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Patricia Kenny

Biography

Patsy is a Senior Research Fellow and joined CHERE in 1990. She worked as a registered nurse before completing the BA in Government and Political Economy at The University of Sydney. Patsy was awarded her Master of Public Health from The University of Sydney in 1998, her treatise investigated patient participation in treatment decisions for breast cancer. Her early research experience comprised the economic evaluation of health care programs involving innovative nursing and midwifery roles as well as the economic evaluation of cancer treatments. More recent research has included health related quality of life (HRQOL) in asthma and lung cancer, preferences of patients and informal carers, nurses’ job preferences and the HRQOL of informal carers. She has experience in the conduct of longitudinal studies and the analysis of repeated measures data, including HRQOL and cost data. She is currently a member of the NSW Population and Health Services Research Ethics Committee.

Image of Patricia Kenny
Senior Research Fellow, Centre for Health Economics Research and Evaluation
Core Member, CHERE - Centre for Health Economics and Research Evaluation
BA, MPH
Member, International Health Economics Association
 

Conferences

Goodall, S., Kenny, P. & Mu, C. 2015, 'What influences the choice of General Practitioners? Evidence from a Discrete Choice Experiment in Australia and New Zealand', CAER Workshop.
Goodall, S., Kenny, P. & Mu, C. 2015, 'What influences the choice of General Practitioners? Evidence from a Discrete Choice Experiment in Australia and New Zealand', Primary Health Care Research Conference, Adelaide.
Goodall, S., Kenny, P. & Mu, C. 2015, 'What influences the choice of General Practitioners? Evidence from a Discrete Choice Experiment in Australia and New Zealand', iHEA 11th World Congress on Health Economics, Milan, July.
Kenny, P.M. 2015, 'Evidence from a Discrete Choice Experiment in Australia and New Zealand', HSRAANZ 9th Health Services & Policy Conference, Melbourne.
De Abreu Lourenco, R., Kenny, P.M. & Hall, J.P. 2014, 'Factors linked to patient GP payments: results of a survey of Australian patients', 2014 PHC Research Conference, Canberra.
Kenny, P.M., Haas, M.R., Goodall, S., Wong, C. & De Abreu Lourenco, R. 2014, 'Patient preferences in General Practice: Important factors for choosing a GP', 2014 PHC Research Conference, Canberra.
De Abreu Lourenco, R., Kenny, P.M. & Hall, J.P. 2013, 'Factors linked to patient GP payments: results of a survey of Australian patients', 8th Health Services and Policy Research Conference, Wellington, New Zealand.
Goodall, S., Kenny, P.M., De Abreu Lourenco, R. & Haas, M.R. 2013, 'Understanding patients' preferences for primary care services: Have Discrete Choice Experiments helped?', 8th Health Services and Policy Research Conference, Wellington, New Zealand.
Kenny, P.M., Haas, M.R. & Goodall, S. 2013, 'Patient preferences in general practice: Important factors for choosing a GP', 8th Health Services and Policy Research Conference, Wellington, New Zealand.
Ewing, J.E., Goodall, S., King, M.T., Smith, N.F. & Kenny, P.M. 2012, 'Preferences for support services among adolescents and young adults with cancer or a blood disorder: Results of a discrete choice experiment', COSA 39th Annual Scientific Meeting and IPOS 14th World Congress of Psycho-Oncology, Brisbane.
Ewing, J.E., Goodall, S., King, M.T., Smith, N.F. & Kenny, P.M. 2012, 'Preferences for support services among adolescents and young adults with cancer or a blood disorder: Results of a discrete choice experiment [conference abstract]', Asia-Pacific Journal of Clinical Oncology, COSA 39th Annual Scientific Meeting and IPOS 14th World Congress of Psycho-Oncology, Wiley, Brisbane, pp. 129-129.
Kenny, P.M. 2011, 'The health related quality of life of informal carers in Australia: Are carers different from non-carers before caregiving commences?', 7th Health Services and Policy Research Conference, Adelaide.
Kenny, P.M., Doiron, D., Street, D. & Hall, J.P. 2010, 'What do nursing students and new graduates value in their first nursing job?', Conference of the Australian Health Economics Society, Sydney.
Kenny, P.M., Hall, J.P., Hossain, I. & Savage, E.J. 2009, 'Supporting palliative care informal carers: Preferences and value of services', 6th Health Policy and Research Conference 2009, Brisbane.
Kenny, P.M., Hall, J.P., Zapart, S., Davis, P. & Hossain, I. 2008, 'Informal care and home-based palliative care: a discrete choice experiment to assess the carers' preferences for support services', Uruguay.
Hall, J.P., Louviere, J.J. & Kenny, P.M. 2007, 'Understanding the preferences of informal caregivers providing palliative care at home', iHEA 6th World Congress on Health Economics, Copenhagen, Denmark.
Hall, J.P., Kenny, P.M. & Hossain, I. 2007, 'The provision of informal care in terminal illness: an analysis of carersâ needs using a discrete choice experiment', Brisbane.
Kenny, P.M., Hall, J.P., Zapart, S., Davis, P. & Hossain, I. 2007, 'Informal care and home-based palliative care: the carersâ preferences for support', 5th Health Services & Policy Research Conference, Auckland.
Kenny, P.M., King, M.T., Hall, J.P., Chaplin, M. & Marks, G.B. 2005, 'The impact of asthma: a longitudinal study of quality of life', 4th Health Services & Policy Research Conference, Canberra.
Kenny, P.M., King, M.T., Hall, J.P., Chaplin, M. & Marks, G.B. 2005, 'The impact of asthma: a longitudinal study of quality of life', 11th Annual National Health Outcomes Conference, Canberra.
Kenny, P.M., King, M.T., Viney, R.C., Boyer, M., Pollicino, C., McLean, J., McCaughan, B.C. & Fulham, M.J. 2004, 'Quality of life in the two years after surgery for non-small cell lung cancer', Quality of Life Research 2004; 13(9)., 11th Annual Conference of the International Society for Quality of Life Research, Springer, Hong Kong, pp. 1594-1594.
Kenny, P.M., King, M.T., Viney, R.C., Boyer, M., Pollicino, C., McLean, J., McCaughan, B.C. & Fulham, M.J. 2004, 'Quality of life in the two years after surgery for non-small cell lung cancer', 10th Annual National Health Outcomes Conference, Canberra.
Boyer, M., Viney, R.C., Fulham, M.J., King, M.T., McCaughn, B., Kenny, P.M., Pollicino, C. & McLean, J. 2001, 'A randomised trial of conventional staging (CS) with or without positron emission tomography (PET) in patients with stage 1 or 2 Non-Small Cell Lung Cancer', American Society of Clinical Oncology Conference, San Francisco.
Viney, R.C., Pollicino, C., Haas, M.R., King, M.T. & Kenny, P.M. 2001, 'Assessing the value of a PET scan for patients with non-small cell lung cancer', International Health Economics Association (iHEA) 3rd World Conference, York, UK.
Kenny, P.M., Hall, J.P., Viney, R.C., Haas, M.R. & King, M.T. 2001, 'Validity of choice modelling for measuring consumer preferences in health', 2nd New Zealand Australia Health Services & Policy Research Conference, Wellington, NZ.

Journal articles

Kenny, P.M., Goodall, S., Street, D. & Greene, J. 2017, 'Choosing a Doctor: Does presentation format affect the way consumers use health care performance information?', The Patient: Patient Centered Outcomes Research.
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De Abreu Lourenco, R., Kenny, P., Haas, M.R. & Hall, J. 2017, 'Factors affecting general practitioner charges and Medicare bulk-billing: results of a survey of Australians - erratum.', Med J Aust, vol. 206, no. 7, pp. 326-326.
Kenny, P., De Abreu Lourenco, R., Wong, C.Y., Haas, M. & Goodall, S. 2016, 'Community preferences in general practice: important factors for choosing a general practitioner.', Health expectations : an international journal of public participation in health care and health policy, vol. 19, no. 1, pp. 26-38.
Understanding the important factors for choosing a general practitioner (GP) can inform the provision of consumer information and contribute to the design of primary care services.To identify the factors considered important when choosing a GP and to explore subgroup differences.An online survey asked about the respondent's experience of GP care and included 36 questions on characteristics important to the choice of GP.An Australian population sample (n = 2481) of adults aged 16 or more.Principal components analysis identified dimensions for the creation of summated scales, and regression analysis was used to identify patient characteristics associated with each scale.The 36 questions were combined into five scales (score range 1-5) labelled: care quality, types of services, availability, cost and practice characteristics. Care quality was the most important factor (mean = 4.4, SD = 0.6) which included questions about technical care, interpersonal care and continuity. Cost (including financial and time cost) was also important (mean = 4.1, SD = 0.6). The least important factor was types of services (mean = 3.3, SD = 0.9), which covered the range of different services provided by or co-located with the practice. Frequent GP users and females had higher scores across all 5 scales, while the importance of care quality increased with age.When choosing a GP, information about the quality of care would be most useful to consumers. Respondents varied in the importance given to some factors including types of services, suggesting the need for a range of alternative primary care services.
Kenny, P.M., Reeve, R. & Hall, J. 2016, 'Satisfaction with nursing education, job satisfaction and work intentions of new graduate nurses', Nurse Education Today, vol. 36, pp. 230-235.
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Moullin, J., Sabater-Hernández, D., García-Corpas, J.P., Kenny, P.M. & Benrimoj, S. 2016, 'Development and testing of two implementation tools to measure components of professional pharmacy service fidelity', Journal of Evaluation in Clinical Practice, vol. 22, no. 3, pp. 369-377.
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De Abreu Lourenco, R., Kenny, P., Haas, M.R. & Hall, J.P. 2015, 'Factors affecting general practitioner charges and Medicare bulk-billing: results of a survey of Australians.', The Medical journal of Australia, vol. 202, no. 2, pp. 87-90.
OBJECTIVE: To identify factors affecting bulk-billing by general practitioners in Australia. DESIGN, PARTICIPANTS AND SETTING: A community-based survey was administered to Australians aged 16 years or older in July 2013 via an online panel. Survey questions focused on patient characteristics, visit characteristics, practice characteristics. MAIN OUTCOME MEASURES: Factors associated with GP bulk-billing. RESULTS: 2477 respondents completed the survey, of whom 2064 (83.33%) reported that the practice that they went to for their most recent GP visit bulk billed some or all patients. Overall, 1763 respondents (71.17%) reported that their most recent GP visit was bulk billed. Taking into account the duration of visits and the corresponding Medicare Benefits Schedule rebate, the mean out-of-pocket cost for those who were not bulk billed was $34.09. RESULTS of a multivariate logistic regression analysis suggest that the odds of being bulk billed was negatively associated with larger practice size, respondents having had an appointment for their visit, higher household income and inner or outer regional area of residence. It was positively associated with the presence of a chronic disease, being a concession card holder and having private health insurance. There was no association between bulk-billing and duration of GP visit, age or sex. CONCLUSIONS: Our results indicate that there are associations between patient characteristics and bulk-billing, and between general practice characteristics and bulk-billing. This suggests that caution is needed when considering changes to GP fees and Medicare rebates because of the many possible paths by which patients' access to services could be affected. Our results do not support the view that bulk-billing is associated with shorter consultation times.
Chenoweth, L., Vickland, V., Stein-Parbury, J., Jeon, Y.H., Kenny, P. & Brodaty, H. 2015, 'Computer modelling with RCT data informs the development of person-centred aged care homes', Neurodegenerative Disease Management, vol. 5, no. 5, pp. 403-412.
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Chenoweth, L., Vickland, V., Stein-Parbury, J., Jeon, Y.H., Kenny, P. & Brodaty, H. 2015, 'Computer modeling with randomized-controlled trial data informs the development of person-centered aged care homes.', Neurodegenerative disease management, vol. 5, no. 5, pp. 403-412.
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To answer questions on the essential components (services, operations and resources) of a person-centered aged care home (iHome) using computer simulation.iHome was developed with AnyLogic software using extant study data obtained from 60 Australian aged care homes, 900+ clients and 700+ aged care staff. Bayesian analysis of simulated trial data will determine the influence of different iHome characteristics on care service quality and client outcomes. Interim results: A person-centered aged care home (socio-cultural context) and care/lifestyle services (interactional environment) can produce positive outcomes for aged care clients (subjective experiences) in the simulated environment.Further testing will define essential characteristics of a person-centered care home.
Milton-Wildey, K.K., Kenny, P.M., Parmenter, G. & Hall, J.P. 2014, 'Educational preparation for clinical nursing: the satisfaction of students and new graduates from two Australian universities', Nurse Education Today, vol. 34, pp. 648-654.
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BACKGROUND: Attrition rates among young and newly registered nurses are high; the capacity of nurse education programmes to prepare nurses for their professional role and the extent to which they are supported during the transition from student to registered nurse may be important factors. OBJECTIVES: This paper examines nursing student and recent graduate satisfaction with their education, focusing on their preparation for work. DESIGN: A descriptive cohort design was used, combining qualitative and quantitative methods to measure and interpret satisfaction. SETTING: Two Australian universities, one urban and one regional. PARTICIPANTS: 530 undergraduate nursing students and recent graduates from the Bachelor of Nursing programmes at the two universities. METHODS: Data were collected via an online survey. Satisfaction with the programmes was measured with closed format questions covering different aspects of the programmes and a single open ended question. Responses were compared between older and younger respondents and between graduates and students at different stages of the programme. RESULTS: Older students were more dissatisfied than younger students with the amount and type of training and their preparation for nursing work. First year students reported the highest levels of satisfaction, and third year students the lowest. The majority of graduates and third year students thought that the programme only partly prepared them for work in nursing. The free text comments particularly highlighted concerns with the amount and quality of clinical education. CONCLUSIONS: Programmes need to take account of the learning requirements of students to maximise the integration of theory and skill development in hospital environments with limited staffing and resources. The clinical environment and support received impact on the quality of learning and satisfaction of student nurses. Students who are dissatisfied with their educational and clinical experiences may choos...
Hall, J.P., Kenny, P.M., Hossain, I., Street, D. & Knox, S.A. 2014, 'Providing informal care in terminal illness: an analysis of preferences for support using a discrete choice experiment', Medical Decision Making, vol. 34, no. 6, pp. 731-745.
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Background: The trend for terminally ill patients to receive much of their end-of-life care at home necessitates the design of services to facilitate this. Care at home also requires that informal care be provided by family members and friends. This study investigated informal carers' preferences for support services to aid the development of end-of-life health care services. METHODS: This cross-sectional study used 2 discrete choice experiments to ascertain the preferences of carers supporting patients with different levels of care need, determined by the assistance needed with personal care and labeled High Care (HC) and Low Care (LC). The sample included 168 informal carers of people receiving palliative care at home from 2 palliative care services in Sydney, Australia. Data were collected in face-to-face interviews; carers chose between 2 hypothetical plans of support services and their current services. Data were analyzed with generalized multinomial logit models that were used to calculate the impact of each attribute on the probability of a carer choosing a service plan. RESULTS: Preferred support included nursing services; the probability of choosing a plan increased significantly if it included nurse home visits and phone advice (P < 0.001). HC carers also wanted doctor home visits, home respite, and help with personal care (P < 0.05), and LC carers wanted help with household tasks, transport, and a case coordinator (P < 0.001). On average, both groups of carers preferred their current services, but this varied with characteristics of the carer and the caregiving situation. CONCLUSIONS: The most valued services are those that support carers in their caregiving role; however, supportive care preferences vary with the different circumstances of patients and carers.
Doiron, D., Hall, J.P., Kenny, P.M. & Street, D. 2014, 'Job preferences of students and new graduates in nursing', Applied Economics, vol. 46, no. 9, pp. 924-939.
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This article investigates the preferences of student and newly graduated nurses for pecuniary and nonpecuniary aspects of nursing jobs. It is the first study applying methods based on discrete choice experiments to a developed country nursing workforce. It is also the first to focus on the transition through university training and into work. This is particularly important as junior nurses have the lowest retention levels in the profession. We sample 526 individuals from nursing programmes in two Australian universities. Flexible and newly developed models combining heteroscedasticity with unobserved heterogeneity in scale and preference weights are estimated.Overall, salary remains the most important feature in increasing the probability that a job will be selected. `Supportive management/staff and `quality of care follow as the most important attributes from a list of 11 nonpecuniary characteristics. However, the subset of new graduates rank `supportive management/staff above salary increases, emphasizing the importance of a supportive workplace in the transition from university to the workplace. We find substantial preference heterogeneity and some attributes, such as the opportunity for clinical rotations, are found to be attractive to some nurses while seen as negative by others. Nursing retention could be improved by designing different employment packages to appeal to these different tastes.
Chenoweth, L., Forbes, I., King, M.T., Fleming, R., Stein-Parbury, J., Yun-Hee, J., Haas, M.R., Kenny, P.M., Luscombe, G. & Brodaty, H. 2014, 'PerCEN: a cluster randomized controlled trial of person-centered residential care and environment for people with dementia', International Psychogeriatrics, vol. 26, no. 7, pp. 1147-1160.
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Background: There is good evidence of the positive effects of person-centered care (PCC) on agitation in dementia. We hypothesized that a person-centered environment (PCE) would achieve similar outcomes by focusing on positive environmental stimuli, and that there would be enhanced outcomes by combining PCC and PCE. Methods: 38 Australian residential aged care homes with scope for improvement in both PCC and PCE were stratified, then randomized to one of four intervention groups: (1) PCC; (2) PCE; (3) PCC +PCE; (4) no intervention. People with dementia, over 60 years of age and consented were eligible. Co-outcomes assessed pre and four months post-intervention and at 8 months follow-up were resident agitation, emotional responses in care, quality of life and depression, and care interaction quality. Results: From 38 homes randomized, 601 people with dementia were recruited. At follow-up the mean change for quality of life and agitation was significantly different for PCE (p = 0.02, p = 0.05, respectively) and PCC (p = 0.0003, p = 0.002 respectively), compared with the non-intervention group (p = 0.48, p = 0.93 respectively). Quality of life improved non-significantly for PCC+PCE (p = 0.08), but not for agitation (p = 0.37). Improvements in care interaction quality (p = 0.006) and in emotional responses to care (p = 0.01) in PCC+PCE were not observed in the other groups. Depression scores did not change in any of the groups. Intervention compliance for PCC was 59%, for PCE 54% and for PCC+PCE 66%. Conclusion: The hypothesis that PCC+PCE would improve quality of life and agitation even further was not supported, even though there were improvements in the quality of care interactions and resident emotional responses to care for some of this group. The Australian New Zealand Clinical Trials Registry Number is ACTRN 12608000095369.
Kenny, P., King, M.T. & Hall, J. 2014, 'The physical functioning and mental health of informal carers: evidence of care-giving impacts from an Australian population-based cohort.', Health Soc Care Community, vol. 22, no. 6, pp. 646-659.
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Informal carers represent a substantial proportion of the population in many countries and health is an important factor in their capacity to continue care-giving. This study investigated the impact of care-giving on the mental and physical health of informal carers, taking account of contextual factors, including family and work. We examined health changes from before care-giving commenced to 2 and 4&nbsp;years after, using longitudinal data from the Household Income and Labour Dynamics in Australia survey. The sample comprised 424 carers and 424 propensity score-matched non-carers. Health was self-assessed, measured with the SF-36 Health Survey Mental Health (MH) and Physical Functioning (PF) scales. Care-giving was classified as non-carer, low (<5&nbsp;hours/week), moderate (5-19&nbsp;hours/week) and high (20 or more hours/week). PF and MH change scores were regressed on baseline scores, care-giving, covariates (including work, family and socio-demographic characteristics) and interactions to identify impacts for subgroups. The physical and mental health impacts differed by gender, and care-giving hours and carer work hours were important contextual factors. Deterioration in both PF and MH was worse for females after 2&nbsp;years and deterioration in MH was worse for males after 4&nbsp;years. Among carers aged 40-64&nbsp;years, there was a 17-point decline in PF (P&nbsp;=&nbsp;0.009) and a 14-point decline in MH (P&nbsp;<&nbsp;0.0001) after 2&nbsp;years for female high caregivers working full-time and 9.3 point improvement (P&nbsp;=&nbsp;0.02) for non-working male high caregivers. Change was not significant for non-carers. The study found that not all carers suffer adverse health impacts; however, the combination of high levels of care-giving with workforce participation can increase the risk of negative physical and mental health effects (particularly in female carers). Working carers providing high levels of care represent a vulnerable subgroup where supportive and preventive services might be focused.
Garcia-Cardenas, V., Sabater Hernandez, D., Kenny, P.M., Martinez-Martinez, F., Faus, M.J. & Benrimoj, C. 2013, 'Effect of a pharmacist intervention on asthma control. A cluster randomised trial', Respiratory Medicine, vol. 107, no. 9, pp. 1346-1355.
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Achievement and maintenance of good asthma control is a major objective in asthma management. However, asthma control in many patients is suboptimal, due to improper use of asthma medications and non-adherence. The aim of this study was to evaluate the effect of a pharmacist intervention on asthma control in adult patients. Methods A 6-month cluster randomized controlled trial was undertaken with allocation of community pharmacies to intervention or control group. Adult asthma patients in the intervention group received a protocol-based intervention addressing individual needs related to asthma control, inhaler technique and medication adherence. Patients in the control group received usual care. Main variables were measured at baseline, 3 and 6 months. Results 336 patients completed the study, 150 in the control group and 186 in the intervention group. The intervention resulted in enhanced asthma control: Patients receiving the intervention had an Odds ratio of 3.06 (95% CI:1.635.73; p < 0.001) of having controlled asthma six months later. In the intervention group mean ACQ scores significantly improved [0.66 points (SD: 0.78); p < 0.001] and the number of controlled asthma patients increased by 30.1% (p < 0.001) after 6 months. The intervention also resulted in improved medication adherence (by 40.3%, p < 0.001) and inhaler technique (by 56.2%, p < 0.001). No significant changes for any of these variables were observed in the control group.
Alison, J.A., Kenny, P.M., King, M.T., McKinley, S.M., Aitken, L.M., Leslie, G. & Elliott, D. 2012, 'Repeatability of the six-minute walk test and relation to physical function in survivors of a critical illness', Physical Therapy, vol. 92, no. 12, pp. 1556-1563.
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Objectives. To evaluate, in survivors of a critical illness: 1) the repeatability of the 6MWT performed at home; 2) the effect on estimates of change in functional exercise capacity if only one 6MWT was performed at follow-up assessments; 3) the relationship between physical functioning (PF) score of the SF-36 and the 6MWT. Design. Repeated measures of 6MWT and SF-36 Health Survey Methods. Eligible participants had an ICU length of stay 48 hours and mechanically ventilated for 24 hours. Two 6MWT and the SF-36 were conducted in participants homes at Weeks 1, 8, and 26 after hospital discharge.
Goodall, S., King, M.T., Ewing, J.E., Smith, N.F. & Kenny, P.M. 2012, 'Preferences for support services among adolescents and young adults with cancer or a blood disorder: A discrete choice experiment', Health Policy, vol. 107, no. 2-3, pp. 304-311.
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Life-threatening illnesses in young people are traumatic for patients and their families. Support services can help patients and families deal with various non-medical impacts of diagnosis, disease and treatment. The aim of this study was to determine which types of support are most valued by adolescents and young adults (AYA) with cancer or blood disorders and their families. Method: A discrete choice experiment (DCE). Separate experiments were conducted with AYA and their carers. Results: Completed surveys were returned by 83 patients and 78 carers. AYA preferred emotional support for themselves (either by counsellors and/or peers), emotional support for their family, financial support and assistance returning to school/work over services relating to cultural and spiritual needs. Covariate analysis indicated female AYA were more likely than males to prefer emotional support, while males were more likely to prefer assistance returning to work/school. Carers preferred emotional support for their AYA and assistance returning to school/work. Like AYA, they were indifferent about services relating to cultural and spiritual needs. Conclusion: Providing the types of support services that people prefer should maximise effectiveness. This study suggests that AYA patients require support services that included financial aid, assistance returning to work/study, emotional support for themselves and for their family.
Elliott, D., McKinley, S.M., Alison, J.A., Aitken, L.M., King, M.T., Leslie, G., Kenny, P.M., Taylor, P.A., Foley, R. & Burmeister, E. 2011, 'Health-related quality of life and physical recovery after a critical illness: a multi-centre randomised controlled trial of a home-based physical rehabilitation program', Critical Care, vol. 15, no. 3, pp. 1-10.
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Introduction: Significant physical sequelae exist for some survivors of a critical illness. There are, however, few studies that have examined specific interventions to improve their recovery, and none have tested a home-based physical rehabilitation program incorporating trainer visits to participants homes. This study was designed to test the effect of an individualised eight-week home-based physical rehabilitation program on recovery.
Kenny, P.M., Hall, J.P., Zapart, S. & Davis, P. 2010, 'Informal care and home-based palliative care: The health-related quality of life of carers', Journal of Pain and Symptom Management, vol. 40, no. 1, pp. 35-48.
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Health is an important factor in the capacity of family and friends (informal carers) to continue providing care for palliative care patients at home. This study investigates associations between the health-related quality of life (HRQOL) of current informal carers and characteristics of the carers and their caregiving situation, in a sample of Australian carers of palliative care patients. The cross-sectional study used the Short Form-36 Health Survey to measure HRQOL. It found carers to have better physical health and worse mental health than the general population. Of 178 carers, 35% reported their health to be worse than it was one year ago. Multiple regression analyses found that the HRQOL of carers whose health had deteriorated in the previous year was associated with the patients care needs but not the carers time input, unlike the carers reporting stable health. Clinicians caring for palliative care patients should be alert to the potential health impairments of informal carers and ensure that they are adequately supported in their caregiving role and have access to appropriate treatment and preventive health care.
King, M.T., Kenny, P.M. & Marks, G.B. 2009, 'Measures of asthma control and quality of life: Longitudinal data provide practical insights into their relative usefulness in different research contexts', Quality of Life Research, vol. 18, no. 3, pp. 301-312.
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Purpose To further our understanding of the relationships between asthma control and health-related quality of life (HRQOL) and provide insights into the relative usefulness of various measures in different research contexts. We present a conceptual model and test it with longitudinal survey data. Methods Participants recruited via population sampling and hospital Emergency Departments completed questionnaires every 6 months for up to 3 years. Measures included: sleep disturbance, use of short-acting beta agonists (SABA), activity limitation, urgent medical visits, hospital use, Marks Asthma Quality of Life Questionnaire (AQLQ-M) and the SF-36 Health Survey. Correlation analysis and multi-level models tested predictions from the conceptual model. Results A total of 213 people with asthma aged 1675 years provided 967 observations. Correlations between asthma control and asthma-specific HRQOL were stronger than those between asthma control and generic HRQOL. The asthma control variables explained 5458% of the variance in asthma-specific HRQOL and 825% of the variance in generic HRQOL. Activity limitation was the main contributor to between-person variation, while sleep disturbance and SABA use were the main contributors to within-person variation. Conclusions Sleep disturbance and SABA use may be most useful in evaluating treatment effectiveness, while activity limitation may be better when monitoring the impact of asthma in populations.
Kenny, P.M., Hall, J.P., King, M.T. & Lancsar, E. 2009, 'Sources of variation in the costs of health care for asthma patients in Australia', Journal of Health Services Research & Policy, vol. 14, no. 3, pp. 133-140.
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Objectives: Individuals with chronic conditions, such as asthma, on average incur high health care costs, though good control can reduce costs and improve health outcomes. However, there may be substantial variation between patients in their use of services and therefore costs. Our objective was to investigate the sources of such variation in health system and out-of-pocket costs for people with asthma. Methods: A longitudinal observational study of 252 people with asthma in New South Wales, Australia, followed for three years, using six-monthly postal surveys and individual administrative data. Factors associated with costs were investigated using generalized linear mixed models. Results: There was substantial variability in costs between individuals but relatively little within-person change over time for the majority. Costs to the health system and out-of-pocket costs were higher with increasing asthma-related health problems and increasing age. Health system costs were less for patients living outside the state capital (Sydney) and for those in the middle income group relative to high and low income groups. Conclusions: Those with poorly-controlled asthma and the elderly require more carefully targeted strategies to improve their health and ensure appropriate use of resources. Access to appropriate services for those living outside of major cities should be improved. Co-payments for the middle-income groups and those living outside major cities should be reduced to improve equity in the use of services.
Kenny, P.M., King, M.T., Viney, R.C., Boyer, M., Pollicino, C., McLean, J., Fulham, M.J. & McCaughan, B.C. 2008, 'Quality of life and survival in the 2 years after surgery for non-small-cell lung cancer', Journal of Clinical Oncology, vol. 26, no. 2, pp. 233-241.
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Purpose Although surgery for early-stage non-small-cell lung cancer ( NSCLC) is known to have a substantial impact on health-related quality of life (HRQOL), there are few published studies about HRQOL in the longer term. This article examines HRQOL and survival in the 2 years after surgery. Patients and Methods Patients with clinical stage I or II NSCLC (n = 173) completed HRQOL questionnaires before surgery, at discharge, 1 month after surgery, and then every 4 months for 2 years. HRQOL was measured with a generic cancer questionnaire (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire [ EORTC-QLQ] C30) and a lung cancer-specific questionnaire (EORTC QLQ-LC13). Data were analyzed to examine the impact of surgery and any subsequent therapy, and to describe the trajectories of those who remained disease free at 2 years and those with recurrent cancer diagnosed during follow-up. Results Disease recurred within 2 years for 36% of patients and 2-year survival was 65%. Surgery substantially reduced HRQOL across all dimensions except emotional functioning. HRQOL improved in the 2 years after surgery for patients without disease recurrence, although approximately half continued to experience symptoms and functional limitations. For those with recurrence within 2 years, there was some early postoperative recovery in HRQOL, with subsequent deterioration across most dimensions.
Lancsar, E., Hall, J.P., King, M.T., Kenny, P.M., Louviere, J.J., Fiebig, D.G., Hossain, I., Thien, F.C., Reddel, H. & Jenkins, C.R. 2007, 'Using discrete choice experiments to investigate subject preferences for preventive asthma medication', Respirology, vol. 12, no. 1, pp. 127-136.
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Background and objective: Long-term adherence to inhaled corticosteroids is poor despite the crucial role of preventer medications in achieving good asthma outcomes. This study was undertaken to explore patient preferences in relation to their current inhaled corticosteroid medication, a hypothetical preventer or no medication. Methods: A discrete choice experiment was conducted in 57 adults with mildmoderate asthma and airway hyper-responsiveness, who were using inhaled corticosteroid =500 &micro;g/day (beclomethasone equivalent). In the discrete choice experiment, subjects evaluated 16 hypothetical scenarios made up of 10 attributes that described the process and outcomes of taking asthma medication, with two to four levels for each attribute. For each scenario, subjects chose between the hypothetical medication, the medication they were currently taking and no asthma medication. A random parameter multinomial logit model was estimated to quantify subject preferences for the aspects of taking asthma medication and the influence of attributes on medication decisions. Results: Subjects consistently made choices in favour of being able to do strenuous and sporting activities with or without reliever, experiencing no side-effects and never having to monitor their peak flow. Frequency of collecting prescriptions, frequency of taking the medication, its route of administration and the strength of the doctor recommendation about the medication were not significant determinants of choice. Conclusions: The results of this study suggest that patients prefer a preventer that confers capacity to maximize physical activity, has no side-effects and does not require daily peak flow monitoring.
Zapart, S., Kenny, P.M., Hall, J.P., Servis, B. & Wiley, S. 2007, 'Home-based palliative care in Sydney, Australia: the carer's perspective on the provision of informal care', Health & Social Care In The Community, vol. 15, no. 2, pp. 97-107.
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The provision of home-based palliative care requires a substantial unpaid contribution from family and friends (i.e. informal care). The present cross-sectional descriptive study, conducted between September 2003 and April 2004, describes this contributi
Fulham, M.J., McCaughan, B.C., Boyer, M., McLean, J., Kenny, P.M., King, M.T., Pollicino, C. & Viney, R.C. 2005, 'FDG-PET in Stage I/II NSCLC: the Australian RCT', Journal of Clinical Oncology, vol. 23, pp. 591-592.
Kenny, P.M., Lancsar, E., Hall, J.P., King, M.T. & Chaplin, M. 2005, 'The individual and health sector costs of asthma: the first year of a longitudinal study in New South Wales', Australian & New Zealand Journal of Public Health, vol. 29, no. 5, pp. 429-435.
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Objective: To identify the resources used and the costs incurred by people with asthma for health care and non-health care products and services to manage asthma. Methods: A prospective, longitudinal study, using self-reported and administrative data, co
Fulham, M.J., McCaughan, B.C., Boyer, M.J., McLean, J.M., Kenny, P.M., King, M.T., Pollicino, C.A. & Viney, R.C. 2005, 'FDG-PET in addition to conventional work-up in non-small-cell lung cancer - In reply', JOURNAL OF CLINICAL ONCOLOGY, vol. 23, no. 7, pp. 1591-1592.
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Viney, R.C., Boyer, M., King, M.T., Kenny, P.M., Pollicino, C., McLean, J., McCaughn, B. & Fulham, M.J. 2004, 'Randomized controlled trial of the role of positron emission tomography in the management of stage I and II non-small-cell lung cancer', Journal of Clinical Oncology, vol. 22, no. 12, pp. 2357-2362.
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Viney, R.C., Boyer, M.J., King, M.T., Kenny, P.M., Pollicino, C.A., McLean, J.M., McCaughan, B.C. & Fulham, M.J. 2004, 'Randomized controlled trial of the role of positron emission tomography in the management of stage I and II non-small-cell lung cancer', JOURNAL OF CLINICAL ONCOLOGY, vol. 22, no. 12, pp. 2357-2362.
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Kenny, P.M., Hall, J.P., Viney, R.C. & Haas, M.R. 2003, 'Do participants understand a stated preference health survey? a qualitative approach to assessing validity', International Journal of Technology Assessment in Health Care, vol. 19, no. 4, pp. 664-681.
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Hall, J.P., Kenny, P.M., King, M.T., Louviere, J.J., Viney, R.C. & Yeoh, A. 2002, 'Using stated preference discrete choice modelling to evaluate the introduction of varicella vaccination', Health Economics, vol. 11, no. 5, pp. 457-465.
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Applications of stated preference discrete choice modelling (SPDCM) in health economics have been used to estimate consumer willingness to pay and to broaden the range of consequences considered in economic evaluation. This paper demonstrates how SPDCM can be used to predict participation rates, using the case of varicella (chickenpox) vaccination. Varicella vaccination may be cost effective compared to other public health programs, but this conclusion is sensitive to the proportion of the target population immunised. A choice experiment was conducted on a sample of Australian parents to predict uptake across a range of hypothetical programs. Immunisation rates would be increased by providing immunisation at no cost, by requiring it for school entry, by increasing immunisation rates in the community and decreasing the incidence of mild and severe side effects. There were two significant interactions; price modified the effect of both support from authorities and severe side effects. Country of birth was the only significant demographic characteristic. Depending on aspects of the immunisation program, the immunisation rates of children with Australian-born parents varied from 9% to 99% while for the children with parents born outside Australia they varied from 40% to 99%. This demonstrates how SPDCM can be used to understand the levels of attributes that will induce a change in the decision to immunise, the modification of the effect of one attribute by another, and subgroups in the population. Such insights can contribute to the optimal design and targeting of health programs.
Kenny, P.J., King, L., Shiell, A., Seymour, J., Hall, J.P., Langlands, A. & Boyages, J. 2000, 'Early Stage Breast Cancer Costs And Quality Of Life One Year After Treatment By Mastectomy Or Conservative Surgery And Radiation Therapy', Breast, vol. 9, no. 1, pp. 37-44.
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This paper reports a descriptive study of the costs and quality of life (QoL) outcome of treatments for early stage breast cancer in a cohort of Australian women, one year after initial surgical treatment. Mastectomy without breast reconstruction is comp
King, M.T., Kenny, P.J., Shiell, A., Hall, J.P. & Boyages, J. 2000, 'Quality Of Life Three Months And One Year After First Treatment For Early Stage Breast Cancer Influence Of Treatment And Patient Characteristics', Quality Of Life Research, vol. 9, no. 7, pp. 789-800.
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This paper reports the quality of life (QoL) of a large cohort of Australian women three and twelve months after surgery for early stage breast cancer (ESBC), and shows that the impact of disease and treatment on QoL differed by age, education and marita
Warner, N., King, M.T., Langlands, A., Kenny, P.M. & Boyages, J. 1999, 'Symptoms 2 weeks, 3 months and 12 months after treatment of early breast cancer: The patient's perspective', Breast, vol. 8, no. 5, pp. 273-277.
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Kenny, P.M., Quine, S., Shiell, A. & Cameron, S. 1999, 'Participation in treatment decision-making by women with early stage breast cancer', Health Expectations, vol. 2, no. 3, pp. 159-168.
Farnworth, M., Kenny, P.M. & Shiell, A. 1994, 'The costs and effects of early discharge in the management of fractured hip', Age and Ageing, vol. 23, no. 3, pp. 190-194.
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Kenny, P.M., King, M.T., Cameron, S. & Shiell, A. 1993, 'Satisfaction with postnatal care: The choice of home or hospital', Midwifery, vol. 9, no. 3, pp. 146-153.
Shiell, A., Cameron, S., Kenny, P.M. & King, M.T. 1993, 'Mother's choice: Reasons women choose hospital stay over early discharge', Health and Social Care in the Community, vol. 2, no. 2, pp. 69-76.
Shiell, A., Kenny, P.M. & Farnworth, M. 1993, 'The role of the clinical nurse coordinator in the provision of cost-effective orthopaedic services for elderly people', Journal of Advanced Nursing, vol. 18, no. 9, pp. 1424-1428.

Other

Hall, J.P., Kenny, P.M. & Power, P. 2013, 'Can we get there from here? Implementing health reform in Australia. CHERE Working Paper 2013/02'.
Kenny, P.M., Doiron, D., Hall, J.P., Street, D., Milton-Wildey, K.K. & Parmenter, G. 2012, 'The training and job decisions of nurses: the first year of a longitudinal study investigating nurse recruitment and retention. CHERE Working Paper 2012/02', CHERE Working Papers.
Doiron, D., Hall, J.P., Kenny, P.M. & Street, D. 2011, 'Job preferences of students and new graduates in nursing. CHERE Working Paper 2011/02'.
Kenny, P.M., Hall, J.P. & King, M.T. 2008, 'Variation in the costs of healthcare for chronic disease in Australia: The case of asthma, CHERE Working Paper 2008/7'.
Objectives Individuals with chronic conditions represent a high healthcare cost group and understanding the cost variation among individuals is important for developing appropriate policy. This study aimed to investigate the sources of variation in the cost of healthcare for a cohort of people with asthma. It examines the costs to the health system and patient out-of-pocket costs. Methods A longitudinal observational study of asthma-related healthcare costs in a cohort of people with asthma (n=252). Participants were followed for three years using six-monthly postal surveys and individual administrative data. The factors associated with health system and patient out-of-pocket costs were investigated using generalised linear mixed models. Results There was substantial variability around the average costs of healthcare for asthma which were associated with asthma-related health measures and socio-demographic variables. The health system costs were less for those living in regional areas relative to Sydney residents and both the health system and patient out-of-pocket costs were highest in the oldest age group and lowest for children. The health system and patient out-of-pocket costs were highest for the high income group while the middle income group had the lowest total cost. Conclusions Our findings suggest that variations should be explored in developing strategies for chronic disease management and that Australia has achieved reasonable equity in access. However, out-of-pocket costs may be a deterrent for the middle income group, which should be a general concern for policies targeting the most disadvantaged group to the exclusion of concern with universal access.
Hall, J.P., Kenny, P.M. & Hossain, I. 2007, 'The provision of informal care in terminal illness: An analysis of carers' needs using a discrete choice experiment. CHERE Working paper 2007/12', CHERE Working Paper.
King, M.T., Winstanley, J., Kenny, P.M., Viney, R.C., Zapart, S. & Boyer, M. 2007, 'Validity, reliability and responsiveness of the EORTC QLQ-C30 and the EORTC QLQ-LC13 in Australians with early stage non-small cell lung cancer, CHERE Working Paper 2007/13', CHERE Working Paper.

Reports

Goodall, S., Kenny, P., Mu, C., Hall, J.P., Norman, R., Cumming, J., Street, D., Greene, J. & REFinE Team Australian National University 2016, REFinE-PHC: Preferences and choice in primary care Consumers and providers, Canberra.
Kenny, P.M., Haas, M.R. & Hall, J.P. CHERE 2010, Costs of non-melanoma skin cancer: Final report, pp. 1-14, Sydney.
Sansoni, J., Marosszeky, N., Jeon, Y., Chenoweth, L., Hawthorne, G., King, M.T., Budge, M., Zapart, S., Sansoni, E., Senior, K., Kenny, P.M. & Low, L. Centre for Health Service Development, University of Wollongong 2007, Dementia Outcomes Measurement Suite (DOMS) Project: Final Report, pp. 1-523, Wollongong, Australia.
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The purpose of this project is to develop a set of recommended measures/tools for routine use in the assessment, diagnosis, screening and outcomes monitoring of dementia conditions and the evaluation of treatments that are applicable for the Australian health care context. By developing a set of recommended measures it is hoped to standardise the assessment and evaluation procedures used in this field to enhance comparability of findings across research and practice settings. Put simply, we a trying to create a tool-kit of measures for clinicians and researchers to use with people with dementia, in order to assist with communication across the field. A related aim is to make recommendations concerning the clarification and standardization of the clinical terminology applicable in this field. To enhance comparisons between studies it is important that standardized approaches to diagnosis and patient classification be undertaken.
Kenny, P.M., Mahmic, A., Lancsar, E., Anderson, R., King, M.T. & Hall, J.P. CHERE 2003, Diaries or questionnaires for collecting self-reported healthcare utilisation and patient cost data?, CHERE Project Report No 20, Sydney.
Kenny, P.M., Hall, J.P., Viney, R.C., Yeoh, A. & Haas, M.R. CHERE 2002, Using qualitative methods to validate a stated preference survey for evaluating health services., CHERE Discussion Paper No 47, Sydney.
Shanahan, M., Van Gool, K., Haas, M.R. & Kenny, P.M. CHERE 2001, Economic evaluation of the NSW hospital in the home pilot project: CHERE Project Report 15, Sydney.
Kenny, P.M., Quine, S., Shiell, A. & Cameron, S. CHERE 1997, Participation in treatment decision making by women with early stage breast cancer: a qualitative approach - Report to the NSW Cancer Council, CHERE Project Report No 5, Sydney.
Kenny, P.M., Brodie, P.M., Eckermann, S.D. & Hall, J.P. CHERE 1994, Westmead hospital team midwifery project evaluation, CHERE Project Report No 4, Sydney.
Scott, A., Cameron, S., Kenny, P.M., King, M.T. & Shiell, A. CHERE 1992, Evaluation of obstetric early discharge - economic evaluation, CHERE Discussion Paper No 12, Sydney.
Cameron, S., Kenny, P.M., Scott, A. & King, M.T. CHERE 1992, Evaluation of obstetric early discharge - reasons for non-participation, CHERE Discussion Paper No 11, Sydney.
Kenny, P.M., Cameron, S., King, M.T., Scott, A. & Shiell, A. CHERE 1992, Evaluation of obstetric early discharge - client satisfaction, CHERE Discussion Paper No 10, Sydney.
Cleland, S., Cameron, S., Kenny, P.M., King, M.T., Scott, A. & Shiell, A. CHERE 1992, Evaluation of obstetric early discharge - overview, CHERE Discussion Paper No 9, Sydney.
Farnworth, M. & Kenny, P.M. CHERE 1992, An economic evaluation of a fractured hip management program., CHERE Discussion Paper No 8, Sydney.