Read about the additional health research projects undertaken by researchers at the Health Services Research Centre.
National Science Challenge 8: Ageing Well – Independence and Housing Tenure
A 4-year project (2016-2020) funded by the Ministry of Business Innovation and Employment with significant emphasis on services for Māori and Pacific health. Project led by Centre for Research Evaluation and Social Assessment (CRESA)
This research is about the future of older people in an increasingly diverse New Zealand where structural population ageing is taking place at the same time as a housing tenure revolution. From the highest rates of home ownership in the Western world, New Zealand's occupation rates are falling rapidly to levels that prevailed in the 1930's. How will this rising reliance on the (mainly private) rental market impact on older people in the future? To what extent will reliance on the rental market inhibit or support older people's wellbeing and independence; promote or reduce older people's ongoing social, economic and cultural contributions and reciprocities; and, reduce or support the mitigation of mental physical, or cognitive disability to maximise engagement and personal dignity? This research explores those impacts and dynamics and works with older people and stakeholders in New Zealand's diverse communities to identify adaptive strategies and tools that will mitigate negative impacts and optimise opportunities for older people to not only add life to their own years but continue to be productive, contributing, and valued members of their communities. This is multi-method research which combines demographic and quantitative data with working with older people and communities to explore the impacts of tenure on older people and community well-being.
Chronic Conditions - Pacific Patients' Perspectives
Pacific patients' perspectives of treatment of chronic conditions
A two-year project (2017-2019) funded by the Health Research Council Pacific Project fund, led by Debbie Ryan, Pacific Perspectives Ltd
Debbie Ryan, Dr Ausaga Fa'asalele Tanuvasa, HSRC; researchers from the University of Auckland, the University of Otago, and clinical partners
Evaluation of ten national demonstration integrated care projects
Nine projects funded by the Government from 1998 were evaluated. The projects were diverse, in terms of size, scope and aims, but all were based in mainstream services. Ten evaluation reports (an individual report on each project, and an Over Report) were published in March 2001.
The team developed an “ideal model of integration” which has at its centre a cyclical process of procedure development, implementation and outcome measurement. Two essential components must be considered at every stage of this cycle: cooperation and collaboration; and Treaty issues.
- projects were most promising for Māori where the project team took time to develop partner relationships with Māori providers and iwi, cemented this in a formal way, and then worked in with Māori at all levels
- changing the culture of organisations and the environment within which organisations interact is an important part of developing integration
- our of the projects showed a strong commitment to the principles of the Treaty of Waitangi, supporting a bicultural service responsive to Māori health
- a cost-effectiveness analysis of the projects could not be done because sufficient quantitative data were not available.
Marie Russell, Pamela Burns, Amanda Gilbert, Adrian Slack, Jackie Cumming, Debbie Peterson, Pauline Norris, Papaarangi Reid (Eru Pomare Māori Health Research Centre, Wellington School of Medicine and Health Sciences)
An extension to the evaluation of the Hawkes Bay shared care pilot
An earlier study evaluated arrangements whereby the care of people with ongoing needs for mental health services is shared between general practitioners and hospital-based community mental health services. the evaluation found that it took almost two years for 7 July 2011 were several achievements such as the development of a consumer focussed care plan. There was not statistically significant improvement in health status, nor were there any changes in secondary service utilisation. Most consumers, GPs and the mental health considered shared care provides an improved service.
This extension project continued the evaluation of the Hawkes Bay shared care pilot project service. It provided for a two-year follow-up of those who joined the pilot in the first year. This provided an opportunity to evaluate the pilot in its established stage.
Katherine Nelson, Jackie Cumming, Debbie Peterson, Evan Roberts, Peter Ellis (Wellington School of Medicine and Health Sciences)
In 1998 PHARMAC changed the way it subsidised ACE-inhibitors (drugs used for hypertension). This meant two ACE-inhibitors were available free of charge (except for normal prescription charges), while patients had to pay substantial charges for other ACE-inhibitors. Extra payments were made to doctors to allow patients to have free (or substantial discounted) visits to change their medication. This project investigates patients’ and doctors’ perceptions of the changes, and their economic impact. Data analysis was completed in 2000 and the final report presented to PHARMAC.
Tim Maling (Wellington School of Medicine and Health Sciences), Victoria Andersen, Bruce Aroll (University of Auckland), Pauline Norris, Jackie Cumming, Evan Roberts
Pharmacists’ counselling about restricted medicine
In the last decade, in New Zealand and elsewhere, medicines which were available only on doctor's prescription are becoming available from pharmacists. This project aimed to determine whether pharmacists ask questions and provide advice when they sell medicine. The project also looked at whether the characteristics of the pharmacy or the purchaser affected the nature or amount of counselling pharmacists provided. It used 'mystery shopper' visits to 180 pharmacies in 1999, and a questionnaire to all pharmacies in New Zealand in 2000. The questionnaire asked for background information on pharmacy characteristics. An excellent response rate was achieved. The study found wide variation between pharmacies in how much counselling they provided to shoppers. Some sold restricted medicines without asking basic questions to find out whether the medicine was appropriate. Two papers from the study have been accepted for publication in refereed journals, and other are in preparation. Numerous seminars and conference presentations have been given, and the results of the study are being in pharmacists' education.
Pauline Norris and Marianna Churchward
Consumer understanding of pharmacy terms
This project looked at consumers’ understanding of nine terms commonly used by pharmacists, such as hypertension, antibiotic, inflammation. Three summer students from different ethnic groups interviewed approximately 80 people of their own ethnic background. The study found low levels of understanding of all the terms, particularly amongst the Tokelauan people. The results have been widely published and are also being used to inform pharmacists' undergraduate education.
Pauline Norris (Supervisor), Kiri Bird, Jack Kirifi and Tamika Simpson (Students)
Consumer involvement in mental health research
This Health Research Council funded training fellowship explores mental health orientated social science research as it is relates to mental health consumer. It also focuses on ethical issues, consumers’ experiences as research participants and researchers, and researchers' experiences of research with consumers. The research commenced in mid-1999 and is due for completion in 2003.
Variations in health care utilisation and geographical access
Concerns about variations in access to health care services have been voiced for many years in New Zealand, and timely, equitable access to health care is a key health policy goal. Understanding these concerns, and meeting the Government's access aims, requires knowledge of how accessible services are, and how to improve this accessibility. While much has been written about variations in access to care and how to improve access to care, this study is a first stage in specifically understanding trends and variations of access to secondary health care in New Zealand. This project is the beginning of a larger programme of research on trends and variations in access to health care. The study, which combines economic and geographical approaches, looks at geographical access, summarising variations and changes in secondary care service utilisation rates over the 1991–1996 period. The project includes the development of conceptual model of access relevant to New Zealand, and through the multidisciplinary approach the original use of important, but under-utilised, national datasets.
Jackie Cumming, Adrian Slack, Dave Mare, Jason Timmins (Motu Economic and Public Policy Research), Lars Brabyn (Waikato University), Canterbury University, Chris Skelly, Barry Borman (Ministry of Health)
Review of New Zealand experience of contracting in health services
This project involves reviewing the experiences of contracting in health care in New Zealand during the 1990s, to provide advice to WHO on the ways in which contracting works in practice in health care. The project involves literature review, contract review and key and formal interviews.
Jackie Cumming, Toni Ashton, Malcolm McKinlay (University of Auckland), Ezrai Fae, Janet Holmes