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
Determining Critical Points In The Potential Palliative Care Pathway In The Last Year Of Life
Funder
National Health and Medical Research Council
Funding Amount
$356,461.00
Summary
People with serious illnesses who are approaching the end of their lives undergo a journey where, along the way, they experience several critical points. Although we know these critical points are crucial to how they might access the best kind of care, we are unsure exactly when these points may occur and how they may vary for different kinds of people. We need to know when is the best time to start withdrawing invasive and purely curative treatments, when are discussions about approaching death ....People with serious illnesses who are approaching the end of their lives undergo a journey where, along the way, they experience several critical points. Although we know these critical points are crucial to how they might access the best kind of care, we are unsure exactly when these points may occur and how they may vary for different kinds of people. We need to know when is the best time to start withdrawing invasive and purely curative treatments, when are discussions about approaching death best introduced and how we can care for people from a diverse range of backgrounds and beliefs within our current health care system. We also need to identify and promote the best possible ways of supporting patients at the end of life and their families as they negotiate the often complex path towards a good death. With this kind of information, health care practitioners, particularly those involved in palliative care, can design better services that put in place pathways where assessment of patient and family needs, referral to the most appropriate services and coordination of all the aspects of care are easy to understand and access for all people. This kind of care can be expensive so we need to use the money allocated to palliative care wisely. This can be achieved with thoughtful research that identifies those most in need, at the time of most need and investigates the best approaches to alleviating pain in suffering in the weeks and months before death. A fair and equitable health care system is not just about keeping people healthy, but also about dealing humanely with the inevitability of deathRead 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
A Model Of Current & Potential Palliative Care Constituency: Measuring Met & Unmet Needs
Funder
National Health and Medical Research Council
Funding Amount
$145,210.00
Summary
Although many health care providers believe palliative care should be offered to all Australians who need it, there is no population-based data to support this claim. This study will provide much needed population-based evidence by measuring the levels of met and unmet needs of people with active, progressive, advanced disease in the last 12 months of their lives. A model of current and potential palliative care constituency will be developed that will lead to improved access to palliative care ....Although many health care providers believe palliative care should be offered to all Australians who need it, there is no population-based data to support this claim. This study will provide much needed population-based evidence by measuring the levels of met and unmet needs of people with active, progressive, advanced disease in the last 12 months of their lives. A model of current and potential palliative care constituency will be developed that will lead to improved access to palliative care for people who do not traditionally access specialist palliative care services.Read moreRead less
This program, run by an established team with skills in public health, clinical epidemiology, biostatistics, health economics and behavioural science addresses the under-researched issues of whether, when and how to use medical tests. The elements of the program follow the sequence in which testing is often done: for screening (early detection), for diagnosis on which to base treatment decisions, and for monitoring the effects of treatment. A common approach throughout is the identification of t ....This program, run by an established team with skills in public health, clinical epidemiology, biostatistics, health economics and behavioural science addresses the under-researched issues of whether, when and how to use medical tests. The elements of the program follow the sequence in which testing is often done: for screening (early detection), for diagnosis on which to base treatment decisions, and for monitoring the effects of treatment. A common approach throughout is the identification of the benefits and harms of testing and assessing their trade-off; how benefits weigh up against harms. This research is relevant to all partners in healthcare, (consumers, clinicians and policy-makers), who currently are being tested or using tests without being fully informed about the accuracy and effects of these tests.Read moreRead less
A Prospective Study To Examine The Effectiveness And Safety Of Antivirals Against Pandemic Influenza
Funder
National Health and Medical Research Council
Funding Amount
$142,394.00
Summary
Pandemic influenza could cause significant mortality in populations of Australia and the south-east Asian region. Currently, avian influenza A (H5N1) is a concern to public health agencies because of its extreme pathogenicity. At present this strain is not transmitted readily between humans. A number of drugs are available to treat influenza infection in humans and research has shown these to be effective in preventing significant mortality in the setting of seasonal influenza epidemics (specifi ....Pandemic influenza could cause significant mortality in populations of Australia and the south-east Asian region. Currently, avian influenza A (H5N1) is a concern to public health agencies because of its extreme pathogenicity. At present this strain is not transmitted readily between humans. A number of drugs are available to treat influenza infection in humans and research has shown these to be effective in preventing significant mortality in the setting of seasonal influenza epidemics (specifically the influenza neuraminidase inhibitors _NIs). As a consequence public health agencies around the world have been stockpiling these drugs and developing sophisticated plans for their use if an influenza pandemic was announced. However, there are no data indicating that the neuraminidase inhibitors (NIs) are safe and effective when used to manage pandemic influenza. Neither are there any data to support the use of these drugs on a population basis. Genetic resistance to NIS has been described but it is not clear if this has any relevance to public health. Our research will clarify this issue. This project will develop a number of clinical trials that could be implemented rapidly should pandemic influenza ever be announced by health authorities in Australia-Singapore or Hong Kong. Patients with suspected influenza infection will be asked to provide informed consent prior to commencing NI therapy. Clinical information will then be collected for a period of approximately one month along with some blood samples and swabs from the throat and nasal passages. Data will be analysed as quickly as possible to help inform the continued use of NI therapy as a cornerstone of the public health agency response to pandemic influenza. In addition, the study team will prepare clinical trials to be conducted in essential workers who are likely to receive long-term NI preventive treatment as well as the immediate contacts of people with presumed influenza infection who are likely to receive short-term prophylaxis with NIs.Read moreRead less