Browsing by Subject "Australia"

Now showing 1 - 6 of 6
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    Cost-effectiveness of a complex intervention in general practice to increase uptake of long-acting reversible contraceptives in Australia
    (CSIRO, 2021) Lewandowska, Milena; De Abreu Lourenco, Richard; Haas, Marion; Watson, Cathy J.; Black, Kirsten I.; Taft, Angela; Lucke, Jayne; McGeechan, Kevin; McNamee, Kathleen; Peipert, Jeffrey F.; Mazza, Danielle; Obstetrics and Gynecology, School of Medicine
    Objective: The aim of this study was to evaluate the cost-effectiveness of the Australian Contraceptive ChOice pRoject (ACCORd) intervention. Methods: An economic evaluation compared the costs and outcomes of the ACCORd intervention with usual care (UC). Data from the ACCORd trial were used to estimate costs and efficacy in terms of contraceptive uptake and quality of life. Rates of contraceptive failure and pregnancy were sourced from the literature. Using a Markov model, within-trial results were extrapolated over 10 years and subjected to univariate sensitivity analyses. Model outputs were expressed as the cost per quality-adjusted life years (QALY) gained and cost per unintended pregnancy resulting in birth (UPB) avoided. Results: Over 10 years, compared with UC, initiating contraception through the ACCORd intervention resulted in 0.02 fewer UPB and higher total costs (A$2505 vs A$1179) per woman. The incremental cost-effectiveness of the ACCORd intervention versus UC was A$1172 per QALY gained and A$7385 per UPB averted. If the start-up cost of the ACCORd intervention was removed, the incremental cost-effectiveness ratio was A$81 per QALY gained and A$511 per UPB averted. The results were most sensitive to the probability of contraceptive failure, the probability of pregnancy-related healthcare service utilisation or the inclusion of the costs of implementing the ACCORd intervention. Conclusions: From a health system perspective, if implemented appropriately in terms of uptake and reach, and assuming an implicit willingness to pay threshold of A$50 000 the ACCORd intervention is cost-effective. What is known about the topic? The uptake of long-active reversible contraceptives (LARC) in Australia is low. The ACCORd trial assessed the efficacy of providing structured training to general practitioners (GPs) on LARC counselling, together with access to rapid referral to insertion clinics. What does this paper add? This study is the first to assess the cost-effectiveness of a complex intervention in the general practice setting aimed at increasing the uptake of LARC in Australia. What are the implications for practitioners? The results show that implementing a complex intervention in general practice involving GP education and the availability of rapid referral to LARC insertion clinics is a cost-effective approach to increase LARC use and its attending efficacy. If the majority of Australian GPs were able to deliver effectiveness-based contraceptive counselling and either insert LARC or use a rapid referral process to a LARC insertion clinic, the additional cost associated with the purchase of LARC products and their insertion would be offset by reductions to health system costs as a result of fewer UPB and abortions. Moreover, the benefits to women's physical and psychological health of avoiding such events is substantial.
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    Country Report 2018: Australia
    (2018) McGregor-Lowndes, Myles
    The federal, state, and territory laws of Australian jurisdictions permit individuals to act together through unregistered associations and organizations for lawful purposes. Each jurisdiction offers one or more forms of incorporation for nonprofit associations with reasonable administrative requirements, although for those associations operating in multiple jurisdictions there are moderately costly reporting burdens.
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    Data for a civil society: how we can harmonise privacy and use population data for public good
    (2007-06-15) Stanley, Fiona
    1. Modernity’s paradox - an uncivil society 2. Population data and record linkage 3. Understanding bias 4. Harmonising individual privacy and public good
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    Effect of short-term exposure to air pollution on daily cardio- and cerebrovascular hospitalisations in areas with a low level of air pollution
    (Springer, 2023) Hasnain, Md Golam; Garcia‑Esperon, Carlos; Tomari, Yumi Kashida; Walker, Rhonda; Saluja, Tarunpreet; Rahman, Md Mijanur; Boyle, Andrew; Levi, Christopher R.; Naidu, Ravi; Filippelli, Gabriel; Spratt, Neil J.; Earth and Environmental Sciences, School of Science
    Exposure to air pollution is associated with increased cardio- and cerebrovascular diseases. However, the evidence regarding the short-term effect of air pollution on cardio- and cerebrovascular hospitalisations in areas with relatively low air pollution levels is limited. This study aims to examine the effect of short-term exposure to different air pollutants on hospital admissions due to cardio- and cerebrovascular diseases in rural and regional Australia with low air pollution. The study was conducted in five local Government areas of Hunter New England Local Health District (HNE-LHD). Hospitalisation data from January 2018 to February 2020 (820 days) were accessed from the HNE-LHD admitted patients' dataset. Poisson regression model was used to examine the association between the exposure (air pollutants) and outcome variables (hospitalisation due to cardio- and cerebrovascular disease). The concentrations of gaseous air pollutants, Sulphur Dioxide (SO2), Nitrogen Dioxide (NO2), Ozone (O3), Carbon Monoxide (CO), and Ammonia (NH3) were below national benchmark concentrations for every day of the study period. In single pollutant models, SO2 and NO2 significantly increased the daily number of cardio- and cerebrovascular hospitalisations. The highest cumulative effect for SO2 was observed across lag 0-3 days (Incidence Rate Ratio, IRR: 1.77; 95% Confidence Interval, CI: 1.18-2.65; p-value: 0.01), and for NO2, it was across lag 0-2 days (IRR: 1.13; 95% CI: 1.02-1.25; p-value: 0.02). In contrast, higher O3 was associated with decreased cardio- and cerebrovascular hospitalisations, with the largest effect observed at lag 0 (IRR: 0.94; 95% CI: 0.89-0.98; p-value: 0.02). In the multi-pollutant model, the effect of NO2 remained significant at lag 0 and corresponded to a 21% increase in cardio- and cerebrovascular hospitalisation (95% CI: 1-44%; p-value = 0.04). Thus, the study revealed that gaseous air pollutants, specifically NO2, were positively related to increased cardio- and cerebrovascular hospitalisations, even at concentrations below the national standards.
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    Population data, ethics and paediatric care: how we can use population data to guide ethical decision making
    (2007-06-13) Stanley, Fiona
    1. Population data and record linkage in WA A) Development/ methods/ advantages B) Examples for child health services 2. The special case of pharmacovigilance 3. Ethical issues 4. Modernity’s paradox and the imperative for good data
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    Reflections on Ethics and Advocacy in Child Health (REACH): Creating a Forum for Ethical Dialogue
    (Elsevier, 2021) Friedman Ross, Lainie; Ott, Mary A.; Pediatrics, School of Medicine