• About
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The Health Performance and Policy Research Unit assesses important end results of healthcare such as effectiveness, safety, quality, and costs. Combining clinical medicine and data science, our goal is to generate research that informs clinical and policy strategies to improve the quality of care received by Australian communities. We are particularly focused on leveraging data routinely collected by health care facilities, and advanced analytical methods, to inform health outcomes and decision-making. We also seek to develop low-cost and implementable methods to measure to measure healthcare performance and reduce unwarranted variation in care.

Our vision is a patient-centered, value-driven and transparent health system that delivers the best possible health outcomes for healthcare dollars spent. We achieve this vision through critical and innovative health services research and training, and by generating research output that both stimulates and empowers clinicians and health services to improve patient care.

Researchers

Flinders University Honours Students

Taylor-Jade Woods

Supervisors: A/Prof Billingsley Kaambwa and A/Prof Peter Speck

Vanessa Woelk

Supervisors: A/Prof Peter Speck and A/Prof Billingsley Kaambwa

ORION: Leveraging Big Data to Inform Nationwide Cardiovascular Health Outcomes
The Observing Recurrent Incidence of Adverse Outcomes following HospitalisatioNs (ORION) study brings together a decade of cardiovascular hospitalisation data from all Australian States. Encompassing millions of healthcare records from more than 450 public hospitals and many private facilities, ORION allows our team to assess important end results of hospital-based cardiovascular care on a national scale and understand how these outcomes vary among the many healthcare facilities in Australia.  
  • National Outcomes of Common Cardiovascular Conditions
Hospitalisations for conditions such as heart failure, acute myocardial infarction, and stroke are exceedingly common. However, outcomes following these hospitalisations are not well known with limited local data. This study examines short-and long-term outcomes such as deaths and readmissions following cardiovascular hospitalizations. The results of this study will inform patients and clinicians who are seeking to better understand the prognosis.  
  • Reducing Unwarranted Variation in Early Complications After Cardiac Pacemaker and Defibrillator Implantation among Australian Hospitals
Implanted pacemakers and cardiac defibrillators are common and costly procedures performed in Australian hospitals. While very effective at treating heart rhythm abnormalities, patients can suffer serious complications which can vary among hospitals suggesting that complications are related to hospital quality. Supported by an HCF Research Foundation grant, the aim of this project is to develop methods to detect unwarranted variation in early complications, and the necessary technical requirements to integrate reporting into clinical practice, using data routinely collected by hospitals.  
  • Value of Elective Coronary Angiography and Percutaneous Coronary Intervention
Coronary angiogram and percutaneous coronary intervention are common cardiac procedures and their benefits are well established in the acute setting. However, the value of elective is increasingly debated. In this project, we seek to define the value of elective coronary angiography and PCI by estimating the procedural outcomes and costs. The specific aims 1) to assess frequency of early outcomes including deaths, unplanned readmissions and procedural-related outcomes complications; 2) Determine the cost associated with these procedures and near-term outcomes; and (3) To evaluate institutional variation in outcome rates that may suggest variation in care quality.  
  • Outcomes of Catheter Ablation for Atrial Fibrillation
Catheter ablation for atrial fibrillation (AF), first introduced in 1998, has rapidly evolved from an investigational procedure to a guidelines-recommended therapeutic option. This project aims to evaluate procedural safety and outcomes using national data irrespective of age or payer. The results of this study will facilitate a better-informed decision of undergoing catheter ablation for AF, as well as assist hospitals and policymakers seeking to improve the quality of this increasingly common procedure.  
  • Avoidable Healthcare Costs Associated with Hospital Readmissions
Unplanned readmissions are distressing to patients, exposures patients to hospital-acquired conditions and are a major cause of bed-block. However, the avoidable costs associated with readmission is poorly understood even though cost-considerations are a major driver of healthcare decision making. The objectives of this study are to: 1) enumerating the cost of unplanned readmissions where a cardiovascular condition has been the primary discharge diagnosis; and 2) identifying key predictors of costs associated with those readmissions. This will inform policy-making decisions and identify patient subsets who may require extra resources during their care.
Safety, Effectiveness of care and Resource use among Australian Hospitals (SAFER Hospitals)
Modern hospital care is fast-paced, complex and expensive. While this has undoubtedly led to better treatments, global concerns exist about the safety and effectiveness of hospital care. The SAFER Hospitals study is a nationwide cohort study that seeks to address this limitation by bringing together linked hospitalisation and outcome data for all public and most private hospitals in Australia. Funded by a Translational Project Grant from the Hospital Research Foundation, SAFER Hospitals will estimate the hospital-wide incidence of serious adverse events, deaths and unplanned hospitalisations following hospital care and how these outcomes vary among hospitals. It will also evaluate the downstream impact by estimating the avoidable costs of these untoward outcomes on the health system.
Predicting 30-Day Readmission or Death in Heart Failure: Looking beyond the C-Statistic

Ranasinghe I, Krumholz HM. Predicting 30-Day Readmission or Death in Heart Failure: Looking beyond the C-Statistic. JAMA Cardiology ; 2016. Nov 1;1(8):965.

Long-Term Risk of Device-Related Complications and Reoperations after Implantable Cardioverter-Defibrillator Therapy

Ranasinghe I, Parzynski CS, Freeman JV, Dreyer RP, Ross JS, Akar JG, Krumholz HM, Curtis JP. Long-Term Risk of Device-Related Complications and Reoperations after Implantable Cardioverter-Defibrillator Therapy. Annals of Internal Medicine ; 2016. May 3. doi: 10.7326/M15-2732.

Differences in Colonoscopy Quality Among Facilities: Development of a Post-Colonoscopy Risk-Standardized Rate of Unplanned Hospital Visits

Ranasinghe I, Parzynski CS, Searfoss R, Montague J, Lin Z, Allen J, Vender R, Bhat K, Ross JS, Bernheim S, Krumholz HM, Drye EE. Differences in Colonoscopy Quality Among Facilities: Development of a Post-Colonoscopy Risk-Standardized Rate of Unplanned Hospital Visits. Gastroenterology; 2016 Jan;150(1):103-13.

Long-term mortality following interhospital transfer for acute myocardial infarction

Ranasinghe I, Barzi F, Brieger D, Gallagher M. Long-term mortality following interhospital transfer for acute myocardial infarction. Heart; 2015. Jul;101(13):1032-40.

Readmissions after Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia among Young and Middle-Aged Adults: A Retrospective Observational Cohort Study

Ranasinghe I, Wang Y, Dharmarajan K, Hsieh AF, Bernheim SM, Krumholz HM. Readmissions after Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia among Young and Middle-Aged Adults: A Retrospective Observational Cohort Study. PLoS Med; 2014. Sep 30;11(9):e1001737.

Epidemiology of Cardiovascular Disease and Depression

Air, T., Tully, P. J., Sweeney, S., & Beltrame, J. Epidemiology of Cardiovascular Disease and Depression. Book: Cardiovascular Diseases and Depression (editors Baune & Tully. Published by Springer) ; 2016. pp. 5-21.

Psychosis, socioeconomic disadvantage, and health service use in South Australia: Findings from the Second Australian National Survey of Psychosis 2015

Sweeney, S., Air, T., Zannettino, L., & Galletly, C. Psychosis, socioeconomic disadvantage, and health service use in South Australia: Findings from the Second Australian National Survey of Psychosis 2015. Frontiers in Public Health; 2015. 3.

Frequent attenders with mental disorders at a general hospital emergency department

Wooden, M. D., Air, T. M., Schrader, G. D., Wieland, B., & Goldney, R. D. Frequent attenders with mental disorders at a general hospital emergency department. Emergency Medicine Australasia; 2009. 21(3), 191-195.

Funding since 2013

Chief InvestigatorsGranting BodyProject TitleGrant TypeTotal funding AmountFunding Period
Ranasinghe INational Heart Foundation (#101186)Leveraging Big Data to Inform Cardiovascular Healthcare OutcomesFuture Leader Fellowship$520,0002017 - 2020
Ranasinghe I, Gallagher M, Scott IThe Hospital Research FoundationSafety, effectiveness of care and resource use among Australian hospitals (SAFER HOSPITALS)Translational$250,0002018-2019
Ranasinghe I, Kaambwa B, Adams RNational Heart FoundationHealthcare Costs and Resource Use associated with 30-day Hospital Readmissions among Heart Failure Patients2017 Vanguard Grant$75,0002018
Ranasinghe ITHRFThe ORION StudyProject$50,0002017
Ranasinghe I, Beltrame J, Tavella R, Zeitz C, Mazumdar S, Cooper BHCF Research FoundationReducing Unwarranted Variation in Early Complications After Cardiac Pacemaker and Defibrillator Implantation among Australian HospitalsÊProject$250,0002016 - 2017
Ranasinghe I, Carniero G, van den Hengel A, Beltrame J, Tavella RUniversity of Adelaide Interdisciplinary Research Funding SchemeNovel Applications of Machine Learning in HealthcareProject$25,0002016 - 2017
Ranasinghe IThe University of Adelaide Interdisciplinary Research Funding SchemeNovel applications of machine learning in healthcareProject Grant$12,5002016 - 2017
Ransinghe ITom Simpson TrustSleep measurement among cardiac patientsEquipment$8,0002016
Ranasinghe I, Labrosciano CSA Hotel Care Community Grants SchemeImpact of sleep disruption during hospitalisation on the risk of readmissionEquipment$7,7802016
Ranasinghe IUniversity of Adelaide Equipment Grants SchemeHigh Performance Computers for the ORION studyEquipment$7,2002016
Ranasinghe INHMRC & Heart Foundation (co-funded)Delivery & Performance of Cardiac Health ServicesNeil Hamilton Fairley Fellowship$389,0002013 - 2016
NameInstitutionCity/Country
Prof Renuka VisvanathanAdelaide G-TRAC Centre, Basil Hetzel Institute, The Queen Elizabeth HospitalAdelaide, Australia
Prof Robert AdamsThe Health Observatory, Flinders UniversityAdelaide, Australia
A/Prof Gustavo CarneiroSchool of Computer Science, The University of AdelaideAdelaide, Australia
Prof Billingsley KaambwaHealth Economics Unit, Flinders UniversityAdelaide, Australia
A/Prof Anand GanesanDepartment of Cardiology, Flinders UniversityAdelaide, Australia
Prof Harlan KrumholzCenter for Outcomes Research and Evaluation, Yale UniversityNew Haven, USA
A/Prof Martin Gallagher and Dr Sradha KotwalThe George InstituteSydney, Australia
Dr Harlan Krumholz and Prof Jeptha CurtisCentre for Outcomes Research and Evaluation, Yale UniversityNew Haven, USA
Prof Steve GuthridgeCentre for Child Development and Education, Menzies School of Health Research, Charles Darwin UniversityDarwin, Australia
Prof David RoderCancer Epidemiology and Population Health, University of South AustraliaAdelaide, Australia
A/Prof Ian ScottDepartment of Internal Medicine and Clinical Epidemiology, Princess Alexandra HospitalBrisbane, Australia
Dr Gerry O'CallaghanIntensive Care Services, SA Health, CALHNAdelaide, Australia