The cost of health care in Australia is over a quarter of a million dollars each minute (nearly 10% of GDP), and is rising faster than the cost of living. In spite of this, Australians are already being denied some forms of care that they want and need, and there may be considerable delays in getting some care that is urgently needed. Combined with an ageing population and new, highly effective but expensive treatments, we are facing an affordability crisis.
Yet, we have shown that Australians are offered appropriate care only about half the time, and that one in ten hospital admissions is associated with harm caused by the health care process rather than an underlying disease or injury, as are over a million general practice encounters each year. The mortality from such harm ranks fourth behind that from cancer, cardiovascular disease and smoking, and is four times the road toll.
There is clearly an urgent need to develop affordable ways of determining who is getting inappropriate care, what is going wrong, and what we should be doing to address the easily preventable or remedial shortcomings of our health care system. We can no longer afford to keep paying for ‘more of the same’. A major problem is that information about clinical care is simply not available at a population level. What is available is usually from a few key centres and is not representative of care ‘across the board’.
We plan to continue to measure, at a population level, how often inappropriate care is given and what is going wrong, but more importantly we are also developing ways to ensure patients get, and health care professionals offer, care that is in-line with latest best practice. Some currently funded projects are described overleaf.
Contact and affiliations
The Patient Safety Research Group (PSRG) is led by Professor Bill Runciman. It provides support for the Australian Patient Safety Foundation (APSF), a not-for-profit organisation devoted to advancing the cause of patient safety.
The PSRG works closely with the Australian Institute of Health Innovation, based at Macquarie University, and with a number of consumer organisations and professional bodies.
If you would like to find out more or wish to collaborate, contact Professor Bill Runciman firstname.lastname@example.org
Key research areas
Towards appropriate care
Funded by a National Health and Medical Research Council (NHMRC) Program Grant.
As part of a larger program of translational research into creating safe, effective systems of care, we are developing an inclusive transparent, wiki-based process for creating agreed clinical standards for common conditions comprising a series of evidence based indicators embedded in electronic tools (‘apps’). These tools will be kept up-to-date and will inform patients, carers and health professionals about the condition in question, guide care, document what has been done and be amenable to audit.
Towards automating the development of evidence-based clinical indicators
Funded by a NHMRC ‘Centre for Research Excellence’ Grant in e-health.
Part of a larger project on computer automation of systematic reviews, we are defining the role and nature of evidence in developing clinical indicators as building blocks for clinical standards.
Determining the appropriateness of care for children in Australia
Funded by a NHMRC Partnership Grant (AIHI with partners BUPA and the NSW, QLD and SA Departments of Health).
This study, based on our recent CareTrack Australia Study, which showed that Australian adults receive appropriate care only 57% of the time, is designed to determine the percentage of care delivered to Australian children that is appropriate, and to obtain a profile of health care incidents that harm children.
Patient-centred e-health approach to improving outcomes for gout
Funded by a NHMRC Partnership Grant (with AIHI, UniNSW, industry partners and the Arthritis Foundation).
This involves the approach outlined for the NHMRC program grant and will culminate in a randomised controlled trial of an ‘app’ for using allopurinol to keep urate levels within a target range, and prevent further attacks of gout.
Near real-time identification of patient safety incidents reported by health professionals
Funded by a NHMRC Project Grant.
This involves computerised free-text analysis to identify clusters of incidents of interest used successfully so far on the Maude (FDA, USA) and the NRLS (NHS, UK) data repositories.
Dynamic interplay of physical and psychosocial safety in frontline health care
Funded by an Australian Research Council (ARC) Linkage Grant.
Safety climate, safety performance and safety outcomes in health care
Funded by an ARC Linkage Project Support Grant.
Incident monitoring (with specialist medical colleges)
Funded by the Australasian College of Emergency Medicine and the Royal Australian and New Zealand College of Radiologists.
The APSF is involved in supporting, analysing and developing recommendations for these national professional bodies to improve the safety and quality of clinical care in the relevant areas.