Kathy Stack WA Department of Health Gail Milner WA Department of Health Jeanette Plenty WA Department of Health Professor Leon Flicker Royal Perth Hospital Dr Paul Varghese Princess Alexandra Hospital (QLD) Summary of Ethics Applications National Applications Due date Date submitted Date of meeting Final approval Department of Health and Ageing Departmental Ethics Committee 18 Oct 2006 18 Oct 2006 06 Nov 2006 13 Dec 2006 Flinders Clinical Research Ethics Committee 27 Nov 2006 30 Oct 2006 11 Dec 2006 18 Dec 2006 ACT Government National Applications Due date Date submitted Date of meeting Final approval ACT Health and Community Care Human Research Ethics Committee 28 Nov 2006 23 Nov 2006 11 Dec 2006 26 Feb 2007 Victorian Government National Applications Due date Date submitted Date of meeting Final approval Austin Health Human Research Ethics Committee 28 Nov 2006 23 Nov 2006 12 Dec 2006 28 Feb 2007 Barwon Health Research and Ethics Advisory Committee 21 Nov 2006 21 Nov 2006 28 Nov 2006 12 Dec 2006 Bundoora Extended Care Centre Human Research Ethics Committee Have asked for project to be overseen by the Northern Human Research Ethics Committee (in same health region) 30 Nov 2006 Eastern Health Research and Ethics Committee QA Process 21 Nov 2006 14 Dec 2006 Not Required Human Research Ethics Committee- A St Vincent's Health Melbourne QA Process 21 Nov 2006 13 Dec 2006 Not Required
The Prince Charles Hospital Health Service District Human Research Ethics Committee 29 Nov 2006 28 Nov 2006 13 Dec 2006 13 Dec 2006 Townsville Health Service District Institutional Ethics Committee 23 Nov 2006 21 Nov 2006 07 Dec 2006 05 Feb 2007 Toowoomba Health Service District Human Research Ethics Committee 29 Nov 2006 27 Nov 2006 14 Dec 2006 06 Dec 2006 West Moreton Health Service District Human Research Ethics Committee 20 Nov 2006 17 Nov 2006 04 Dec 2006 26 Feb 2007 NSW Government National Applications Due date Date submitted Date of meeting Final approval NSW Department of Health Human Research Ethics Committee 23 Nov 2006 20 Nov 2006 14 Dec 2006 01 Feb 2007 SA Government National Applications Due date Date submitted Date of meeting approval SA Department of Health Human Research Ethics Committee 26 Oct 2006 26 Oct 2006 08 Nov 2006 09 Feb 2007 Tasmanian Government National Applications Due date Date submitted Date of meeting approval Southern Tasmania Health & Medical Human Research Ethics Committee 09 Nov 2006 09 Nov 2006 11 Dec 2006 04 Dec 2006 WA Government National Applications Due date Date submitted Date of meeting Final approval Confidentiality of Health Information Committee 29 Jan 2007 06 Feb 2007 19 Feb 2007 NT Government National Applications Due date Date submitted Date of meeting Final approval Central Australia Human Research Ethics Committee 26 Oct 2006 21 Nov 2006 23 Nov 2006 24 Nov 2006
1.1: National Evaluation of the Transition Care Program timetable Report Name July - 2005 August - 2005 September - 2005 October - 2005 November - 2005 December - 2005 January - 2006 February - 2006 March - 2006 April - 2006 May - 2006 June - 2006 July - 2006 August - 2006 September - 2006 October - 2006 November - 2006 December - 2006 January - 2007 February - 2007 March - 2007 April - 2007 May - 2007 June - 2007 July - 2007 August - 2007 September - 2007 October - 2007 November - 2007 December - 2007 Regional Characterization Study1 Quality Assessment Study Models of Transition Care Study Recipient Snapshot Study Controlled Comparison Study Cost and Effects Study 1: In the Regional Characterization population data were estimated at 30 June 2006; Aged Care places at 31 December 2005 and 30 June 2006; Australasian Rehabilitation Outcomes Centre provided data as at 30 June 2006
Table 10.1: Transition Care Program: assumptions behind the model and evidence for these assumptions. No. Assumption Evidence 1 The planning benchmark for residential aged care is not being met in a number of regions (Principle 1 page 5 (Australian Health Ministers' Advisory Council 2004)). We identified regions where the planning benchmarks for residential aged care were not met. 2 Provision of step-down and rehabilitation is variable and few jurisdictions have known benchmarks for estimating the level of provision (Principle 1 page 5 (Australian Health Ministers' Advisory Council 2004)) We confirmed that provision of rehabilitation beds was variable but across Australia was around 3.0 per 1,000 older people aged 70 plus for the 2005/06 period. Victoria had a substantially larger subacute sector than other jurisdictions. 3 Alternate models of care in settings other than hospitals can lead to improvements in functional status from an additional period of time limited low intensity therapy and care. We confirmed that improvements in functional status occurred 4 The alternative models should be in additional to the other existing services jurisdictions provide to support older people moving from hospital to home. We found that these older people entered these services at the end of existing hospital services. There was much variation in the point at which this occurred and in jurisdictions where there were limited rehabilitation services TC appeared to substitute for rehabilitation services. 5 Older people waiting for residential aged care are “blocking” hospital beds (Service provision for older people in the acute – aged care system (Gray, Dorevitch et al. 2002). No evidence was provided on this issue. 6 TC services should have a on recovery or maintaining function as well as facilitating long-term care arrangements. There was evidence that the units focused on recovery and maintaining function.
• 213 Combination places Functional Change (as measured using the MBI at admission and discharge for the TC episode) • Overall - Mean admission MBI 67.3 - Mean discharge MBI 79.1 • Community - Mean admission MBI 77.1 - Mean discharge MBI 85.8 • Residential - Mean admission MBI 60.5 - Mean discharge MBI 72.3 • Overall - Mean admission MBI 64.3 - Mean discharge MBI 76.9 • Community - Mean admission MBI 73.7 - Mean discharge MBI 84.8 • Residential - Mean admission MBI 51.1 - Mean discharge MBI 65.0 • Overall the groups appear similar, however, the functional status at of residential based TC and community-based TC recipients in the NETCP appears lower than the ICRS sample Hospital Readmission (one or more in the follow-up period) • 3 months follow-up - Overall 21% • 6 month follow-up - Overall 22% • A breakdown by type of TC was not presented in the ICRS report • 3 months post ACAT approval - Overall 37% - Community 39% - Residential 35% • 6 months follow-up - Overall 47% - Community 51% - Residential 43% • ICRS used data for hospital readmissions may have underestimated the true incidence Living at home at follow-up • 3 months follow-up - Overall 81.6% • 6 months follow-up - Overall 81.5% • A breakdown by type of TC was not presented in the ICRS report • 3 months post ACAT approval - Overall 78% - Community 96% - Residential 55% • 6 months post ACAT approval - Overall 70% - Community 93% - Residential 42% • The difference between ICRS and NETCP possibly reflects the higher proportion of community dwelling TC recipients in ICRS Economic analysis • Cost-benefit approach • Residential costs $236 per day or 10,500 per episode • Community costs $86 per day (5,300 per episode) • Overall cost benefit of 4.7 million in savings • Cost-effectiveness approach • Taking into account of hospital readmissions and residential aged care admissions in the follow-up period, at six months post ACAT approval TC cost $344 per additional day of survival without institutional care • Two different approaches were used. ICRS implicitly assumed that the average 65 day LOS in TC would have been spent entirely in residential aged care in the absence of TC. Hospital costs were not taken into account in ICRS