Economic and quality of care evaluation of dialysis service models in remote Australia

Protocol for a mixed methods study

Gillian Gorham, Kirsten Howard, Samantha Togni, Paul Lawton, Jaquelyne Hughes, Sandawana William Majoni, Sarah Brown, Sue Barnes, Alan Cass

    Research output: Contribution to journalArticleResearchpeer-review

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    Abstract

    Background: Australia's Northern Territory (NT) has the country's highest incidence and prevalence of kidney disease. Indigenous people from remote areas suffer the heaviest disease burden. Concerns regarding cost and sustainability limit the provision of dialysis treatments in remote areas and most Indigenous people requiring dialysis relocate to urban areas. However, this dislocation of people from their family, community and support networks may prove more costly when the broader health, societal and economic consequences for the individual, family and whole of government are considered.

    Methods: The Dialysis Models of Care Study is a large cross organisation mixed methods study. It includes a retrospective (2000-2014) longitudinal data linkage study of two NT cohorts: Renal Cohort 1- comprising approximately 2000 adults who received dialysis and Renal Cohort 2- comprising approximately 400 children of those adults. Linkage of administrative data sets from the Australian and New Zealand Dialysis and Transplant Registry, NT Departments of Health, Housing and Education by a specialist third party (SA/NT Datalink) will enable extraction of activity, financial and outcome data. Interviews with patients, clinicians and service providers, using a snowball technique, will canvass relevant issues and assist in determining the full costs and impacts of the five most used dialysis Models of Care.

    Discussion: The study uses a mixed methods approach to investigate the quantitative and qualitative dimensions of the full costs and outcomes associated with the choice of particular dialysis models of care for any given patient. The study includes a large data linkage component that for the first time links health, housing and education data to fully analyse and evaluate the impact on patients, their families and the broader community, resulting from the relocation of people for treatment. The study will generate a large amount of activity, financial and qualitative data that will investigate health costs less directly related to dialysis treatment, costs to government such as housing and/or education and the health, social and economic outcomes experienced by patients. This approach fills an evidence gap critical to health service planners.

    Original languageEnglish
    Article number320
    Pages (from-to)1-7
    Number of pages7
    JournalBMC Health Services Research
    Volume17
    Issue number1
    DOIs
    Publication statusPublished - 3 May 2017

    Fingerprint

    Quality of Health Care
    Dialysis
    Northern Territory
    Economics
    Health Education
    Information Storage and Retrieval
    Costs and Cost Analysis
    Health Care Costs
    Community Networks
    Kidney Diseases
    New Zealand
    Health Services
    Registries
    Renal Dialysis
    Organizations
    Interviews
    Transplants
    Kidney
    Incidence
    Health

    Cite this

    Gorham, Gillian ; Howard, Kirsten ; Togni, Samantha ; Lawton, Paul ; Hughes, Jaquelyne ; Majoni, Sandawana William ; Brown, Sarah ; Barnes, Sue ; Cass, Alan. / Economic and quality of care evaluation of dialysis service models in remote Australia : Protocol for a mixed methods study. In: BMC Health Services Research. 2017 ; Vol. 17, No. 1. pp. 1-7.
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    abstract = "Background: Australia's Northern Territory (NT) has the country's highest incidence and prevalence of kidney disease. Indigenous people from remote areas suffer the heaviest disease burden. Concerns regarding cost and sustainability limit the provision of dialysis treatments in remote areas and most Indigenous people requiring dialysis relocate to urban areas. However, this dislocation of people from their family, community and support networks may prove more costly when the broader health, societal and economic consequences for the individual, family and whole of government are considered. Methods: The Dialysis Models of Care Study is a large cross organisation mixed methods study. It includes a retrospective (2000-2014) longitudinal data linkage study of two NT cohorts: Renal Cohort 1- comprising approximately 2000 adults who received dialysis and Renal Cohort 2- comprising approximately 400 children of those adults. Linkage of administrative data sets from the Australian and New Zealand Dialysis and Transplant Registry, NT Departments of Health, Housing and Education by a specialist third party (SA/NT Datalink) will enable extraction of activity, financial and outcome data. Interviews with patients, clinicians and service providers, using a snowball technique, will canvass relevant issues and assist in determining the full costs and impacts of the five most used dialysis Models of Care. Discussion: The study uses a mixed methods approach to investigate the quantitative and qualitative dimensions of the full costs and outcomes associated with the choice of particular dialysis models of care for any given patient. The study includes a large data linkage component that for the first time links health, housing and education data to fully analyse and evaluate the impact on patients, their families and the broader community, resulting from the relocation of people for treatment. The study will generate a large amount of activity, financial and qualitative data that will investigate health costs less directly related to dialysis treatment, costs to government such as housing and/or education and the health, social and economic outcomes experienced by patients. This approach fills an evidence gap critical to health service planners.",
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    Economic and quality of care evaluation of dialysis service models in remote Australia : Protocol for a mixed methods study. / Gorham, Gillian; Howard, Kirsten; Togni, Samantha; Lawton, Paul; Hughes, Jaquelyne; Majoni, Sandawana William; Brown, Sarah; Barnes, Sue; Cass, Alan.

    In: BMC Health Services Research, Vol. 17, No. 1, 320, 03.05.2017, p. 1-7.

    Research output: Contribution to journalArticleResearchpeer-review

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    T1 - Economic and quality of care evaluation of dialysis service models in remote Australia

    T2 - Protocol for a mixed methods study

    AU - Gorham, Gillian

    AU - Howard, Kirsten

    AU - Togni, Samantha

    AU - Lawton, Paul

    AU - Hughes, Jaquelyne

    AU - Majoni, Sandawana William

    AU - Brown, Sarah

    AU - Barnes, Sue

    AU - Cass, Alan

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    AB - Background: Australia's Northern Territory (NT) has the country's highest incidence and prevalence of kidney disease. Indigenous people from remote areas suffer the heaviest disease burden. Concerns regarding cost and sustainability limit the provision of dialysis treatments in remote areas and most Indigenous people requiring dialysis relocate to urban areas. However, this dislocation of people from their family, community and support networks may prove more costly when the broader health, societal and economic consequences for the individual, family and whole of government are considered. Methods: The Dialysis Models of Care Study is a large cross organisation mixed methods study. It includes a retrospective (2000-2014) longitudinal data linkage study of two NT cohorts: Renal Cohort 1- comprising approximately 2000 adults who received dialysis and Renal Cohort 2- comprising approximately 400 children of those adults. Linkage of administrative data sets from the Australian and New Zealand Dialysis and Transplant Registry, NT Departments of Health, Housing and Education by a specialist third party (SA/NT Datalink) will enable extraction of activity, financial and outcome data. Interviews with patients, clinicians and service providers, using a snowball technique, will canvass relevant issues and assist in determining the full costs and impacts of the five most used dialysis Models of Care. Discussion: The study uses a mixed methods approach to investigate the quantitative and qualitative dimensions of the full costs and outcomes associated with the choice of particular dialysis models of care for any given patient. The study includes a large data linkage component that for the first time links health, housing and education data to fully analyse and evaluate the impact on patients, their families and the broader community, resulting from the relocation of people for treatment. The study will generate a large amount of activity, financial and qualitative data that will investigate health costs less directly related to dialysis treatment, costs to government such as housing and/or education and the health, social and economic outcomes experienced by patients. This approach fills an evidence gap critical to health service planners.

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    KW - Outcomes

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