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The following list outlines funded projects from 2005 to 2010, including time-limited projects, some taking place over weeks or months and other work, usually complex program evaluations that last for two or three years.

2010 research projects

Background

The CareSearch website was launched in 2004 and was initially designed to be a support and resource for specialist palliative care providers. In July 2006 the Knowledge Network Project commenced with the aim of establishing the first Australian Palliative Care Knowledge Network

It was envisaged that this network would provide a ‘one stop shop’ for information and practical resources to serve the needs of all those providing or affected by palliative care.

Following consultation across the sector, the CareSearch website was modified (in 2007) to incorporate patient and carer information and general practitioner (GP) resources. In May 2008 the new website, CareSearch palliative care knowledge network, was launched. CHSD has undertaken a series of evaluations aimed at improving the useability of the site and its information content. In 2010 the evaluation covered three components of the website: 

  • CareSearch Nurses Information Newsletter (CNIN) 
  • @CareSearch Newsletter
  • CareSearch Research Data Management System (RDMS)

The CareSearch Nurses Information Newsletter

This evaluation used an on-line survey and semi-structured telephone interviews about the Nurses Information Newsletter (CNIN), designed to identify what would be useful for nurses to improve their practice and to gain an understanding of how nurses use the newsletter and identify any areas for improvement.

The CNIN is a tool to help nurses with day to day clinical and practice issues, providing information about evidence, research and practice in palliative care. The feedback highlighted a lack of confidence and understanding of evidence based practice concepts amongst nurses, as well as uncertainty about how to use the site’s resources to solve real clinical issues. 

The majority of respondents to the on-line survey reported that the Newsletter is an important resource, almost all of them had used it and the associated resources to increase their knowledge and about two thirds have used it to improve their practice. Examples were information about spiritual care, better understanding of evidence-based practice and developing care plans for home use.

The respondents who were telephoned were also very supportive of the CNIN and its identified primary role of providing evidence based information to nurses. The need to get access to reliable evidence quickly and efficiently by nurses was seen as an important and necessary function in improving practice in palliative care services. 

Almost a quarter of the respondents to the on-line survey did not identify themselves as having a nursing role, suggesting that there is a considerable number of non-nursing professionals who are seeking relevant and reliable evidence about palliative care. Developing other ways of getting this information out to that group of clinicians and other professionals, such as through allied health journals, was also identified as an issue to explore.

The telephoned respondents suggested that the in-depth coverage of a topic on a regular basis such as monthly or quarterly may be a useful addition to the current content. The occasional need for a login and password made it not as simple as they would have liked. Another idea was a self-contained version of the CNIN that could be printed out and distributed to an audience that did not have regular access to the internet.

The @CareSearch Newsletter

The @CareSearch Newsletter is produced monthly and is emailed to all registered users of the CareSearch website (in 2010 this number was approximately 1,750). It is also available as a PDF document from the CareSearch website. The purpose of the newsletter is to update the palliative care community on the latest developments relating to the website.

The survey was designed to test the impact and effectiveness of the newsletter and identify possible areas for improvement. Over half of respondents preferred to receive the newsletter as a stand-alone PDF so it could be printed and shared, with the preferred size between 1 and 4 pages.

Less than half of the respondents reported that the newsletter had enabled them to make changes in palliative care practice, and of these, only a third (about one eighth of total respondents) reported that they had been able to use the information from the @Caresearch newsletter to change practice within their service. This is consistent with the literature which indicates that passive dissemination of information tends to be ineffective with, at best, only small changes in practice. About one third of respondents thought that the newsletter needed to change but few suggestions were made on how to do this. 

The Knowledge Network Research Data Management System

This evaluation project was an on-line survey and semi-structured telephone interviews about the Research Data Management System (RDMS). The RDMS is a multi-site research platform that has been developed to support research work within palliative care by providing access to a tool that: 

  • Enables the online design of data collection forms and questionnaires 
  • Allows for web-based and email-based form completion 
  • Enables data entry from multiple sites with a single co-ordinating site 
  • Provides for basic reporting of results with features such as percentages, graphs, and tables 
  • Allows export of data to other programs such as Excel, Access or SPSS. 

The platform was launched in 2005 and in 2010 had approximately 250 registered users accessing over 100 active surveys or forms in use in various research projects. The RDMS supports research groups working in all Australian jurisdictions, some of which have international partners. The platform is used for clinical trials, feedback surveys, audit activities and workforce related activities.

Feedback from the on-line survey was very positive about the RDMS, with 90% saying they would recommend the RDMS to others. Respondents were pleased with the support provided by the CareSearch team to users when they needed assistance. So, part of the success of the RDMS was attributed to the support provided by the team to responding to user problems and issues, especially with a workforce that has not traditionally been “data-aware”.

Background

The aim of this project was to review the literature on instruments used for the effective assessment of social isolation amongst clients and for the outcomes assessment of therapeutic interventions designed to reduce social isolation. From this review the best instruments used to assess social isolation were recommended, including any adaptations that may have be required for these instruments (e.g. item modification, field testing, and the development of rating scale versions). In addition to this, the report identified the most promising instruments to use for the assessment and monitoring of social isolation amongst Ageing, Disability and Home Care clients. The recommendations included consideration of the best way to implement assessment and outcome evaluation measures for social isolation in routine practice. The particular target groups for this project were the elderly, young people with disabilities, and their carers.

Download the final report

Sansoni J, Marosszeky N, Sansoni E and Fleming G (2010) Final Report: Effective Assessment of Social Isolation. Centre for Health Service Development, University of Wollongong.

 

Project team: Jan Sansoni, Nick Marosszeky, Emily Sansoni, Glenn Fleming

Background

The particular focus of this report is shaped by lessons from projects related to outcome measurement conducted by one research centre over a decade and the policy context of the current (late 2010) reform agenda in both the health and community care sectors. These sectors are not separate systems when looked at from the point of view of an individual who requires assistance to maintain their health and independence at home and lessons from both sectors are
useful. Common and/or better integrated systems that are adapted to accommodate more of the client’s own viewpoint (as distinct from a program management point of view) will support the policy aim of personalising or individualising service responses.

Download the final report (pdf)

 

Background

This project built on a related piece of work in 2009; a study of the health of people in immigration detention for the Department of Immigration and Citizenship. The 2010 review of the literature and current practice on models of care for refugee health was undertaken to support the update of the Refugee Health Plan for NSW Health. It informs how models of care have been changing and how best to develop services to meet the support needs of refugees.

Once refugees’ health needs are described, the key question is how best to respond to them. NSW Health issued its Strategic Directions in Refugee Health Care in NSW ten years ago to provide a framework and direction for service and strategy development in refugee health in NSW. In consideration of the significant changes in national government policies, major changes in the countries of origin of refugees and significant refugee health service developments in the last decade, a new plan for refugee health was developed to guide future service delivery.

The report and workshop involved in this project provides one plank in the planning process. Reviewing the literature on models of care across Australia and internationally informs how best to respond to the continuum of need and to guide the set of objectives, strategies and suitable measures that can be embodied in the new plan.

Government policies on refugee health within the jurisdictions and internationally should be informed by evidence from studies of the health of this marginalised and often traumatised group, as well as evidence about what works best in dealing with their needs.

Download the literature review  

Owen A, Grootemaat P, Samsa P, Fildes D and Eagar K (2009) Review of the Literature and Practice on Models of Care for Refugee Health. Centre for Health Service Development, University of Wollongong.

 

Project team: Alan Owen, Pam Grootemaat, Peter Samsa, Dave Fildes, Kathy Eagar

2009 research projects

Background

ACT Health funded a targeted literature review on new models of care and their implications for capital planning.

This review assessed the available evidence regarding current/emerging models of care, changes in workforce, and technological innovation in terms of their implications on the future level of demand for ACT Government funded health services. The major purpose of this macro analysis was to assess, where possible, the plausibility of key ACT Health planning assumptions in view of the identified trends in the health care environment and the likely impact on future service delivery. This review allowed us to leverage off the excellent work of many CHSD team members put into reports from: SAFTE, Veterans’ Home Care, Community Health Review, NSW Clinical Redesign and the Gold Coast Hospital Avoidance Program.

Download the final report

Thompson C, Masso M and Eagar KM (2009) The effects of model of care/demand management strategies on projected public sector acute and community based health services in the ACT. Centre for Health Service Development, University of Wollongong.

 

Project team: Cristina Thompson, Malcolm Masso and Kathy Eagar

 

Background

The Cancer Australia came to an end with submission of the final report on 30 June 2009. Three reports documented the establishment, operation, impact and outcomes of Cancer Australia. CHSD (in conjunction with the Centre for Research in Learning and Change at the University of Technology, Sydney), was commissioned by the Chief Executive of Cancer Australia to conduct an independent organisational evaluation in May 2008.

Specifically, CHSD was asked to ‘determine whether Cancer Australia is meeting its responsibilities efficiently and effectively’. Particular emphasis was placed on the evaluation maximising the further development and overall effectiveness of Cancer Australia. The evaluation framework outlined three levels of evaluative analysis; formative, summative, and developmental.

Report 1 focused on formative evaluation issues and aimed to answer the question ‘how can we learn and get better as we go?’. It also documented the history and establishment phase of Cancer Australia.

Report 2 addressed formative and developmental evaluation issues in relation to nine ‘key success factors’ drawn from the organisational development literature through synthesising stakeholder perspectives and documentary sources. Data for Report 2 was drawn from over 50 individual interviews and focus groups with key stakeholders within the cancer control sector – government and non-government organisations, clinicians, researchers and consumers. Its aim was to assist the organisation to reflect upon the findings and ‘find opportunities for continuous learning and development’.

Report 3 developed a summative analysis and aimed to integrate what has been learned, generating summative conclusions and proposing options for the future development of the organisation. These findings were also informed by an analysis of the impact of Cancer Australia’s performance at three levels – the consumer, the provider and the system. This third report addressed the question of whether, and to what extent, the performance of Cancer Australia met its legislative, policy and organisational responsibilities.

Download the final reports

Owen A, Thompson C, Dunston R and Eagar K (2009) Cancer Australia: the first phase, October 2006 to December 2008. Centre for Health Service Development, University of Wollongong.

Thompson C, Owen A, Dunston R and Eagar K (2009) Discussion Paper - Cancer Australia: the first phase, October 2006 to December 2008. Centre for Health Service Development, University of Wollongong.

Thompson C, Owen A, Dunston R and Eagar K (2009) Cancer Australia: achievements, outcomes and future directions. Centre for Health Service Development, University of Wollongong.

 

Project team: Cristina Thompson, Alan Owen, Roger Dunston and Kathy Eagar

Background

The Gold Coast Health Service District (GCHSD) established a hospital avoidance pilot program with a ‘single entry point’ for developing more immediate responses to patients’ needs. The purpose of this program was to reduce emergency department (ED) presentations, hospital admissions from the ED, the average length of stay (LOS) for patients, the readmission of complex patients, and the need for ambulance transfers.

The pilot program began in July 2008 and operated until 31 December 2009. The Centre for Health Service Development was commissioned by Queensland Health to undertake an independent evaluation of the pilot program in the GCHSD. We used our evaluation framework and our experience in a similar program in NSW (Evaluation of the Sub Acute and Fast Track Elderly (SAFTE) Care Program) to provide guidance for decision makers on how the program is operating.

Download the final evaluation report 

Eagar K, Green J, Quinsey K, Masso M, Owen A, Grootemaat P and Thompson C (2009) Evaluation of the Gold Coast Hospital Avoidance Program: Final Report. Centre for Health Service Development, University of Wollongong.

 

Project team: Kathy Eagar, Janette Green, Karen Quinsey, Malcolm Masso, Alan Owen, Pam Grootemaat and Cristina Thompson

Care Planning Sub-Program Evaluation Reports

Background

The Care Planning Sub-Program was one of four sub-programs of the Local Palliative Care Grants Program (LPCGP), which was funded by the Australian Government and was announced in the 2005 federal Budget.

There were 33 Care Planning projects throughout Australia, with funding of between $100,000 (GST exc) and $250,000 (GST exc), up to three years, and ending by March 2009.

Overall, the Care Planning Sub-Program aimed to support health professionals to improve patient care through:

  • Developing and implementing flexible models of service delivery
  • Improving collaboration between services
  • Supporting smooth and appropriate transitions between settings of care

The program had six specific objectives, and many of the projects addressed several of these objectives:

  1. Develop resources or tools for care planning
  2. Involve carers and families in care planning
  3. Trial models of care (e.g. case conferencing)
  4. Address the needs of particular population groups
  5. Support the translation of research into practice
  6. Promote high-quality evaluation of current initiatives

The national evaluation of the Care Planning Sub-Program was conducted by the Centre for Health Service Development, University of Wollongong.

Care Planning 3rd Workshop Presentations

Presentations from the third Care Planning Workshop (28-29 July 2008, Novotel Brighton Le Sands, Sydney):

Care Planning 2nd Workshop Presentations

Presentations from the second Care Planning Workshop (26-27 June 2007, Novotel Brighton Le Sands, Sydney):

Other relevant presentations

Presentations from the first Care Planning Workshop (27-28 November 2006)

Rural Palliative Care Program Workshop Presentations (24 November 2006)

 

Project team: Karen Quinsey, Anita Westera, Pam Grootemaat, Kathryn Williams, Darcy Morris, Dave Fildes

Background

The CHSD was commissioned by NSW Health to review the teaching and research components of the Resource Distribution Formula (RDF). Two components in the RDF were reviewed. The ‘Indirect Teaching and Research’ factor in the RDF covers the indirect costs of teaching, research, and learning. It also covers differences in patient severity that cannot adequately be measured by the AR-DRG classification. The ‘Direct Teaching and Research’ factor in the RDF covers not only teaching and research, but also learning.

In summary, the major deliverables included a targeted literature review of relevant international and national approaches to this subject area; consultation with NSW Area Health Services and other key clinical stakeholders; development of options for modelling and analysis; and finally a recommended way forward for review by the NSW RDF Technical Committee. The project was completed in December 2009.

Download the final report

Eagar K, Thompson C, Green J, Balasingam D and Tarn M (2009) Review of Direct and Indirect Teaching and Research Factor: NSW Health Resource Distribution Formula. Centre for Health Service Development, University of Wollongong.

 

Project team: Kathy Eagar, Cristina Thompson, Janette Green, Darssan Balasingam, Michael Tarn

Victorian Department of Human Services

Background

CHSD was commissioned to undertake a project for the Victorian Department of Human Services to develop a minimum dataset (MDS) for hospital based palliative care consultation teams. The project developed and trialled a State-wide MDS that measured the activities and outcomes of palliative care consultancy teams in Victoria. The project aimed to produce an MDS that could be used to monitor quality and clinical outcomes, team activity and client satisfaction, as well as support the ongoing role of the consultation teams.

During March and April, meetings were held with each of the 12 services which outlined the project and helped CHSD develop an understanding of the various models that operate across teams. A workshop, attended by all teams, was held on 19 May to consolidate the findings of the consultation process and agree on the composition of a dataset to pilot in July. During June, the pilot dataset and associated forms were finalised and training sessions were held for all teams. During July, all teams participated in the MDS pilot data collection. About 60 clinicians across 13 hospitals captured clinical and service utilisation data about patients treated during this time. The data collected was then analysed and informed a MDS that was routinely collected by all teams from 1 July 2010. The project was successfully completed in December 2009.

Download the final report

Gordon R, Martin P, Balasingam D, Fildes D and Tarn M (2009) The Development of a Minimum Dataset for Victorian Hospital Based Palliative Care Consultancy Teams: Final Report. Centre for Health Service Development, University of Wollongong.

 

Project team: Robert Gordon, Peter Martin, Darssan Balasingam, David Fildes and Michael Tarn

2008 research projects

Background

The Clinical Services Redesign Program was a three year program (2005-2008) by the NSW Health Department to improve the performance of the health system, particularly in the areas of emergency departments, elective surgery and aged care. It was part of a broader reform strategy that involved top-down performance management and additional resources.

CHSD undertook an evaluation of the program over two years (2006-2008) in collaboration with two colleagues from the University of Wollongong – Professor Helen Hasan and Dr Grace McCarthy – and Professor Paul Bate and Dr Glenn Robert from University College London.

The evaluation combined strong elements of quantitative and qualitative data analysis and provided an excellent opportunity to develop skills in qualitative research, using techniques not previously employed. The evaluation also utilised an innovative approach to the use of seasonally adjusted time series data. The evaluation of the CSRP represented a major piece of work (our largest evaluation since the SNAP study when the Centre began) investigating the use of the redesign methodology, primarily involving acute hospital-based services, and has the potential to provide a platform for similar work in the future. The lessons learnt from the evaluation have influenced a number of other projects subsequently undertaken in the Centre.

Reports

Masso M et al (2007) First Annual Report on the NSW Clinical Services Redesign Program. Centre for Health Service Development, University of Wollongong and University College London.

Masso M et al (2007) Second Annual Report on the NSW Clinical Services Redesign Program. Centre for Health Service Development, University of Wollongong and University College London.

Masso M et al (2008) Third Annual Report on the NSW Clinical Services Redesign Program. Centre for Health Service Development, University of Wollongong and University College London.

Eagar K, Masso M, Robert G and Bate P (2008) The NSW Clinical Services Redesign Program: achievements and lessons. Centre for Health Service Development, University of Wollongong and University College London.

Related Journal Article

Masso M, Robert G, McCarthy G and Eagar K (2010) The Clinical Services Redesign Program in New South Wales: perceptions of senior health managers. Australian Health Review, 34 (3): 352-9.

 

AHSRI project team: Malcolm Masso, Luise Lago, Peter Siminski, Helen Hasan, Frances Simmonds, Sonia Bird, Karen Quinsey, Joseph Carolan, Grace McCarthy, Kathy Eagar

Collaborators: Glenn Robert, Paul Bate

Background

In late 2007, the Centre was approached by NSW Health to conduct a scoping study about current opportunities for dementia education and training for health professionals in NSW. The study was conducted between March 2008 and July 2008, and included interviews with 27 key stakeholder groups representing health and care service providers with whom people with dementia and their carers interact during their ‘dementia journey’, and with patient/client and carer representatives, as well as training providers and peak organisations. In addition, a short internet search was conducted to complement this work and inform the Department of the current opportunities for dementia education and training for health professionals in NSW.  

Two key messages emerged from the study as follows:

  • It is clear that dementia is core business for the health system and that this needs to be reflected at the systemic as well as local level.
  • The philosophy of person-centred care should underpin the delivery of health and care services.

In total, 19 recommendations were made to the Department to improved dementia training opportunities for health professionals. These included suggestions for the use of one-off training funds under the current NSW Dementia Action Plan 2007– 2009, should recurrent funding become available. In addition, recommendations were made regarding systemic changes which could be undertaken to make dementia training more accessible and integrated within education and training programs for health professions, community care providers, and for the community in general.

Download the final report

Marosszeky N, Westera A and Sansoni J (2008) Dementia Training for Health Professionals - Scoping Study. Centre for Health Service Development, University of Wollongong.

 

Project team: Nick Marosszeky, Anita Westera and Jan Sansoni

Background

This project, commissioned by the Department of Immigration and Citizenship, involved a retrospective case review of the health of a sample of 720 people held in detention in 2005/06.

The project was completed in February 2008 and Professor Kathy Eagar briefed the Minister of Immigration (Chris Evans) about the results at a meeting in parliament house in June 2008.

The Minister announced major changes to Australian detention policy on 29 July. In doing so, he said:

“The impacts on both the physical and mental health of the detainees are severe. Recent research undertaken by the Centre for Health Service Development at Wollongong University dramatically highlights the deleterious health impacts of long-term detention”.

The conclusions were published in the Medical Journal of Australia. The accompanying editorial pointed out:

“This is the largest Australian study to date of the health of people who have been in detention, and the first to follow up a cohort over an entire year. Studying the health of such people in the past in Australia has been challenging; five previous studies, although valuable, were necessarily small scale.”

Related publications

For the whole of the editorial and more detail on these topical matters, see ‘Immigration detention and health’ by Christine B Phillips, Med J Aust 2010; 192 (2): 61-62.

The original article is entitled ‘The health of people in Australian immigration detention centres’ by Janette Green and Kathy Eagar, Med J Aust 2010; 192 (2): 65-70.

Background

The Centre undertook a review of the AIDS Resource Distribution Formula (RDF) in New South Wales for the AIDS/Infectious Disease Branch (AIDB) of NSW Health that was completed in early 2009. The outcome of the project was an appropriate model for NSW Health to determine the equitable allocation of funds to Area Health Services for the delivery of local HIV, sexually transmissible infections, Hepatitis C services and the Needle and Syringe Program.

The need for these services varies across NSW. To ensure geographic equity in the allocation of funds across the Areas, NSW Health has been using an AIDS Resource Distribution Formula. This is a statistical model that allocates funding on the basis of population need.

In 2004, the AIDS-RDF was reviewed for the first time in almost ten years. That review recommended substantial changes to the Area allocations for local service delivery and these were subsequently introduced over a four-year period. In order to maintain geographic equity in the allocation of funds, the AIDS-RDF model needed to be reviewed  again. In particular, the project involved investigating whether the current model appropriately allocates funds to local services, including clinical and non-clinical service delivery, and whether it adequately accounts for cross-Area Health Service patient flows.

 

Project leader: Rob Gordon

Background

The State-wide Services Development Branch of NSW Health commissioned a costing study to inform the NSW Blood and Marrow Transplantation (BMT) Service Plan. The BMT Service Plan will provide comprehensive planning framework for BMT services to 2011.

The project considered variables such as population projections, increasing demand for services, changes in utilisation rates and the impact of emerging technologies in establishing service configuration and resource requirements for BMT services across NSW. Issues around regulatory and research developments were also taken into account.

The costing study is an important component of the planning and development process for BMT services. Allogeneic BMT in particular, is recognised as one of the most complex and costly procedures provided in the health system. It is therefore critical to develop a thorough understanding of both current cost structures and factors that are likely to impact on costs and resource requirements in the future.

Download the final report

Gordon R, Thompson C, Carolan J, Eckstein G and Rostron C (2009) A Costing Study of Blood and Marrow Transplantation Services in NSW: Final Report. Centre for Health Service Development, University of Wollongong.

 

Project team: Rob Gordon, Cristina Thompson, Joseph Carolan, Gary Eckstein, Catherine Rostron

Background

The NSW Community Health Review was a strategic review of community health in NSW undertaken during 2008.  This project was funded by NSW Health and consisted of three major components:

  1. An audit of the scope of activity and existing investment in community health services.  This audit was undertaken by NSW Health.
  2. Analysis of gaps in current provision of community health services with a focus on service delivery, governance, linkages and referral pathways with other parts of the health system including general practice, other providers of primary care services and acute and population health services.
  3. Development of a vision for the future role and operation of a revitalised community health service sector with a focus on core services to be provided by community health services, best buys and areas for investment and disinvestment and a staged pathway for reform.

The scope of the NSW Community Health Review was limited to community health services provided by NSW Health Area Health Services.  It did not include community health services provided by Non-Government Organisations (NGOs). 

The Centre for Health Service Development produced three reports for the NSW Community Health Review:

Report 1 - Community health: the evidence base summarised research on models of community health service delivery in NSW, elsewhere in Australia and internationally and synthesised the evidence on the effectiveness of community health interventions.

Report 2 - Community health: the state of play in NSW described current clinical and management structures and identified existing gaps in service provision.  It also addressed issues such as linkages and referral pathways with general practices and other community based health services and with the acute and population health sectors.

Report 3 – Community health at the crossroads: which way now?  This report built on the first two reports.  It was strategically focussed and designed to inform future planning and resource allocation decisions in NSW.

These reports are available to download below.

Download the reports

Owen A, Thompson C, Samsa P, Grootemaat P, Fildes D and Eagar K (2008) Community health: the evidence base. A report for the NSW Community Health Review. Centre for Health Service Development, University of Wollongong.

Eagar K, Owen A, Cranny C, Samsa P and Thompson C (2008) Community health: the state of play in NSW. A report for the NSW Community Health Review. Centre for Health Service Development, University of Wollongong. 

Eagar K, Owen A, Cranny C, Thompson C and Samsa P 2008) Community health at the crossroads: which way now? Final report of the NSW Community Health Review. Centre for Health Service Development, University of Wollongong.

 

Project team: Kathy Eagar, Alan Owen, Cristina Thompson, Peter Samsa, Pam Grootemaat, Dave Fildes, Carla Cranny

Background

This was an important project in 2008 that addressed ways of estimating the funding required to close the gap in Aboriginal and Islander health in Far North Queensland. It was commissioned by the Queensland Aboriginal and Islander Health Corporation (QAIHC) and addressed three questions:

1. What is the current cost of primary health services in Cape York and Yarrabah?

2. What would it cost to bring these communities up to the current national average?

3. Consistent with the Prime Minister’s commitment, what would it cost to close the health gap?

The project was undertaken in collaboration with the Apunipima Cape York Health Council in Cape York and the Gurriny Yealamucka Health Services Aboriginal Corporation in Yarrabah.

Download the final report

Eagar K and Gordon R (2008) Access and equity - the funding required to close the gap in Aboriginal and Islander health in Far North Queensland. Centre for Health Service Development, University of Wollongong.

 

Project team: Kathy Eagar, Rob Gordon

2007 research projects

Background

One of the achievements for AHOC in 2007 was the completion of the Dementia Outcomes Measurement Suite Project (DOMS) for the Australian Department of Health and Ageing in October. The 935-page final report outlined the review of over 800 instruments to find the best measures to assess the status and symptoms of people with dementia. The scope of the project included recommending a set of instruments suitable for routine use in the Australian health care sector in the areas of dementia specific assessment, health related quality of life, cognitive assessment, social participation, associated behavioural and mental symptoms, functioning, utility and satisfaction measures.

The recommendations contained in the report will help to standardise the assessment, screening and outcomes evaluation procedures used in the field and enhance the comparability of findings across research and practice settings.

Download the final report

Sansoni J, Marosszeky N, Jeon Y-H, Chenoweth L, Hawthorne G, King M, Budge M, Zapart S, Sansoni E, Senior K, Kenny P, Low L (2007) Final Report: Dementia Outcomes Measurement Suite Project. Centre for Health Service Development, University of Wollongong.

Download the Final report - Appendices (pdf)

Download the Final report - Synopsis (pdf)

Related publications

Sansoni J, Marosszeky N, Hawthorne G and Sansoni E (2009) Some highlights of the Australian dementia outcomes measurement suite (DOMS) project: social isolation. Alzheimer's Association International Conference on Alzheimer's Disease, 11-16 Jul 2009, Vienna, Austria. Alzheimer's & Dementia 5 4 (2009) P90.

Sansoni J, Marosszeky N and Sansoni E (2008) The Dementia Outcomes Measurement Suite: tools for practice improvement (Guest lecture series). Eastern Australia Dementia Training and Study Centre (EADTSC), University of Wollongong, 19 August 2008.

Sansoni J, Marosszeky N and Sansoni E (2008) Recent findings: Dementia Outcomes Measurement Suite. Minister's Dementia Advisory Group Meeting, Canberra, 26 May 2008.

Sansoni J, Marosszeky N and Sansoni E (2009) The Dementia Outcomes Measurement Suite (DOMS) Project. Alzheimer's & Dementia Volume 5, Issue 5, September 2009, Pages e7–e8.

 

AHSRI project team: Jan Sansoni, Nick Marosszeky, Emily Sansoni, Kate Senior

Collaborators: Yun-Hee Jeon, Lynn Chenoweth, Graeme Hawthorne, Madeleine King, Marc Budge, Siggi Zapart, Patsy Kenny, Lee-Fay Low

Background

This project was a sequel to work for the Department of Health and Ageing’s Carer Section on assessment to identify the needs of carers (the development of the CENA tool) including the factors that sustain carers in their caring role. Its aim was to identify effective interventions and to develop and propose a prioritised research agenda in this area. 

The Effective Caring project was carried out during 2007 in several stages including an international literature review and a workshop with service delivery and academic experts to identify priorities for improving routine practice in carer support networks and priorities for building a coherent research and development agenda. 

The final report incorporated both the literature review and the outcomes of the national workshop and is expected to be a valuable resource for policy and practice in Australia. It provides an evidence base, both for carer interventions and for a research agenda that complements and extends the work already done on understanding and assessing carers' needs.

Download the final Report

Eagar K, Owen A, Williams K, Westera A, Marosszeky N, England R and Morris D (2007) Effective Caring: a synthesis of the international evidence on carer needs and interventions. Volume One: The Report. Centre for Health Service Development, University of Wollongong.

Eagar K, Owen A, Williams K, Westera A, Marosszeky N, England R and Morris D (2007) Effective Caring: a synthesis of the international evidence on carer needs and interventions. Volume Two: Attachments to the Report. Centre for Health Service Development, University of Wollongong.

Related Journal Article

Williams K and Owen A (2009) A contribution to research and development in the carer support sector: lessons on effective caring. Family Matters, 82: 38-46.

 

Project team: Kathy Eagar, Alan Owen, Kate Williams, Anita Westera, Nick Marosszeky, Rochelle England, Darcy Morris

Background

Under the National Palliative Care Strategy (NPCS) the Australian Divisions of General Practice was funded to trial eight projects in a range of rural and remote settings implementing the Rural Palliative Care (RPC) model, based on an earlier CHSD evaluation of a Griffith-based (GAPS) model. The role of the CHSD was to evaluate each of the projects and the Program as a whole, using the evaluation framework and tool kit shared with the Caring Communities Program evaluation.

The three year evaluation of the Rural Palliative Care Program (RPCP) was completed in 2007 with both local evaluation project reports and a consolidated report drawing out the lessons from the program and recommending how a national approach could be expanded to the range of other rural areas.

Download the final report

Quinsey K, Masso M, Fildes D, Siminski P, Grootemaat P, Matete S and Eagar K (2007) Providing Palliative Care in Rural Australia: results of a national program evaluation. Centre for Health Service Development, University of Wollongong.

Quinsey K, Owen A, Masso M, Fildes D and Eagar K (2007) Lessons from the National Evaluation of the Rural Palliative Care Program: a synthesis of the findings and recommended next steps. Centre for Health Service Development, University of Wollongong.

Related Publications

Masso M and Owen A (2009) Linkage, coordination and integration – evidence from rural palliative care. Australian Journal of Rural Health, 17 (5): 263–267

Grootemaat P, Quinsey K and Owen A (2008) Rural Palliative Care Program National Evaluation Project: Patient and Carer Experiences. National Health Outcomes Conference Wollongong, Australia: Australian Health Outcomes Collaboration. Centre for Health Service Development, University of Wollongong.

 

Project team: Karen Quinsey, Malcolm Masso, Dave Fildes, Peter Siminski, Pam Grootemaat, Sheila Matete, Alan Owen, Kathy Eagar

Background

The SAFTE Evaluation was completed in early 2007. It examined the relationship between the usage of emergency department services and the availability of community-based services, particularly for older people, across four pilot sites.

The SAFTE evaluation was focused on the outcomes for clients and the value for money aspect of a particular demand management strategy that was part of the larger NSW Health system-level reform agenda called the Clinical Services Redesign Program. CHSD was the independent evaluator of both programs.

Download the final SAFTE report

Westera A, Stevermuer T, Samsa P, Quinsey K, Owen A, Marosszeky N and Eagar K (2007) The NSW SAFTE Care Program – evaluation of a pilot program to prevent unnecessary hospital attendances by older people. Centre for Health Service Development, University of Wollongong.

 

Project team: Anita Westera, Tara Stevermuer, Peter Samsa, Karen Quinsey, Alan Owen, Nick Marosszeky and Kathy Eagar

Background

The Sydney South West Health Service commissioned the Centre to develop a population needs-based resource allocation model for HIV, needle and syringe exchange programs and sexual health services. This was a very practical project to assist the health system in its planning and resource allocation decisions. It followed on from earlier work for the State Health Plan and similar modelling for South East Sydney Illawarra.

 

Background

Veterans' Home Care (VHC), a program of the Department of Veterans’ Affairs (DVA), was established in 2001 with the aim of helping veterans and war widows / widowers with low care needs to remain in their own homes for longer.  In this program, DVA contracts with service provider organisations around Australia to deliver domestic assistance, personal care, safety-related home and garden maintenance and / or respite care.

In 2007, CHSD conducted an independent review of the VHC program to assess the capability of the program to continue to meet the needs of veterans in terms of quality of life, independence and health, given the ageing of the target group and the growing complexity of their needs. 

The review involved all aspects of the Centre’s expertise, with a complex data analysis component, an international literature review, extensive surveys (by mailout to a sample of 1500 veterans and on-line to assessors and providers) and national consultations in the field.  The final report presented a range of feasible options for how the program could be modified to be more useful for the veteran population as it changes over time and more integrated with the other services they use.

Final report

The final VHC report can be accessed from the links below:

 

Project team: Kathy Eagar, Janette Green, Alan Owen, Tineke Robinson, Peter Siminski, Catherine Rostron, Tara Stevermuer, Pam Grootemaat, Nick Marosszeky 

Background

In 2006, CHSD was originally commissioned by the Victorian Department of Human Services (DHS) to develop a catalogue of evidence-based strategies for the health and wellbeing of children aged 0-8 years. The original catalogue was created for the Best Start program, which has a particular focus on prevention and early intervention with vulnerable families, including socially disadvantaged families, Aboriginal and Torres Strait Islander (ATSI) families, people from culturally and linguistically diverse (CALD) backgrounds, and families living in rural areas.

Subsequently, the Catalogue of Evidence-Based Strategies for improving the health and wellbeing of Victoria’s children was commissioned by the Victorian Department of Education and Early Childhood Development (DEECD). In this 2010 report, revised narrative reviews and, where necessary, new catalogue entries were provided for 12 indicators originally reviewed in 2008. 

The task in updating the catalogue was to check whether any relevant, new evidence had emerged in the academic or grey literature for each of the indicators being reviewed. This may mean adding a new strategy and catalogue entry for an indicator, instead of or in addition to existing strategies. 

The indicators updated in this work in 2010 include seven adolescent indicators linked to prevention of school disengagement and promotion of success for young people at risk of leaving school early, and in addition, updates were provided for four child and adolescent indicators:

  • Hospitalisation rate for asthma
  • Low birth weight
  • Proportion of children with emotional or behavioural difficulties
  • Proportion of families who are food insecure

The catalogue now has wider application beyond the Best Start program, and is a key element in the Victorian Child and Adolescent Monitoring System (VCAMS), providing practical guidance to policy makers and program developers. Nevertheless, the above goals, priorities and service delivery models remain relevant. It is available via the Victoria Education and Training website.

Reports

 

Project team: Kate Williams, Dave Fildes, Nick Marosszeky, Sheila Matete, Pam Grootemaat, Carrie Findlay, Malcolm Masso, Heather Yeatman, Deanne Condon-Paoloni, Nadine Harwood, Chris Magee, Darcy Morris, Kathy Eagar 

2006 research projects

ACT Health

Background

The Centre was commissioned by ACT Health, on behalf of the Health Reform Agenda Working Group, to review issues related to the funding of cancer services in Australia. The first report, completed in December 2005, contains the results of a literature review conducted to identify the degree to which funding arrangements can contribute to good practice in cancer care and also contains commentary on the funding arrangements in each jurisdiction and issues and priorities for enhancing cancer control based on interviews with state and territory representatives.

The project continued into 2006 with analysis of Medical Benefits Schedule data and hospital data on cancer treatment services over the previous five years to identify trends in service usage by funding source and highlight any impacts that changes to funding policy have had on the provision or distribution of cancer services. The results from this data analysis and the findings of the literature review were then used to identify options and opportunities for changes to current funding arrangements that would support best practice cancer care.

Final reports

Masso M, Gibbs A, Cranny C, Williams K, Fildes D, Grootemaat P, Samsa P, Matete S and Eagar K (2006) Cancer Funding Reform Report 1: Literature and Practice Review. Centre for Health Service Development, University of Wollongong.

Eagar K, Green J, Cranny C, Pearse J, Shorten B, Lago L, Stevermuer T and Siminski P (2006) Cancer Funding Reform Report 2: Trends in Cancer Services and Funding 1999-2004. Centre for Health Service Development, University of Wollongong.

Background

This program was an initiative by the Commonwealth Department of Health and Ageing designed to improve the quality of palliative care in the community by assisting families, carers and health service providers to give better support to people who are dying.

Tenders were invited in October 2002 for funding of between $50,000 and approximately $200,000 for those organisations with an interest in improving the quality of palliative care in the community. This opportunity stimulated a lot of interest from various organisations and approximately 270 submissions were received nationally. Thirty-seven projects were funded, totalling around $4.7 million over 4 years.

These 37 projects address several 'themes' associated with palliative care, including:

  • Improving community awareness of palliative care;
  • Supporting dying people and their families;
  • Increasing awareness of palliative care as an integral part of the health care system;
  • Delivering education to support professionals providing palliative care services;
  • Creating effective partnerships between palliative care providers, other health service providers and health systems, to coordinate care for dying people.

Download the final evaluation reports

Background

The National Continence Management Strategy (NCMS) has funded a number of major research studies relevant to the outcomes evaluation of continence conditions. This work built on research undertaken for the project Refining Continence Measurement Tools (Sansoni et al., 2006). The Revised Urinary Incontinence Scale (RUIS) and the Revised Faecal Incontinence Scale (RFIS) were found to have excellent internal consistency reliability (RUIS 0.91, RFIS 0.89) in a large community sample.

However, a limitation of community survey data is its derivation from subjective reports of incontinence symptoms collected in face to face interviews, rather than from confirmed clinical diagnoses. This restricts the range of responses to incontinence items, particularly for the more severe levels of symptoms. Therefore it was necessary to trial the revised continence measures in a range of clinical settings in follow-up field trials. This 2010 study was designed to address this issue by field testing the revised scales in eleven clinical settings across Australia.

The relationships between the revised instruments, type of treatment, clinical feedback and patient satisfaction were examined. Additional reliability data were collected from post-test patients in order to examine the test-retest reliability of the instruments over a two week period. Data analyses indicated that the RUIS and the RFIS have excellent psychometric properties. The RUIS and the RFIS performed well in clinical settings demonstrating good evidence that these instruments were sensitive to changes in continence status as a result of treatment, making them suitable for outcome evaluation. 

The use of such measures can provide effective feedback to clinicians concerning the effectiveness of their treatments, can facilitate the systematic review and monitoring of patients, and assist in identifying ways to improve practice.

Background

In June 2004, Essential Equity prepared a report for the AIDS and Infectious Diseases Branch (AIDB) of NSW Health on proposals for a Resource Distribution Formula to guide the allocation of funds. The report explored allocation under each of the three distinct programs operated by AIDB. New models were developed for the AIDS/HIV program and for the Sexually Transmissible Diseases (STD) program. However, the third program being for distribution of Needles and Syringes already had a needs based model in place. It was called the Injecting Drug Users (IDU) score developed in 1996 from data available at that time. While our report indicated that the IDU score may have some deficiencies resulting from the age of the model and its generalised assumptions, we did not feel it was necessary to develop a new distribution process given the pressing need for allocation mechanisms in the other two programs.

Essential Equity and the Centre for Health Service Development were then engaged by AIDB to formally develop a new model for the Needles and Syringes Program prepared through similar methodology to the proposals recommended for use with HIV/AIDS and STD. The final report, completed in April 2006, showed the relationship between various indicators of need defined by AIDB and current distribution patterns that were largely based on the IDU. A distribution formula for NSW Health Areas was developed using data on the incidence of Hepatitis C, ambulance attendances for drug overdose and the supply of methadone and buprenorphine.

2005 research projects

Background

A Midwifery Group Practice program offering continuous, caseload care by midwives to women with ‘low-risk’ pregnancies was developed and run as a pilot program at The Wollongong Hospital. During late 2004 and the first half of 2005, CHSD carried out an independent evaluation of this model, focusing on two main research questions: the safety record of the program, as demonstrated by its clinical outcomes and peer reviews of selected cases; and whether the program was acceptable to consumers and clinicians. In June 2005 the report was presented to the steering committee and a working group was established to consider the viability and future of the program.

The final report and a related journal article are available to download:

 

AHSRI project team: Kathryn Williams, Kathy Eagar, Luise Lago

Collaborators: Anne Lainchbury

A study to estimate differences between average and marginal costs in NSW public hospitals

Background

The Centre was commissioned by NSW Health to undertake a small study to estimate the marginal cost of providing services associated with opening additional beds or treating additional patients in NSW public hospitals. The report presented a set of findings for consideration by the Department to assist in formulating policy options around the potential to allocate additional hospital funding based on the marginal cost of providing particular types of services.

Background

The Centre was commissioned by NSW Health to develop an assessment and priority rating system for the Program of Appliances for Disabled People (PADP). The project aimed to deliver assessment tools that could be used to assess need in a consistent way across NSW and that were acceptable to key stakeholders, based on evidence and consistent with policy.

An extensive literature review and consultation process resulted in support for basing assessment and subsequent consideration of priority on the twin concepts of need (as measured by function) and the capacity of the applicant and their carer to benefit from provision of the equipment requested from PADP.

After pilot testing a suite of assessment and priority rating tools a field trial of the tools was conducted at four sites in NSW. The results indicated that while full uniformity may not be possible, a common and more standardised system is feasible. The full report of the project was delivered to NSW Health in November 2005.

Download the final report

Masso M, Owen A, Stevermuer T, Williams K, Ramsey L, Gordon R and Eagar K (2005) PADP Assessment and Priority Setting based on Need and Capacity to Benefit. Centre for Health Service Development, University of Wollongong.

Journal article

Masso M, Owen A, Stevermuer T, Williams K and Eagar K (2009) Assessment of need and capacity to benefit for people with a disability requiring aids, appliances and equipment. Australian Occupational Therapy Journal, 56: 315–323.

Earlier years

SNAP study and report

The purpose of the National SNAP study was to develop a casemix classification for sub-acute and non-acute care provided in a variety of treatment settings. The study was established so that the resultant classification could be used for both funding and clinical management purposes.

To download the SNAP report please click the following link:

Eagar K, et al. (1997) The Australian National Sub-Acute and Non-Acute Patient Classification (AN-SNAP): report of the National Sub-Acute and Non-Acute Casemix Classification Study. Centre for health Service Development, Univeristy of Wollongong.

 

For further information, visit the AN-SNAP and SNAPshot page.

Background

The Centre for Health Service Development was commissioned to evaluate the Griffith Area Palliative Care Service (GAPS) project. Three reports were produced: the first report described the evaluation framework and a baseline assessment of the project at the end of its planning phase; the second report covered the changes implemented in the delivery of palliative care services over the first nine months; and the final report described the achievements of the project after 18 months.

Download the first three reports

After the project was evaluated it generated useful tools for palliative care research (see CHSD Palliative Care Research).

These tools were used in the National Palliative Care Strategy which translated the results into a set of projects implementing elements of the models of care in the Caring Communities Program and and related work was undertaken in palliative care in the Care Planning Sub-Program

The Rural Palliative Care Program (RPCP) was funded by the Department of Health and Ageing (2003-2006) to trial eight projects implementing the Rural Palliative Care model (based on the Griffith GAPS model) through general practice networks. In 2008-2010 the Rural Palliative Care Program was expanded to more communities in a range of rural and remote settings. 

The GAPS experience was also reviewed in its local context four years after the project ended:

  • Masso M, Fildes D, Quinsey K and Matete S (2007) GAPS revisited: follow up evaluation of an Australian rural palliative care service. Progress in Palliative Care, 15 (5): 233-239.

 

Project team: Kathy Eagar, Alan Owen, David Perkins, Kate Senior, David Cromwell, Rob Gordon, Malcolm Masso, Dave Fildes, Karen Quinsey, Sheila Matete

Care Net Illawarra (Illawarra Coordinated Care Trial): Local Evaluation

Funder: Commonwealth Department of Health and Family Services
Duration: 1997 - 2000

Background

The Trial aimed to assess whether actively coordinating the care of frail elderly clients improves their overall health status, while costing a similar amount.

During 1997-8 the Centre worked on the estimates of the funding pool, advised the Trial on establishing funding rules and assisted with the training of care coordinators and client assessment matters. In late 1997 the Centre was successful in submitting a tender for the role of local evaluator for the Illawarra Coordinated Care Trial. The funding source for the local evaluation was the (then) Commonwealth Department of Health and Family Services, through Care Net Illawarra.

In 2000, the CHSD completed the evaluation of the Illawarra Coordinated Care Trial, Care Net.

At the local level, the lessons from the evaluation of coordinated were used in 2001 to assist in the planning for a possible second round of the Trials. Planning was carried out in the Illawarra, and assistance was provided to an Aboriginal trial on the Mid-North Coast. Coordinated care lessons were also used in the Commonwealth’s Sharing Health Care initiative, as well in planning for the evaluation of NSW HACC-sponsored, comprehensive assessment pilot projects.

Associated reports, publications, papers

Perkins D, Owen A, Cromwell D, Adamson L, Eagar K, Quinsey K and Green J (2001) The Illawarra Coordinated Care Trial: better outcomes with existing resources? Australian Health Review, 24 (2): 161-71.

Cromwell D (2001). Falling in the water: Funds pooling in the Illawarra Coordinated Care Trial. In The Australian Coordinated Care Trials: reflections and lessons. Commonwealth Department of Health and Aged Care, Canberra. ISBN 0 642 44745 4.

Perkins D and Owen A (2001). Learning from Coordinated Care Trials in Fine M, Perkins D, Owen A, and Warner M. (2001), Coordinated care on trial: Background to the emergence of the national coordination agenda in health care, Australian Studies in Health Services Administration, (ASHSA), No. 90, UNSW, Sydney.

Perkins D and Owen A (2001). Lessons in governance from Care Net Illawarra, in The Australian Coordinated Care Trials: Reflections and Lessons. Commonwealth Department of Health and Aged Care, Canberra. ISBN 0 642 44745 4.

Perkind D and Owen A (2002) GPs and the Care Net Trial, in The Australian Coordinated Care Trials Book 5, Commonwealth Department of Health and Aged Care, Canberra.

 

Introduction

In recent times there has been an expansion in the provision of palliative care services and innovative programs and projects in Australia. The CHSD has been involved in the evaluation of several key programs funded under the National Palliative Care Program – including the Caring Communities Program (CCP) and the Rural Palliative Care Program (RPCP).

Our involvement in these programs has highlighted two important issues. The first relates to the potential difficulties in obtaining Human Research Ethics Committee approval for palliative care projects involving human subjects. The second relates to the need for a consistent and measured approach to evaluation of palliative care services and programs.

Subsequently, the CHSD was commissioned by the Australian Government to produce two informative booklets to provide additional information relating to navigating palliative care research through a HREC and evaluating palliative care projects, programs and services.

These resources are not only useful for projects funded by the National Palliative Care Program but also for the broader research community conducting research in palliative care.

In addition, AHSRI is home to the Palliative Care Outcomes Collaboration (PCOC), a collaboration between four Australian university research centres which has established a voluntary network of palliative care service providers who collect and submit specific data items to PCOC for analysis. With funding from the Department of Health, PCOC has has developed a national benchmarking system to improve clinical palliative care outcomes in both the public and private sectors.

Human Research Ethics Committees and Palliative Care Research

CHSD produced a guide designed to assist palliative care researchers to prepare sound research ethics applications for review by Human Research Ethics Committees and to undertake ethical palliative care research that is consistent with NHMRC Guidelines. These guidelines have now been reissued in a new form and are available to download:

Masso M, Dodds S, Fildes D, Yeatman H and Eagar K (2004) Ethical research in palliative care: a guide through the Human Research Ethics Committee process. Centre for Health Service Development, University of Wollongong.

Evaluating Palliative Care Services and Programs

The following guide provides a practical guide to the methods and tools that are available to evaluate palliative care projects, programs and services.

Eagar K, Cranny C and Fildes D (2004) Evaluation and palliative care: a guide to the evaluation of palliative care services and programs. Centre for Health Service Development, University of Wollongong.

Evaluation Tools for Research in Palliative Care

The above evaluation guide makes reference to a suite of evaluation tools referred to as the Palliative Care Evaluation Tool Kit. This kit includes instruments that have recently been developed and field tested as well as existing evaluation tools reported in the literature. Together, these provide a choice of tools with which to collect evaluation data.

This Tool Kit can be downloaded in PDF format at the link below:

The Palliative Care Evaluation Tool Kit

The individual tools within this kit are supported by an electronic evaluation database which allows the user to enter data from tools in the Tool Kit into a user-friendly Microsoft Access database.

This database is freely available to those wishing to use it at the link below:

The Palliative Care Database (ZIP File)

Please note that this database is written in Access 2000 and may not perform efficiently in earlier versions.

Links to CHSD Palliative Care Projects

Palliative Care Links

CareSearch - CareSearch is the result of a project funded by the Australian Government to improve the evidence available to palliative care clinical practitioners, researchers and educators nationally.

Palliative Care Outcomes Collaboration - For detailed information on the palliative care outcomes work at AHSRI, please visit the PCOC website.

Background

This Review was commissioned by the Tasmanian Department of Health and Human Services (DHHS). In commissioning the Review, the Department identified a number of increasing challenges for the Tasmanian Palliative Care Service. These include a 22.4% increase in demand for services between 2000 and 2003 and an ageing and highly regionalised Tasmanian population. Staff pressures and turnover had also been identified as a matter of concern for DHHS.

In summary, the project had two broad elements. The first was the evaluation element. It included an analysis of existing palliative care services and an analysis of supply and demand. The second was the planning element that included the development of a model for future palliative care services.

The following report presents the results of the Review, providing details of the methodology used, as well as data summaries, findings and recommendations.

Download the final report:

Eagar K, Gordon R, Quinsey K and Fildes D (2004) Palliative Care in Tasmania: current situation and future directions. Centre for Health Service Development, University of Wollongong

Access pervious projects

Return to the research projects home page for more information on our work, or to explore previous archives. 

AHSRI research projects

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