Anderson, R, Haywood, P, Usherwood, T, Haas, M & Hall, J 2005, 'Alternatives to for-profit corporatisation: The view from general practice', Australian Journal of Primary Health, vol. 11, no. 2, pp. 78-78.
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The aim of this study was to assess the expressed preferences of general practitioners (GPs) for alternative organisational models to for-profit GP corporatisation. A review of the findings of six feasibility studies that examined alternative organisational models for general practice in Australia was undertaken. Five feasibility studies were conducted within nine Divisions of General Practice, and a feasibility study was conducted by a state-based organisation among all 15 of its member Divisions. Overall, the six projects demonstrated a strong resistance among most GPs to any alternative model that involved giving up autonomy over practice matters. Consequently, the most favoured alternative organisational model was the 'service company' - the establishment of a third party to provide a range of practice support services. In general, there was implicit acceptance that the service company could recover the cost of support service provision by charging GPs on a fee-for-service basis, and also that the Division itself would be the most acceptable organisation to take on this role. However, in four Divisional areas GPs revealed very low motivation towards either working together or with the local Division as a service company. Although these feasibility studies were carried out using different methods, and in a small sample of mostly urban Divisions, they suggest that many GPs would support their Divisions - or some other Division-related third party - to become more active providers of a range of practice support services.
Burgess, L & Street, DJ 2005, 'Optimal designs for choice experiments with asymmetric attributes', Journal of Statistical Planning and Inference, vol. 134, no. 1, pp. 288-301.
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In this paper we establish the form of the optimal design for choice experiments in which attributes need not have the same number of levels for testing main effects only, when there are k attributes, and all choice sets are of size m. We give a construction for optimal and near-optimal designs with small numbers of choice sets. We derive the general form of the determinant of the information matrix for estimating main effects and two-factor interactions and derive the optimal designs for this situation in some special cases. © 2004 Elsevier B.V. All rights reserved.
Fulham, MJ, McCaughan, BC, Boyer, M, McLean, J, Kenny, PM, King, MT, Pollicino, C & Viney, RC 2005, 'FDG-PET in Stage I/II NSCLC: the Australian RCT', Journal of Clinical Oncology, vol. 23, pp. 591-592.
Fulham, MJ, McCaughan, BC, Boyer, MJ, McLean, JM, Kenny, PM, King, MT, Pollicino, CA & Viney, RC 2005, 'FDG-PET in addition to conventional work-up in non-small-cell lung cancer - In reply', JOURNAL OF CLINICAL ONCOLOGY, vol. 23, no. 7, pp. 1591-1592.
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Haas, M 2005, 'The impact of non-health attributes of care on patients' choice of GP', Australian Journal of Primary Health, vol. 11, no. 1, pp. 40-40.
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After completing a structured evaluation of their general practitioner (GP) in terms of non-health factors, 128 people who had visited their GP in the past six months for treatment of a minor condition were administered a discrete choice experiment (DCE) designed to evaluate their preferences for non-health attributes of care within a general practice consultation. SAS and SYSTAT were used to analyse responses. Trust, legitimation, recognition of and support for emotional distress, dignity, reassurance and information (whether it is asked for or not), were the attributes respondents valued most highly. In general, participants were unwilling to change GPs.
Hall, J 2005, 'Health care workforce planning: can it ever work?', Journal of Health Services Research & Policy, vol. 10, no. 2, pp. 65-66.
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Hall, J 2005, 'The politics of medicare: who gets what, when and how by GWENDOLYN GRAY. UNSW Press, Australia, 2004. No. of pages: 111. ISBN 0‐86840‐703‐8', Health Economics, vol. 14, no. 8, pp. 869-870.
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Hall, J & Maynard, A 2005, 'Healthcare lessons from Australia: what can Michael Howard learn from John Howard?', BRITISH MEDICAL JOURNAL, vol. 330, no. 7487, pp. 357-359.
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Hall, JP 2005, 'Book Review: 'The politics of Medicare: who gets what, when and how' by Gwendolyn Gray', Health Economics, vol. 14, no. 8, pp. 869-870.
Kenny, P, Lancsar, E, Hall, J, King, M & Chaplin, M 2005, 'The individual and health sector costs of asthma: the first year of a longitudinal study in New South Wales', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, vol. 29, no. 5, pp. 429-435.
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Objective: To identify the resources used and the costs incurred by people with asthma for health care and non-health care products and services to manage asthma. Methods: A prospective, longitudinal study, using self-reported and administrative data, commenced in 2001 in New South Wales (NSW). Data sources included two six-monthly surveys, hospital admission data from NSW Health, and pharmaceutical benefits and Medicare data. A cohort of 245 people with asthma, aged between 5-75 years, was recruited from the general population and from hospital emergency departments. The study measured the use and cost of health care services and products, including alternative therapies and home modifications. Costs to both the health care system and individuals were measured. Results: General practitioner visits and asthma medications were the items of health care most commonly used. Medications were also the largest component of individual costs for health care in terms of the average payment and the number of people facing an out-of-pocket cost, although home equipment and modifications were the most expensive individual items. The distribution of individual costs was highly skewed, ranging from $0 to $4,882 per person per annum (median $89). Admitted hospital care was the largest component of the cost to the health care system. Conclusion: While individual costs were not large for the majority, some people faced substantial costs, with the highest of these being for non-health care items. Implications: Asthma management policies may need to incorporate schemes to alleviate the impact of costs for the minority experiencing significant out-of-pocket expenses.
Pirkis, J, Goldfeld, S, Peacock, S, Dodson, S, Haas, M, Cumming, J, Hall, J & Boulton, A 2005, 'Assessing the capacity of the health services research community in Australia and New Zealand', Australia and New Zealand Health Policy, vol. 2, no. 1, pp. 4-4.
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Background: In order to profile the health services research community in Australia and New Zealand and describe its capacity, a web-based survey was administered to members of the Health Services Research Association of Australia and New Zealand (HSRAANZ) and delegates of the HSRAANZ's Third Health Services Research and Policy Conference. Results: Responses were received from 191 individuals (68%). The responses of the 165 (86%) who conducted or managed health services research indicated that the health services research community in Australia and New Zealand is characterised by highly qualified professionals who have come to health services research via a range of academic and professional routes (including clinical backgrounds), the majority of whom are women aged between 35 and 54 who have mid- to senior-level appointments. They are primarily employed in universities and, to a lesser extent, government departments and health services. Although most are employed in full time positions, many are only able to devote part of their time to health services research, often juggling this with other professional roles. They rely heavily on external funding, as only half have core funding from their employing institution and around one third have employment contracts of one year or less. Many view issues around building the capacity of the health services research community and addressing funding deficits as crucial if health services research is to be translated into policy and practice. Despite the difficulties they face, most are positive about the support and advice available from peers in their work settings, and many are actively contributing to knowledge through academic and other written outputs. Conclusion: If health services research is to achieve its potential in Australia and New Zealand, policy-makers and funders must take the concerns of the health services research community seriously, foster its development, and contribute to maximising its ca...
Street, DJ, Burgess, L & Louviere, JJ 2005, 'Quick and easy choice sets: Constructing optimal and nearly optimal stated choice experiments', INTERNATIONAL JOURNAL OF RESEARCH IN MARKETING, vol. 22, no. 4, pp. 459-470.
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In this paper we compare a number of common strategies for constructing discrete choice experiments. Two of the strategies, including one based on theoretical constructions for optimal discrete choice experiments, produce designs that are better than those that come about from random grouping and from using the LMA construction. A simple account of this theoretical construction is given. © 2005 Elsevier B.V. All rights reserved.
Viney, R, Savage, E & Louviere, J 2005, 'Empirical investigation of experimental design properties of discrete choice experiments in health care', Health Economics, vol. 14, no. 4, pp. 349-362.
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Experimental design is critical to valid inference from the results of discrete choice experiments (DCEs). In health economics, DCEs have placed limited emphasis on experimental design, typically employing relatively small fractional factorial designs, which allow only strictly linear additive utility functions to be estimated. The extensive literature on optimal experimental design outside health economics has proposed potentially desirable design properties, such as orthogonality, utility balance and level balance. However, there are trade-offs between these properties and emphasis on some properties may increase the random variability in responses, potentially biasing parameter estimates.
This study investigates empirically the design properties of DCEs, in particular, the optimal method of combining alternatives in the choice set. The study involves a forced choice between two alternatives (treatment and non-treatment for a hypothetical health care condition), each with three, four-level, alternative-specific attributes. Three experimental design approaches are investigated: a standard six-attribute, orthogonal main effects design; a design that combines alternatives to achieve utility balance, ensuring no alternatives are dominated; and a design that combines alternatives randomly. The different experimental designs did not impact on the underlying parameter estimates, but imposing utility balance increases the random variability of responses. Copyright © 2005 John Wiley & Sons, Ltd.
Warren, E, Anderson, R, Proos, AL, Burnett, LB, Barlow-Stewart, K & Hall, J 2005, 'Cost-effectiveness of a school-based Tay-Sachs and cystic fibrosis genetic carrier screening program', GENETICS IN MEDICINE, vol. 7, no. 7, pp. 484-494.
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Purpose: To explore the cost-effectiveness of school-based multidisease genetic carrier screening. Method: Decision analysis of the cost-effectiveness of a school-based Tay-Sachs disease and cystic fibrosis genetic carrier screening program, relative to no screening. Data relating to ethnicity profile, test-accepting behavior, and screening program cost were sourced from an existing program in Sydney, Australia. Results: Compared to no screening, the incremental cost-effectiveness of the screening program is A$5,834 per additional carrier detected. This cost-effectiveness ratio is most sensitive to changes in genetic test accuracy, and the cost of laboratory assays. The results imply a cost per affected birth avoided of approximately A$530,000 (≈ US$371,000). Conclusions: This preconceptional genetic carrier screening program offers comparable cost-effectiveness to prenatal screening programs for cystic fibrosis.
Wise, S 2005, 'The right to time off for dependants', Employee Relations, vol. 27, no. 2, pp. 126-140.
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PurposeTo examine the factors which influence the implementation of employees’ right to time off for dependants protected by the Employment Relations Act 1999.Design/methodology/approachThe responses of two organisations in the same corporate group with identical policy provision are examined. Formal provision in the two companies was broadly similar providing an opportunity to examine how centrally developed, statutory‐based policy operates in different organisational contexts. Using qualitative reports from line managers and human resource managers the interaction and tensions between formal policy and informal, discretionary practice are examined.FindingsLine manager attitudes to discretionary decision making and other company policies, especially flexitime, produced very different outcomes for employees highlighting a continuing challenge for governments and organisations: Is it more important to be consistent in implementation or responsive to individual circumstances?Research limitations/implicationsThe paper uses data from only two organisations, although it complements national research on the usage rates of parents’ statutory rights to leave.Practical implicationsFactors which can influence and detract from the effective implementation of statutory‐based employment rights are highlighted.Originality/valueIn focusing on parent's right to time off for dependant emergency an important element of the work‐lif...
