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(2000)ReportThe Linked Care Trial was an innovative approach to linking health and community care services for people in need of ongoing care, established in 1996-97 in the municipalities of Hornsby and Ku-ring-gai in Sydney’s northern suburbs. The trial formed part of a national program of Coordinated Care Trials (CCTs) established in 1996 to test whether it was possible to coordinate the care currently provided by a variety of different health and community care services and practitioners using funds pooled from a number of Commonwealth and State programs. This flexible use of funding was to be managed by care coordinators (CCs) assigned to each participant, 1 using an individual care plan to help organise the medical care and social assistance that each would receive. The local evaluation of the Linked Care Trial was to test whether this approach could be practically implemented in the local community and, if so, to determine whether this led to a more effective use of existing resources with improved outcomes for participants and caregivers. This final evaluation report reviews progress with Linked Care and the evaluation from commencement of the Live Phase of the trial in 1997 to its formal conclusion in December 1999. Drawing on quantitative and qualitative data collected as part of the local evaluation, the report presents an analysis of findings with respect to a number of separate components of Linked Care. It also identifies the conditions which underlie the achievements of Linked Care and considers obstacles that constrained the achievement of trial goals or which could have affected the evaluation.
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(2000)ReportThe Linked Care Trial was an innovative approach to linking health and community care services for people in need of ongoing care, established in 1996-97 in the municipalities of Hornsby and Ku-ring-gai in Sydney’s northern suburbs. The trial formed part of a national program of Coordinated Care Trials (CCTs) established in 1996 to test whether it was possible to coordinate the care currently provided by a variety of different health and community care services and practitioners using funds pooled from a number of different Commonwealth and State programs. This flexible use of funding was to be managed by care coordinators (CCs) assigned to each participant, 1 using an individual care plan to help organise the medical care and social assistance that each would receive. The local evaluation of the Linked Care Trial was to test whether this approach could be practically implemented in the local community and, if so, to determine whether this led to a more effective use of existing resources with improved outcomes for participants and caregivers.
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(2000)ReportThe Linked Care Trial was an innovative approach to linking health and community care services for people in need of ongoing care, established in 1996-97 in the municipalities of Hornsby and Ku-ring-gai in Sydney’s northern suburbs. The trial formed part of a national program of Coordinated Care Trials established in 1996 to test whether it is possible to coordinate the care currently provided by a variety of different health and community care services and practitioners using funds pooled from a number of different Commonwealth and State programs. This flexible use of funding was to be managed by care coordinators (CCs) assigned to each participant, using an individual care plan to help organise the medical care and social assistance that each would receive. The Evaluation of the Linked Care Trial was to test whether this approach could be practically implemented in the local community and, if so, to determine whether this led to a more effective use of existing resources with improved outcomes for participants and caregivers. This service provider experience thematic report reviews progress with Linked Care and the evaluation from commencement of the Live Phase of the trial in 1997 to its formal conclusion in December 1999. Drawing on quantitative and qualitative data collected as part of the Local Evaluation, the report presents an analysis of findings with respect to a number of separate components of Linked Care. It also identifies the conditions which underlie the achievements of Linked Care in this period and considers obstacles that have constrained the achievement of trial goals or which could have affected the evaluation. Service providers were integral to Linked Care as partners in Linked Care management, contributors to the fund pool, subcontractors of care coordination services and the providers of health and community care to the participants.
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(2000)ReportThe Linked Care Trial was an innovative approach to linking health and community care services for people in need of ongoing care, established in 1996-97 in the municipalities of Hornsby and Ku-ring-gai in Sydney’s northern suburbs. The trial formed part of a national program of Coordinated Care Trials (CCTs) established in 1996 to test whether it was possible to coordinate the care currently provided by a variety of different health and community care services and practitioners using funds pooled from a number of different Commonwealth and State programs. This flexible use of funding was to be managed by care coordinators (CCs) assigned to each participant, 1 using an individual care plan to help organise the medical care and social assistance that each would receive. The local evaluation of the Linked Care Trial was to test whether this approach could be practically implemented in the local community and, if so, to determine whether this led to a more effective use of existing resources with improved outcomes for participants and caregivers. This client experience report reviews progress with Linked Care and the evaluation, from commencement of the live phase of the trial in 1997 to its formal conclusion in December 1999. Drawing on quantitative and qualitative data collected as part of the local evaluation, the report presents an analysis of a number of components of Linked Care from the perspective of participants.
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(2009)ReportThis report describes key findings from the e-male survey, a national, online survey of men who have sex with men (MSM) in Australia. The survey was conducted in 2008 by the National Centre in HIV Social Research and attracted over 4,000 men to the survey site. The project aimed to assess whether internet use builds social capital amongst gay and other homosexually active men and the implications of online social networks for HIV prevention. The project also assessed the advantages and disadvantages of internet-based recruitment and data collection among Australian MSM.
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(2023)ThesisIn Australia, there is no standardised approach to measuring performance of alcohol and other drug (AOD) treatment services. Non-government organisations (NGOs) that provide AOD treatment in Australia manage contracts from multiple funding sources, with performance measures varying between funders. They have reported a high reporting burden and inconsistent expectations from different funders to demonstrate accountability. The primary aim of this thesis was to establish a list of performance measures that are acceptable to service users, treatment providers, and funders; explore approaches to improve implementation of performance measures; and make recommendations to funders of non-government AOD treatment. The research approach involved three phases: 1) an assessment by three independent raters of existing measures used in contracts against best practice; 2) focus groups with service users, treatment providers, and funders (n=10 focus groups) to identify the most important performance measures among diverse stakeholders and explore the challenges associated with implementation; 3) a Delphi process with a purposeful sample of service users, treatment providers, and funders to prioritise a core set of performance measures. Phase One found over 500 unique measures used in contracts for AOD treatment services, with most not adhering to best practice. Further, the majority were output and process measures. In Phase Two, focus groups identified that access, outcome, and experience measures were the most important measurement types across all stakeholder groups, with structural measures also important to service users. In Phase Three, 17 performance measures reached consensus. In contrast to Phase One, the final set were mostly outcome, access, and structural measures (n= 11/17) with only one measure each for output and process. Further, key findings from the focus groups highlighted that identification of measures is only part of a robust performance measurement system. Support systems for collecting, analysing, interpreting, and reporting performance data are also needed. At the policy-level, implementation of the final set of measures can improve accountability of public funds, and support the collection of standardised performance-related data to inform funding decisions and treatment planning. At the practice-level, the measures have the potential to reduce reporting burden, improve organisational efficiency, and inform quality improvement initiatives.
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(2023)ThesisIntroduction The World Health Organization (WHO) estimates 5.4 million snakebites annually. In 2019, WHO released a strategy to halve the burden of snakebite by 2030. This doctoral research aimed to generate practice and policy relevant evidence at three levels: globally, by understanding the prioritisation process in the WHO; nationally, in India, by evaluating the primary health care (PHC) system; and regionally, in South Asia, by fostering research on treatments. Methods To understand the global prioritisation of snakebite, I conducted a policy analysis, using interviews and documents as data sources. To evaluate health systems in India, I analysed secondary data for the first nationwide assessment of structural capacity and continuum of snakebite care. To understand health systems resilience, I used quantitative (analysis of facility-level data) and qualitative (interviews) approaches to understand the effects of COVID-19 and conducted an evidence synthesis on the effect of climate change. Through an overview of systematic reviews of treatments, I identified the need for a core outcome set (COS) on snakebite. I developed a COS for snakebite research in South Asia, by conducting a systematic review of outcomes and a Delphi survey. Results The policy analysis identified factors which enabled prioritisation of snakebite, and identified unaddressed challenges of sustaining legitimacy, and acceptance within the neglected tropical disease community. I identified structural limitations of the PHC system and gaps in referral pathways, in India. Relevant to the context, I report, how COVID-19 accentuated existing barriers, and identified that the choice of provider is a complex process with multiple factors interplaying. Evidence synthesis indicates the need to prepare health systems for possible geographic shifts in snakebite burden due to climate change. The overview of systematic reviews identified gaps in the evidence ecosystem. By developing a COS for future intervention research on snakebite treatments, I addressed the gap of non-standardised measurement of outcomes. Conclusion The findings of the thesis, provides contextually relevant evidence aligned with pillars of the WHO strategy, to practice and policy at global, national, sub-national, and program level. The policy analysis and COS work provides broader methodological insights, beyond snakebite.