VicCPchild- Prospective Cohort Study Of Children With Cerebral Palsy
Funder
National Health and Medical Research Council
Funding Amount
$613,587.00
Summary
Cerebral palsy is the most common cause of physical disability in children affecting 1 in 500 young Australians. While the brain lesion is static, the musculoskeletal problems are progressive and require lifelong management (cost of US$946,000 over life per person). Only large prospective population-based studies give a true indication of the incidence of physical problems, determine the pathway(s) to outcome and determine the best pathways to successful treatment and efficient resource allocati ....Cerebral palsy is the most common cause of physical disability in children affecting 1 in 500 young Australians. While the brain lesion is static, the musculoskeletal problems are progressive and require lifelong management (cost of US$946,000 over life per person). Only large prospective population-based studies give a true indication of the incidence of physical problems, determine the pathway(s) to outcome and determine the best pathways to successful treatment and efficient resource allocation. The broad aim of this project is: This population based cohort study (n - 240) aims to determine the pathway to motor outcome from diagnosis at 18 months to 5 years based on the nature of the brain injury at 24 months (structural MRI of the nature, location and timing of the brain lesion). Secondary Aims: Determine the rate of musculoskeletal deformity (hip displacement, spasticity, muscle contracture). Potential impact of medical co-morbidities (nutrition, epilepsy, respiratory problems) Patterns of participation and HRQOL. Patterns of medical resource use: treatment costs and outcomes. This study will: Allow clinicians to better the likely functional outcomes of children with CP from an earlier age based on the rate and limit of gross motor development and nature and severity of the brain lesion, determine the nature and timing of physical deformities to aid prevention and treatment; provide information on resource use for future planning and organisation of medical and therapy services. This in turn will give more accurate prognostic counseling as well as target areas for early therapy. Our multidisciplinary research group is uniquely placed to conduct this world-first study with access to two entire birth years of children linked to our Victorian Cerebral Palsy Register. Recruitment is conducted at both the Royal Children's Hospital and the Monash Medical centre in order to ensure state wide referral and easy access for families.Read moreRead less
The WA Safety And Quality Of Surgical Care Project: Improving The Safety, Quality And Provision Of Surgical Care.
Funder
National Health and Medical Research Council
Funding Amount
$583,500.00
Summary
The basis of this application is a three-year project which aims to improve the safety, quality and the provision of surgical care. This application constitutes the core of the WA Safety and Quality of Surgical Care Project (SQSCP), which was established in 1996 to evaluate the clinical epidemiology, health care utilisation, patient safety and health outcomes following admission to hospital for specific surgical and medical procedures in Western Australia (WA). The study will use data from the W ....The basis of this application is a three-year project which aims to improve the safety, quality and the provision of surgical care. This application constitutes the core of the WA Safety and Quality of Surgical Care Project (SQSCP), which was established in 1996 to evaluate the clinical epidemiology, health care utilisation, patient safety and health outcomes following admission to hospital for specific surgical and medical procedures in Western Australia (WA). The study will use data from the WA Data Linkage System, which brings together 15 million records from hospital morbidity, death, cancer, midwives notification and mental health databases. Surgical procedures have been selected for review based on national priorities and after consultation with the WA Branch of the Royal Australasian College of Surgeons (RACS) and other clinical Colleges. This application proposes to continue the core research activities of the SQSCP. A special focus will be on the use of minimally invasive surgical techniques including laparoscopic, endoscopic and endoluminal procedures, which have increased dramatically during the last decade. The study will also evaluate differences in the outcomes of surgical care in rural and metropolitan settings. The findings of the SQSCP will be comprehensively disseminated to surgeons, the RACS, hospital managers, health policy makers and consumers. The rationale of this project is that by providing high quality data on the epidemiology, utilisation and outcomes of surgical care, we will be able to increase the knowledge-base that will contribute to improvements in the safety, quality and provision of surgical care in Australia and internationally. The aims of the SQSCP are consistent with national health priorities and the recommendations of the Taskforce on Quality of Australian Health Care Study, the Australian Council for Safety and Quality in Health Care and the National Institute of Clinical Studies.Read moreRead less
What Matters To Women Diagnosed With Breast Cancer During Their Reproductive Years? A Qualitative Investigation Of Fertility, Reproductive Health, Heritability, And Related Psychosocial Needs Using A Population-based Sample
Funder
National Health and Medical Research Council
Funding Amount
$363,158.00
Summary
Breast cancer in women of reproductive age is especially challenging because fertility can be reduced, pregnancy discouraged, and family formation compromised by the illness and its treatment. This research addresses major gaps in knowledge about the needs of young women with breast cancer. Interviews with 100 breast cancer survivors about fertility, family formation, experiences of health care, and ideas about approaches that may assist them will be used to improve fertility-related care.
A Population-based Survey Of Recent Mothers In South Australia And Victoria
Funder
National Health and Medical Research Council
Funding Amount
$1,098,661.00
Summary
This study involves a postal survey of women giving birth in SA and Victoria in 2007. The survey will be mailed to around 7,000 women by hospitals and home birth practitioners in early 2008, five months after women have given birth. All Indigenous women who give birth in SA and Victoria during 2008, approx. 900 women, will be invited to participate in the survey by completing the survey by mail or by interview. The study will investigate the childbirth and early postnatal experiences, physical a ....This study involves a postal survey of women giving birth in SA and Victoria in 2007. The survey will be mailed to around 7,000 women by hospitals and home birth practitioners in early 2008, five months after women have given birth. All Indigenous women who give birth in SA and Victoria during 2008, approx. 900 women, will be invited to participate in the survey by completing the survey by mail or by interview. The study will investigate the childbirth and early postnatal experiences, physical and emotional health of representative samples of women giving birth in each state. Women living in metropolitan, regional and remote areas, and women having first and subsequent births will be included. A major aim of the study will be to monitor the impact of maternity services strategies implemented in each State, and determine whether the expansion of midwife care and other models providing continuity of care have resulted in improvements in women's overall experiences of maternity care. The study will also investigate women's experiences of psychosocial inquiry and support, explore women's views of universal postnatal home visiting programs and monitor the impact of the continuing trend towards shorter length of postnatal hospital stay on women's health after childbirth, breastfeeding and infant readmission. The impact of organisational and policy changes in maternity care has not been subject to careful or rigorous evaluation. The conduct of population-based surveys of recent mothers in Victoria provides a unique and important source of information for monitoring the impact of policy changes on maternal health and well-being, and women's experiences of maternity care. Repeating the survey, extending the survey to include women giving birth in SA and a representative sample of Indigenous women will provide valuable evidence regarding the responsiveness of maternity services and the extent to which policy changes have led to improvements in maternity care.Read moreRead less
Use And Adequacy Of Diabetic Retinopathy Screening: A Whole Population Linked Data Study
Funder
National Health and Medical Research Council
Funding Amount
$219,382.00
Summary
Diabetes and its health complications are major public health issues presently facing Australia. Currently, around 7% of Australians have diabetes and it is estimated that 300 million people will be diabetic within 20-years. One major complication of diabetes is diabetic retinopathy, which is the most common cause of blindness in working-age adults. Although early treatment can prevent vision loss from diabetic retinopathy, often there are no visual symptoms until the condition is more advanced ....Diabetes and its health complications are major public health issues presently facing Australia. Currently, around 7% of Australians have diabetes and it is estimated that 300 million people will be diabetic within 20-years. One major complication of diabetes is diabetic retinopathy, which is the most common cause of blindness in working-age adults. Although early treatment can prevent vision loss from diabetic retinopathy, often there are no visual symptoms until the condition is more advanced and less treatable. Consequently, it is vital that people with diabetes have their eyes examined regularly. We aim to investigate the use of eye services by people with diabetes. The WA Data Linkage System provides the unique opportunity to efficiently examine the benefits of specialist eye care in diabetics within WA over a 17-year period. The study period encompasses the introduction of NHMRC guidelines for diabetic retinopathy screening in 1997. This will enable us to examine the effectiveness of these guidelines in increasing ophthalmic services use by people with diabetes. Evaluating these trends will provide important data on the effectiveness of policy and NHMRC guidelines in improving diabetic eye care, which has never been comprehensively investigated. Early intervention can prevent and delay vision loss from diabetic retinopathy, substantially reducing the personal and community burden from diabetes. The identification of poorly screened groups will enable more targeted programs to improve the use of ophthalmic series, which in turn may reduce the risk of: i) eye surgery related to diabetes, ii) injury resulting from diabetes-related vision disorder or iii) blindness. The feasibility of using linked health data to evaluate eye screening in diabetics will enable future work addressing processes of care in the prevention of other diabetic complications to be undertaken quickly and cost-effectively.Read moreRead less
Population Based Estimates Of MBS, PBS And Hospital Utilisation Rates Using Prevalent Chronic Disease Denominators
Funder
National Health and Medical Research Council
Funding Amount
$246,000.00
Summary
This project will use hospital morbidity and mortality data from the WA Data Linkage System, linked to the Medicare Benefits Scheme and Pharmaceutical Benefits Scheme databases to produce measures of disease occurrence and health service utilisation within the Western Australian population according to indices of social and geographical disadvantage. The first objective will involve establishing teams of clinicians and researchers who will work together to develop and validate lists of MBS and P ....This project will use hospital morbidity and mortality data from the WA Data Linkage System, linked to the Medicare Benefits Scheme and Pharmaceutical Benefits Scheme databases to produce measures of disease occurrence and health service utilisation within the Western Australian population according to indices of social and geographical disadvantage. The first objective will involve establishing teams of clinicians and researchers who will work together to develop and validate lists of MBS and PBS item numbers that are indicative of specified chronic diseases. This information will then be used to identify patients with these conditions from the MBS and PBS databases during the period 1990-2003 and this method of case ascertainment will be compared with the use of the Hospital morbidity data system alone. Once groups of patients have been identified, their utilisation rates of MBS, PBS and hospital services will be calculated. The effect of social and geographical indices on the occurrence of disease and the utilisation of services will also be studied. Trends over time in health status and health service utilisation are vital to the evidence-based planning and evaluation of health services and to the provision of an equitable and accessible health service which is based on the needs of the community. The work will represent the first time that the utilisation of Australian MBS and PBS itemised services is measured in diagnostically defined groups of patients with chronic diseases.Read moreRead less
Effectiveness Of Continuing Medical Eduation And Feedback In Altering Diabetes Outcomes At A Population Level. A RCT.
Funder
National Health and Medical Research Council
Funding Amount
$947,956.00
Summary
Changing clinical practice so that it is closer to best-evidence care is important to improving health outcomes. This research will test a multi-component intervention with GPs to improve popultaion outcomes for people with diabetes. Rural communities will be randomly allocated to the intervention and control groups, and groups will be compared on indicators of diabetes management at the population level.
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
The Quality Of Surgical Care Project: Quality Assurance, Clinical Audit And Outcomes Evaluation In Western Australia
Funder
National Health and Medical Research Council
Funding Amount
$346,018.00
Summary
The Quality of Surgical Care Project (QSCP) is a unique quality assurance program in Australia which promotes best practice in surgical and procedural care. The objectives of the QSCP are to evaluate the outcomes of surgical procedures in Western Australia (WA) and to compare them with international standards. The QSCP was established in 1996, as a collaborative venture among the Royal Australasian College of Surgeons (RACS), the Department of Public Health, (UWA) and the Health Department of WA ....The Quality of Surgical Care Project (QSCP) is a unique quality assurance program in Australia which promotes best practice in surgical and procedural care. The objectives of the QSCP are to evaluate the outcomes of surgical procedures in Western Australia (WA) and to compare them with international standards. The QSCP was established in 1996, as a collaborative venture among the Royal Australasian College of Surgeons (RACS), the Department of Public Health, (UWA) and the Health Department of WA. The QSCP is only possible because of the unique population-based record linkage available in this state and is consistent with priorities identified in the National Health Information Development Plan in the areas of record linkage and health outcomes, as well as with the monitoring of interventions recommended by the Taskforce on Quality in Australian Health Care. The surgical procedures reviewed are selected to include a broad range of surgical specialties on the basis of national priority, in consultation with the RACS and with input from the Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S). This application proposes to continue the core program in promoting best practice in procedural care by reviewing selected procedures including the outcomes of laparoscopic and endoscopic procedures, and endoluminal stenting surgery due to their rapid proliferation during the 1990's. This second stage of the QSCP proposes the introduction of two new quality assurance themes. Firstly, to promote the clinical safety and post-implementation surveillance of new surgical interventions and other medical technology by establishing the WA Registry and Surgical Audit of New Surgical Interventions. Secondly, to comprehensively and independently audit all surgical mortality at a population level. A dissemination strategy will be established to 'complete the loop' in the evaluation and audit processes.Read moreRead less
Health System Performance And Outcomes For Indigenous Australians With Cancer: A National Study.
Funder
National Health and Medical Research Council
Funding Amount
$412,354.00
Summary
Cancer has only recently been recognised as a significant Indigenous health issue, partly because no national information has been available on the impact of cancer on Indigenous people or on health system performance for Indigenous cancer patients. Recent research in the Northern Territory has demonstrated large deficiencies in diagnosis, treatment and survival for Indigenous compared to other cancer patients. Despite imperfect data on Indigenous status, important information can be obtained ab ....Cancer has only recently been recognised as a significant Indigenous health issue, partly because no national information has been available on the impact of cancer on Indigenous people or on health system performance for Indigenous cancer patients. Recent research in the Northern Territory has demonstrated large deficiencies in diagnosis, treatment and survival for Indigenous compared to other cancer patients. Despite imperfect data on Indigenous status, important information can be obtained about health system performance for Indigenous Australians from national administrative databases and registers. This project will assess health system performance and outcome for Indigenous people with cancer at a national level for the first time. It will compare Indigenous with non-Indigenous cancer survival rates for Australia as a whole, including regional (urban-rural-remote) variations and time trends. For those states where data on stage at diagnosis and hospital treatment are available, it will also investigate the performance of diagnostic and treatment services for Indigenous cancer patients by comparing their stage at diagnosis and surgical treatment with that for non-Indigenous patients. Time trends for each of these issues will be examined using data from those states with data of adequate quality and consistency over the past 10-15 years. This project will provide the methodological basis for regular reporting of Indigenous cancer survival and related statistics in the national cancer reporting system and demonstrate that national monitoring of the acute care system for Indigenous people is possible for other conditions. The results of this research will directly inform acute care policy and practice for Indigenous people with cancer (particularly the relative need for improvement in primary health or acute care services), and have implications for the performance of the acute care system system more generally for Indigenous Australians.Read moreRead less