Case study: Partnering with the NSW government to improve health services
In 2013, NSW Health awarded a tender to a collaborative consortium led by The George Institute to do an independent evaluation of one of its chronic disease management programs. These evaluations are critical for identifying potential areas of improvement in the quality and efficiency of health services. The success of that initial review has led to The George Institute being one of the NSW government's trusted, ongoing partners in independent evaluations to help improve government services.
NSW Health's chronic disease management program started in 2010 and aimed to support patients with conditions like diabetes, cardiovascular diseases and chronic obstructive pulmonary disease to better manage their conditions in the community, reducing the burden on the hospital system. The program also provided health coaching that addressed risk factors, medication and self-management.
Leading the quantitative evaluation part of the review was Associate Professor Laurent Billot, Director of The George Institute’s Statistics Division. "The idea was to try and help people manage their disease outside of hospital and reduce the cost associated with hospital care, but the results were not as expected,” said Prof Billot. The evaluation found that instead of reducing hospitalisation rates, the program was putting patients in contact with health professionals who spotted problems that needed to be treated in hospitals which may have otherwise been missed. In that way, the program may have been life-saving in some cases.
What did The George Institute do?
One of the evaluation recommendations was that the program was enrolling patients whose condition had already deteriorated, and resulted in increased hospitalisation. If the program was able to target patients before they reached the hospital, the potential benefits of self-management could be better harnessed, the evaluation suggested.
"Although the program did not meet its primary objective of reducing hospitalisations, it may have helped in a different way," said Prof Billot.
NSW Health took up the findings of the evaluation and has built on the learnings. In particular, the program was aligned with its wider integrated care strategy. This refined approach aims to identify people with chronic conditions earlier and enrolling them in community-based care to improve their health outcomes and reduce their risk of future hospitalisations.
Resulting partnership and impact
The George Institute continues to be a preferred supplier for NSW government departments for independent evaluations. Further projects have so far included:
- Advising on a framework and guidelines for NSW Treasury for people and organisations wishing to propose social impact initiatives.
- Advising on the development of algorithms to predict the risk of hospitalisation for people in NSW, to assist with the identification of patients who might benefit from a range of integrated care initiatives
- Advising on linkage of hospital data to GP data within Western Sydney PHN to assess the feasibility of the linkage, and test whether adding GP data could help predict future risk and assist with the correct identification of patients.
The George Institute’s contribution to evaluating and improving NSW Health’s programs is a benefit for both the efficiency of health sector services and the health of people in NSW, Australia.