. PO is thought to be caused by the body's reaction to wear particles generated from the articulating surface of the prosthesis. However, it has not previously been possible to accurately exp ....We will seek to address an important clinical problem in orthpaedics, namely the bone loss that commonly occurs around joint replacement prostheses. Termed peri-prosthetic osteolysis (PO), this bone loss can result in the loosening and ultimate failure and need for revision of the artificial joint components. PO is thought to be caused by the body's reaction to wear particles generated from the articulating surface of the prosthesis. However, it has not previously been possible to accurately explore the relationship between prothesis wear and PO, or the progression of PO, because of a lack of techniques to image and measure the volume of PO around metal prosthesis components. We have developed a means to accurately and reproducibly measure the volume of bone loss, using CT, and will do so longitudinally in joint replacement patients to obtain the first information about the progression of PO. New computer based methods will be used concurrently to relate prosthesis wear and migration parameters to PO. Patients who come to surgery for replacement of failed prostheses will be investigated further by analysis of the tissues involved in the bone loss around prostheses. Basic science experiments will seek to understand the underlying causes of PO and the findings will be important in interpreting the clinical results. An animal model will be used to seek approaches to inhibiting the pathological response to wear particles. The significance of these studies is that they will lead to improved outcomes for joint replacement patients, increasing the interval to revision surgery, which is both extremely costly and brings an attendant morbidity and mortality.Read moreRead less
An Exploration Of Functional Decline And The Potential For Rehab In Patients With Advanced Non-small Cell Lung Cancer
Funder
National Health and Medical Research Council
Funding Amount
$50,000.00
Summary
Lung cancer is one of the commonest human cancers and the leading cause of cancer deaths. People with advanced cancer experience significant decline in functional capacity as their disease advances and they approach death. This decline is likely to have significant impact on quality of life. In lung cancer this decline can be exacerbated by chronic illnesses such as chronic obstructive pulmonary disease (COPD). While significant clinical benefits have been demonstrated in COPD patients with the ....Lung cancer is one of the commonest human cancers and the leading cause of cancer deaths. People with advanced cancer experience significant decline in functional capacity as their disease advances and they approach death. This decline is likely to have significant impact on quality of life. In lung cancer this decline can be exacerbated by chronic illnesses such as chronic obstructive pulmonary disease (COPD). While significant clinical benefits have been demonstrated in COPD patients with the introduction of pulmonary rehabilitation, little research has been conducted to either map the functional status of lung cancer patients or to explore the application of pulmonary rehabilitation in this setting. This study seeks to begin a program of work in this area through first exploring the characteristics of functional decline in this group and then assessing the feasibility and acceptability of a rehabilitation program specifically addressing the functional status needs identified.Read moreRead less
Threats to the water quality and ecosystem of Coffin Bay, South Australia. Coffin Bay (South Australia) is experiencing worsening environmental conditions despite its major economic and ecological importance. Research is needed to understand the cause of this decline, particularly in light of a recent bacterial outbreak that impacted the aquaculture industry. This multidisciplinary project aims to deliver world-leading scientific advice based on novel field techniques and innovative models of th ....Threats to the water quality and ecosystem of Coffin Bay, South Australia. Coffin Bay (South Australia) is experiencing worsening environmental conditions despite its major economic and ecological importance. Research is needed to understand the cause of this decline, particularly in light of a recent bacterial outbreak that impacted the aquaculture industry. This multidisciplinary project aims to deliver world-leading scientific advice based on novel field techniques and innovative models of this complex inverse estuary system and its surrounding catchment. The new understanding of the sources, fluxes and fate of nutrients within the bay and the surrounding catchment, arising from this project, is expected to benefit management decision-making and establish a new standard in estuarine water quality investigation.Read moreRead less
Improving water quality modelling by better understanding solute transport. Poor stream water quality is a critical problem in Australia and globally. Stream water quality depends directly on pathways and time taken for water to transport pollutants through catchments. Predicting these pathways is highly challenging and currently requires specialised data. This project aims to better model the movement of water from rainfall to streams, enable greatly improved use of water quality data routinely ....Improving water quality modelling by better understanding solute transport. Poor stream water quality is a critical problem in Australia and globally. Stream water quality depends directly on pathways and time taken for water to transport pollutants through catchments. Predicting these pathways is highly challenging and currently requires specialised data. This project aims to better model the movement of water from rainfall to streams, enable greatly improved use of water quality data routinely collected in Australia's catchments and thereby better predict water quality behaviour. Proposed field studies aim to support this development. The outcomes sought are improved planning and management of water quality in our rivers, lakes and estuaries, improved health of these water bodies and improved water supplies.Read moreRead less
Mid-Career Industry Fellowships - Grant ID: IM230100222
Funder
Australian Research Council
Funding Amount
$865,628.00
Summary
Large scale urban stormwater reuse: safe, clear and odourless water supply. This project aims to improve the resilience of Australian water supplies by building capacity in urban stormwater reuse. The project expects to address an industry-identified need to determine the suitability of urban lakes and wetlands for stormwater harvesting and develop chemical-sensory monitoring techniques to assess the quality of harvested water. Expected outcomes include the establishment of satellite-based remot ....Large scale urban stormwater reuse: safe, clear and odourless water supply. This project aims to improve the resilience of Australian water supplies by building capacity in urban stormwater reuse. The project expects to address an industry-identified need to determine the suitability of urban lakes and wetlands for stormwater harvesting and develop chemical-sensory monitoring techniques to assess the quality of harvested water. Expected outcomes include the establishment of satellite-based remote sensing as a key technology for stormwater applications and the widespread use of improved techniques for monitoring odorants by the water industry. This should provide significant benefits by informing adaptive planning and infrastructure readiness at water utilities and guiding Australian policy on stormwater reuse.Read moreRead less
Resilient design of energy pile foundations toward zero carbon buildings. This project aims to investigate the complex thermo-hydro mechanical interactions affecting the effectiveness of energy pile foundations for improved energy efficiency of new buildings. Using cutting-edge micro to field-scale methods, this project expects to underpin the development of experimentally validated predictions of the geotechnical performance of energy piles. Expected outcomes of this project are the establishme ....Resilient design of energy pile foundations toward zero carbon buildings. This project aims to investigate the complex thermo-hydro mechanical interactions affecting the effectiveness of energy pile foundations for improved energy efficiency of new buildings. Using cutting-edge micro to field-scale methods, this project expects to underpin the development of experimentally validated predictions of the geotechnical performance of energy piles. Expected outcomes of this project are the establishment of new approaches to improve the resilient design of energy pile foundations, provision of new recommendations for their design and increased integration for zero carbon buildings. These outcomes will contribute significantly toward strategies to decarbonise energy systems in buildings to meet carbon neutrality goals.Read moreRead less
Geometry of wall-turbulence and its potential to advance scalable models. This project aims to unravel the connections between the statistical geometry of wall-turbulence and the dynamical interactions of its instantaneous motions. Predicting the complex behaviour of turbulent fluid flow over surfaces in relative motion is central to atmospheric modelling for climate and agriculture, and reducing the environmental effect of fossil fuel usage. Wall-turbulence statistics organise according to a pr ....Geometry of wall-turbulence and its potential to advance scalable models. This project aims to unravel the connections between the statistical geometry of wall-turbulence and the dynamical interactions of its instantaneous motions. Predicting the complex behaviour of turbulent fluid flow over surfaces in relative motion is central to atmospheric modelling for climate and agriculture, and reducing the environmental effect of fossil fuel usage. Wall-turbulence statistics organise according to a predictable geometric structure, and the notorious complexity of turbulent wall-flow dynamics could be clarified through its inherent geometry. This project expects to construct a basis for predicting engineering and atmospheric wall-flows, which would enhance atmospheric flow prediction, reduce energy consumption and further environmental sustainability.Read moreRead less
Self-similar scale interactions in turbulent boundary layers. Predicting and controlling turbulent fluid flow next to a solid surface (the turbulent boundary layer) is of critical importance to ensuring a sustainable energy and environmental future. While recent research has yielded a clearer physical understanding of these flows, converting this understanding into tools useful to engineering practice remains a central obstacle. The proposed research directly addresses this fundamental challenge ....Self-similar scale interactions in turbulent boundary layers. Predicting and controlling turbulent fluid flow next to a solid surface (the turbulent boundary layer) is of critical importance to ensuring a sustainable energy and environmental future. While recent research has yielded a clearer physical understanding of these flows, converting this understanding into tools useful to engineering practice remains a central obstacle. The proposed research directly addresses this fundamental challenge by precisely connecting the eddy interactions of the turbulence to the mathematical equations that rigorously describe these flows. As such it holds breakthrough potential toward the development of turbulent boundary layer prediction and control schemes that do not rely on ad hoc models or assumptions.Read moreRead less