HSIS Economic evaluation of local projects

What is the problem?

Based on efficiency and equity, Australia’s healthcare system is rated fifth in the world. Australians are living longer lives without disability and with better quality of life. However, health gains made by reducing the burdens associated with infectious diseases have been replaced with new burdens from chronic diseases such as cardiovascular disease, cancer, and diabetes. While Australia’s spending on healthcare is modest compared with countries such as the United States, there is growing concern about the affordability of the country’s health budget.

Australia’s Productivity Commission has raised inconsistent evaluation of healthcare as a major problem hindering improved efficiency in Australia’s health system. It is conservatively estimated that 20 percent of the annual healthcare spending (est. AUD $34 billion, 2016 dollars) could be better spent. Governments need to know whether the healthcare funded by taxpayers is delivering value for money. In turn, healthcare decision makers need to know whether the care delivered through Australia’s health system works and is cost-effective.

About the research translation program

In response to these issues, a recent NSW Regional Health Partners project developed a framework to inform, guide and promote the evaluation and implementation of cost-effective health technologies and models of care. A core aim of the framework is to optimise patient outcomes through the delivery of value-based healthcare. A core principle on which the framework is based is to use evaluation of both effect and value to determine whether technologies and models of care should be allowed to enter or remain in the health system.

The framework was derived from international best practice in the conduct of health technology assessment, insights gained from the literature and the views of senior health service managers and clinicians across Australia. The framework presents a detailed approach to improve local level healthcare evaluation.

Aspects of the framework are being trialled in NSWRHP. Principles from the framework will be applied to six new projects funded by the Medical Research Future Fund:

  • Thirsty? Choose water;
  • Tailoring strategies to improve child immunisation in areas of low coverage in local health districts in NSW through partnerships and community engagement;
  • Embedding cultural safety in health professional child protection responses to Aboriginal families in NSW paediatric care settings;
  • Increasing the implementation of mandatory physical activity policy in NSW primary schools across three NSW jurisdictions;
  • Acute telestroke implementation to increase treatment rates and improve outcomes for rural and regional stroke patients (‘At It’ study); and
  • Using technology platforms to improve the use of chronic disease prevention services to reduce child obesity.

What will be the impact?

The framework will be useful to guide the evaluation of six new MRFF projects, thereby providing evidence for their continuation or disbandment. The project will also have tested the framework and provided feedback for its refinement. In the longer term, the project will have refined a tool that captures information about effectiveness and cost. This tool will be used by future decision makers to select high value healthcare that delivers affordable outcomes for patients.


For more information, contact Andrew Searles – Andrew.Searles@hmri.org.au or Penny Reeves – penny.reeves@hmri.org.au