Centre for Primary Health Care and Equity
This is a leading centre in Australia for research in primary health care and equity. Our research is mainly applied, and we work closely with clinicians, health service organisations, non government organisations and government at all levels as research partners and to support the implementation of our findings in policy and practice. Our research has informed the policy on primary health care and equity at both national and state levels, including the current health reforms.
The Centre was formed in 2005, and includes a group on campus (in the AGSM building), the Centre for Health Equity Research Training and Evaluation (CHETRE) at Liverpool and the General Practice Unit at Fairfield. We have 35 full time equivalent staff and 15 PhD candidates. Our research budget for 2011 was $4.9m and we produced 49 publications. The Centre is supported by a Capacity Building Infrastructure Grant from NSW Health
SOME RECENT PhD TOPICS AT CPHCE
- Evaluation of health assistants in general practice
- Equity focused health impact assessment
- Do patient attitudes contribute to frequent admissions?
- Urban renewal and public housing: Impacts on public health
- Inter-organisational and inter-professional relationships and their impact on primary diabetes care
- Psychological distress and prevention of cardiovascular disease in general practice
- Cardiovascular risk assessment and prescribing in general practice
- Self management support for patients with chronic illness
- Physical activity and implementation of preventive care in general practice
- Improving the quality of care to Aboriginal and Torres Strait Islander patients who attend general practices in urban Sydney
- End of life decision making: advanced care planning
We have three streams of research, and also support a practice based research network (PHReNet).
Prevention and management of chronic disease
New approaches to preventing and managing chronic disease are being developed, with an increasing emphasis on high quality care within primary health care, particularly general practice. Within this stream there are two main programs of work: improving and organising care for chronic disease and preventing chronic disease. Research in 2012 includes projects addressing risk factor assessment and management in general practice and community health, the role of practice nurses in COPD, self management and health literacy, and a large partnership project on the implementation of guidelines to prevent chronic disease. Within this stream a new collaborative Centre for Research Excellence - COMPaRE-PHC - is being established to conduct research in the prevention and management of obesity in primary health care. This has received $2.5m funding with funding from the Australian Primary Health Care Research Institute. Our research has contributed to health policy and programs including the National Primary Care Strategy and the work of the National Preventive Health Agency.
Primary health care system development
Part of the national health service reforms involve the establishment of new primary care organisations: “Medicare Locals”. Our research provides evidence to shape and support the work of these new structures. We have two main areas of research: integration within primary health care and between it and hospital care, and access to primary health care. Our research includes a study of access to primary health care for people with diabetes and the impact of best practice primary health care. This involves analysis of register and cohort data linked to hospitalisation, MBS and other administrative data. We also have developed a primary health care leadership program for staff in primary health care services and are conducting an evaluation of the NSW Health Connecting Care program and a established the Primary Health Care Research Unit to support primary health care research in south western Sydney.
Understanding health inequalities and intervening to reduce them
The equity stream is focused on identifying the causes of health inequity and developing individual, community and public policy level interventions to address health inequities. There are three main program areas within this research theme: early childhood, disadvantaged communities and populations, and equity and healthy public policy (including
Health Impact Assessment). Our early childhood research includes randomised controlled trial of sustained early childhood home visiting (MESCH) and a cohort study of Aboriginal children born in Campbelltown Hospital (now in their first year at school) (the Gudaga study). In the Bulindidi Gudaga we are evaluating an Indigenous early childhood home visiting program, based on the MECSH model. We have conducted a ten year evaluation of a community regeneration intervention in Miller, and have a major program of research and development on health impact assessments (including equity focused health impact assessments). We are in the translation stage of a vocationally oriented CBT-based training program to improve the health of people who are unemployed which we have developed over the past decade.
Practice based research network
Following the completion of the primary health care research capacity building initiative we have maintained the Primary Health Care Research Network (PHReNet). Within this we have established a small electronically linked network of practices and other services with the aim of conducting research on the integration of care between general practice and hospital services.