Patient-Centred Research to reduce Inequalities in health outcomes

PCRI is a multidisciplinary health services research program that investigates the structure and processes of the health care system and the well-being of hospitalised individuals aiming to reduce inequalities in health outcomes.

The series of studies focuses on clinical, and demographic and socio-economic factors associated with different health outcomes aiming to: inform evidence-based policy making, highlight comparative outcome research and ultimately improve the health of Victorians.

Researchers and HDR candidates involved in this program are from the La Trobe Rural Health School (LRHS) in the disciplines of Nursing & Midwifery, Exercise Science Physiology, and Public Health, partnering with national and international colleagues with expertise in content or research method.

Key to the program’s success is the collaboration with Victorian healthcare organisations at an organisational level and also with research active clinicians. Hospitals included in various studies in the program include: Bendigo Health, Monash Health, Dandenong Hospital, Casey Hospital, The Alfred, Western Health and Peninsula Health.

Research Team Members

  • Dr George Mnatzaganian
  • Dr Melanie Bish
  • Dr Kathy Tori
  • Dr Steve Begg
  • A/Prof Michael Kingsley
  • Prof Mark Gussy
  • Dr Jason Fletcher, Intensivist - Bendigo Health
  • Dr Cameron Knott, Intensivist - Bendigo Health
  • Dr Mark Putland, Emergency Medicine Physician- Bendigo Health
  • Dr Nicola Yuen, Obstetrician and Gynaecologist- Bendigo Heatlh
  • Dr Anju Agarwal, Obstetrician and Gynaecologist- Bendigo Heatlh
  • Ms Fiona Faulks, Deputy Director of Nursing Women's & Children's Services- Bendigo Health
  • Ms Jennifer Pitson, Manager Maternity/Women’s Health- Bendigo Health
  • Dr Elizabeth Pennington, Paediatric Surgeon- Bendigo Health
  • Dr Madeleine Ward, Obstetric and Gynaecology Registrar- Monash Health
  • Prof George Braitberg, Emergency Medicine Physician- Royal Melbourne Hospital
  • Dr Marietta Taylor, Senior Dentist- Bendigo Health
  • Prof Menaka Abuzar, Professor of Prosthodontics- Griffith University
  • Dr John Stephenson, Senior Biostatistician- University of Huddersfield
  • Prof Tom Marwick, Director- Baker Heart and Diabetes Institute
  • Dr Maree Mastwyk, Clinical Trials Unit Manager- Florey Department of Neuroscience and Mental Health

HDR students

Student nameDegreeSupervisorProject title
Helen NightingalePhDA/Prof Michael Kingsley, Dr George Mnatzaganian, Dr Leesa Hooker and Dr Melanie BishAn antenatal weight management intervention for rural women
Georgios ZisisPhDDr George Mnatzaganian, Prof Tom Marwick and Dr Maree MastwykRisk-guided strategy for reducing readmission for acute decompensated heart failure

Recent Publications

2016 Publications

  • Mnatzaganian G, Braitberg G, Hiller JE, Kuhn L, Chapman R. Sex differences in in-hospital mortality following a first myocardial infarction: symptomatology, delayed presentation, and hospital setting. BMC Cardiovasc Dis. 2016; 16:109. DOI:10.1186/s12872-016-0276-5.
  • Huynh QL, Negishi K, Blizzard L, Sanderson K, Venn AJ, Marwick TH. Predictive Score for 30-Day Readmission or Death in Heart Failure. JAMA Cardiol. 2016;1(3):362-4. doi: 10.1001/jamacardio.2016.0220.
  • Huynh QL, Negishi K, Blizzard L, Saito M, De Pasquale CG, Hare JL, Leung D, Stanton T, Sanderson K, Venn AJ, Marwick TH. Mild cognitive impairment predicts death and readmission within 30 days of discharge for heart failure. Int J Cardiol. 2016;221:212-7. doi: 10.1016/j.ijcard.2016.07.074.
  • Xanthos PD, Gordon BA, Begg S, Nadurata V, Kingsley MI. A comparison of age- standardised event rates for acute and chronic coronary heart disease in metropolitan and regional/remote Victoria: a retrospective cohort study. BMC Public Health. 2016;16(1):391.

Current Projects

Assessment and management of chest pain in emergency departments

*Retrospective cohort study; nested case-control study.

Aims:

  • To assess gender and socio-economic differences in the assessment and management of approximately 80,000 chest pain presentations in three Victorian emergency departments (January 2009 – December 2013).
  • To investigate socio-economic gradients in admission to specialised care units among hospitalised individuals presenting with chest pain.

Collaborating hospitals:

Inequalities in mortality following first acute myocardial infarction

*Retrospective cohort study.

Aims:

  • To assess gender and socio-economic differences in mortality following first acute myocardial infarction (AMI) in a five year period.
  • To investigate the mortality attributable risk attributed to hospital treating ward among patients diagnosed with first AMI

Collaborating hospitals:

Obesity, morbid obesity and obstetric complications in regional

*Retrospective cohort study.

Aims:

  • To estimate the prevalence of overweight, obesity and morbid obesity in women giving birth in Bendigo Health during January 2010 - December 2016
  • To measure obstetric complications associated with obesity / morbid obesity
  • To compare direct hospital health costs for normal-weight, over-weight, obese, and morbid obese obstetric populations giving birth in Bendigo Health

Collaborating hospital:

Survival of government subsidised complete dentures in a large population of adult patients in Victoria

*Prospective cohort study.

Aims:

  • To quantify the survival of sets of complete dentures provided to approximately 122,000 individuals at a subsidised cost by Dental Health Services Victoria (DHSV).
  • To assess the effect of various interventions such as relines, repairs, adjustments and single denture replacements on the survival of complete dentures.
  • To investigate the association of type of clinician, gender, age, socioeconomic, rurality with the longevity of complete dentures.

Collaborating organisations:

Risk-guided strategy for reducing readmission for acute decompensated heart failure

*Prospective randomised controlled trial.

Aims:

  • To assess the effectiveness of a recently developed and validated risk algorithm (TasHELP) in reducing readmission among patients diagnosed with acute decompensated heart failure.
  • To investigate the impact of co-morbidities on readmission rates
  • To measure quality of life of patients whose readmission risk was evaluated with (intervention arm) and without (control) TasHelp algorithm.

Collaborating organisations: