Case Study: Hepatitis B Treatment Access
March 24th, 2017 by ejoughin
Outline of the Research
Chronic hepatitis B infection (CHB) affects approximately 1% of the Australian population, with the burden of infection disproportionately borne by migrants and Aboriginal and Torres Strait Islanders – groups with distinctive spatial settlement and migration characteristics. In addition to CHB infection risk, these populations experience well-documented challenges in accessing health services more broadly. Associate Professor Benjamin Cowie, Director of WHO Collaborating Centre for Viral Hepatitis at The Peter Doherty Institute for Infection and Immunity (PDIII), and his colleague Professor Jodie McVernon, Director of Doherty Epidemiology at PDIII are leading a research project, examining current access to care for people living with CHB, and develop models of future care requirements and strategic delivery. This cross-disciplinary project draws on additional expertise from the University of Melbourne (Dr Martin Tomko, Department of Infrastructure and Engineering; and Dr Nick Golding, Quantitative and Applied Ecology Group) and RMIT University (Dr Bernhard Jenny, Geospatial Science).
The research is jointly funded by the Victorian and Federal Departments of Health, the Royal Melbourne Hospital and the CRC for Spatial information (CRCSI), and involves collaborators with deep data knowledge at the Australian Institute of Health and Welfare, and Menzies School of Health Research. The project aligns with these organisations vision of conducting world class research and development in spatio-temporal modelling of spatial health data and analysis, to drive improvements in health outcomes and reducing the burden of disease in vulnerable populations. This research will be an exemplar of the applications of spatial data and related analytic approaches to inform health sector planning and delivery for optimal population benefit, enhancing ‘demand side’ awareness of their usefulness.
How AURIN was used
The research team identified that AURIN was uniquely placed to bring key datasets on health and population from multiple data providers (demography, migration, health care provision) together in a securitised framework, enabling them to consider the influence of mobility and access to services on CHB diagnosis and treatment provision. In particular, the National Health Services directory (NHSD) allows Professor McVernon’s team to securely analyse high quality and sensitive data that is usually difficult to access, and labourious to spatialise.
The NHSD is a point-level dataset published by Healthdirect, and is a comprehensive and consolidated national directory of health services and related health service providers in both the public and private sectors across all Australian jurisdictions. The NHSD provides consistent, authoritative, reliable and accessible information about health services to support health professionals with the delivery of healthcare. Professor McVernon credits the availability of this data through AURIN for driving this particular aspect of their research:
“Knowing that AURIN provided access in this way helped us to frame a question that we ordinarily wouldn’t have been able to answer”.
AURIN worked with the Australian National Data Service (ANDS) to negotiate access to the NHSD, and prepared the data to make it research ready for researchers from a variety of disciplines through the AURIN Portal. This collaborative approach is part of AURIN’s wider strategy to partner with national organisations enabling access to quality data for the research community.
Impact of research
By analysing this specific junction of healthcare services provision and spatially distributed members of society that need them, we can better service future populations and ultimately improve health for future generations. Access to the NHDS data specifically allows the research group to produce spatially explicit estimates of differences in the level of CHB case assessment, treatment uptake, and clinical outcomes of public health importance. They will be able to model the spatial distribution of determinants of variation between communities, including cultural factors, mobility and health sector access. They will also develop interactive maps and visualisations to help predict future spatially distributed disease burden.
As part of their AURIN-enabled research, the research group will be able to conduct scenario modelling of future requirements, and outcomes of alternative strategic investments. This will allow researchers and health providers to determine the measures most likely to improve overall program impact, regardless of uncertainty in future projections. The findings will be published through a series of maps.
The project is expected to be completed by March 2018.