The evaluation of the Primary Health Network (PHN) After Hours Program aimed to assess how well the program was being delivered and whether it continues to be the right response in the current context. The evaluation used a mixed methods approach, including case studies of eight PHN localities, interviews with national stakeholder groups and PHNs, a survey of PHNs and service providers and analysis of MBS and PIP data, emergency department presentations and potentially preventable hospitalisations. We made recommendations to sharpen the program’s focus, improve accountability and support the sustainability of services. Our recommendations recognised the importance of retaining flexibility in the program to meet local needs but also the need to target gaps in particular geographic areas and specific population groups.
The objective of this study was to identify predictors of acute-care treatment costs and length of stay for patients with traumatic spinal cord injury (TSCI). The project involved a record linkage study of healthcare utilisation and costs over a 3 year period for a group of patients aged 16 years or more with incident TSCI in New South Wales. Generalised Linear Model regression was used to identify predictors of higher acute care treatment costs for patients with TSCI. Scenario analysis quantified the proportionate cost impacts of patient pathway modification. Direct transfer to SCIU for patients with acute TSCI resulted in lower treatment costs, shorter length of stay, and less costly complications. Modeling showed that optimising patient-care pathways can result in significant acute-care cost savings.
This evidence check focused on the barriers and enablers of implementing a patient centred medical home model of care. The evidence check found that the patient centred medical home model has the potential to improve quality of care, and enhance the experiences of primary care of patients and staff. However, it requires a major change effort for most practices, involving changes to work roles, processes, and implementation of new technology. There are many potential barriers that can impact the success of implementation. However, lessons have been reported in the literature, many of which can be implemented as strategies to overcome these challenges.
This project involved a document review of key policies and progress reports by the Commonwealth and jurisdictions against the nine priority areas of the NTS. It also involved consultations with the Commonwealth, state and territory health authorities, NGOs, and tobacco control experts. Data compiled and analysed by the Australian Institute of Health and Welfare (AIHW) were also considered to show progress against each of the indicators from the NTS. Overall, the findings indicate that significant progress has been made against most of the nine priority areas of the NTS.
HPA used a mixed methods approach for the evaluation component of this multi-year project. Qualitative data were gathered across Australia through interviews and focus groups with patients and patients’ carers/families, GPs, other primary care staff, pharmacists and other providers. Quantitative data were gathered or sourced from existing collections to analyse how things have changed for patients enrolled in the HCH trial and to compare their outcomes with similar patients receiving care from non-HCH practices. A series of reports by HPA feature the findings of the evaluation.
HPA developed a new Australian Emergency Care Classification (AECC) to
replace the Urgency Related Groups (URGs) and the Urgency Disposition Groups (UDGs) to price emergency care. This study was used to identify individual variables contributing to the complexity of patients in emergency care, as reflected in costs, and then to determine how these would be used in combination to define end classes for the classification. The AECC was developed using a combination of statistical analysis and clinical input: the splits in the classification demonstrate statistical as well as clinical validity.