CHERE develops and uses advanced theory and methods in health economics to achieve excellence in research and produce new knowledge. We have collaborations with other leading researchers in Australia and in other countries. Our research broadly covers the financing, organisation and delivery of health services. Our areas of expertise are financing and the use of health care services; economic evaluation and health outcomes measurement; preferences and decision making in health care; and the health workforce.
Financing the health system and the incentives generated for how health services are used is a key concern in Australia as in other countries. Developments in medical technology and increasing community expectations make it more difficult to ensure that health services deliver value for money. Australia has a unique combination of public and private sources of finance for health care, and public and private sector providers. CHERE has considerable work investigating the impact of these, particularly around private health insurance. There are substantial data sets, collected for administrative purposes and surveys, which have been under-used for research. The increasing availability of panel studies are presenting new opportunities to investigate how individuals respond to changes in personal circumstances, how past experiences within the health system impact on present choices and how changes in the policy setting shape decisions and impact on outcomes. Panel data also allow more sophisticated approaches to control for unobserved heterogeneity across individuals. This approach will allow for better modelling of policy responses over time.
Economic evaluation and health outcomes measurement are an important component of the application of economics research to health care decision making. Increasingly health care funders and providers wish to assess the cost-effectiveness (efficiency) of interventions, not just their safety and effectiveness. Methods in economic evaluation are developing rapidly and CHERE has a strong focus on the application of rigorous and up to date methods, and extending these applications to complex interventions. The assessment of health outcomes that are relevant to end users, sensitive to differences in alternative interventions, and valid in comparing across health care services remains a major challenge in applying economic evaluation. CHERE is also involved in work that explores how different decision makers use and can use the results of such evaluations.
Individuals make choices about their life styles, whether to use health care, and what services to use. Health system outcomes - aggregate use of services, costs and health outcomes - depend on these choices. So understanding how individuals make choices is fundamental to understanding how the health system works, and predicting the impact of changes in policy settings or constraints. Often the data available do not include all the factors that are relevant to individuals' choices. Or in the case of new technologies, data simply do not exist as the relevant options are not yet available. Discrete choice modelling of stated preference data can address these crucial gaps and provide more insight into key choices, whether of consumers, providers or funders.
CHERE has developed substantial expertise in the use of this approach in health care settings.
The health workforce is crucial to the productivity, effectiveness and accessibility of health care. To date there has been little Australian research in this field. CHERE is engaged in this topic, particularly around the nursing workforce.