2024 RTP round - An economic assessment of the “Consider Home Over Inpatient Care Every Time (CHOICE)” program in Western Australia

Status: Closed

Applications open: 7/07/2023
Applications close: 25/08/2023

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About this scholarship
Description/Applicant information

Internationally, there is growing evidence that older adults who are admitted to hospitals are at greater risk of further complications and declining health than those cared for at home. An extended stay in the hospital has been linked with an increased prevalence of hospital-acquired infections, increased risk of developing delirium, physical deconditioning, a reduction in functional capacity, and increased early entry into residential care. Thus, the traditional provider hospital model may be less effective and cost-effective than a more patient-centric model that provides assessment and care for older adults in their homes.  
The shortcomings of the traditional provider hospital model necessitate the development of service models, as demonstrated by the United Kingdom’s National Health Service (NHS), which provides a Discharge to Assess (DTA) approach. When a patient no longer requires acute care, DTA programs aim to reduce the patients’ time in the hospital by diverting ongoing assessment and care into the community. These programs are linked to improved patient outcomes, more appropriate home care prescriptions, reduced cost, and improved hospital capacity. DTA programs have shortened inpatient length of stay (LOS) for patients over 75 without increasing readmissions. This practice will assist in supporting critical flow for those patients who require inpatient acute and sub-acute care.   
In response to the implications of increased hospital stay for older adults, Fiona Stanley Hospital has introduced the CHOICE (Consider Home Over Inpatient Care Every time) model. This patient-centred model has several significant benefits that can lead to more effective patient outcomes and overall cost savings for the health system. The CHOICE model supports the notion of positive risk-taking that focuses on planning discharge home upon arrival at the hospital. This process involves an early supported plan that adopts a trans-professional assessment model. 
Receiving care at home is linked to several benefits, including; a familiar environment and routine are essential for people with cognitive impairments; incidental household activity will help maintain strength; it is more accurate to assess a person’s function in their home; rehabilitation and reablement can be tailored to meet real life goals; decisions about residential care are life-changing decisions and should be made after recovery and in the most appropriate setting and most importantly, home is where the heart is. 
This PhD project will use quantitative economic methods to explore the effectiveness and cost-effectiveness of the CHOICE model of care compared to the traditional models of hospital care. The evidence generated from this project will be important to health policy planners in Australia and other developed countries, and low- and middle-income countries. 

This study will use economic methods to explore the effectiveness and cost effectiveness of the CHOICE model compared to traditional models of hospital care to generate economic insights to inform population health and planning. 

1. Identify and measure the effectiveness and cost effectiveness of the CHOICE program on clinical and patient reported outcome measures.  
2. Identify and measure the impact of CHOICE on health systems activity with a focus on (i) length of hospital stay, (ii) unplanned hospital readmissions, and (iii) inappropriate Emergency Department (ED) visits. 

This project will explore an important research question that has important implications to health system effectiveness. By evaluating the effectiveness and cost-effectiveness of the CHOICE program, the research aims to provide valuable insights that can lead to potential cost savings and efficiencies within the health system. By diverting ongoing assessment and care into the community, the CHOICE program can reduce the length of hospital stays for older adults, thus freeing up valuable hospital resources. This can result in cost savings by minimizing hospital-acquired infections, reducing the risk of delirium, preventing physical deconditioning, and delaying or avoiding early entry into residential care. By focusing on a patient-centric approach that promotes assessment and care in the home environment, the CHOICE program can lead to improved patient outcomes, more appropriate prescription of home care, reduced healthcare costs, and enhanced hospital capacity. The findings of this research project can inform healthcare policies and decision-making, ultimately benefiting the health system by optimizing resource allocation and improving the overall efficiency of care for older adults in both low-income and developed countries. 

This project may provide an Internship opportunity. 

Student type

• Future Students

Faculty

• Faculty of Health Sciences

Course type

• Higher Degree by Research

Citizenship

• Australian Citizen
• Australian Permanent Resident
• New Zealand Citizen
• Permanent Humanitarian Visa
• International Student

Scholarship base

• Merit Based

Value

The annual scholarship package (stipend and tuition fees) is approx. $60,000 - $70,000 p.a.

Successful HDR applicants for admission will receive a 100% fee offset for up to 4 years, stipend scholarships at the 2023 RTP rate valued at $32,250 p.a. for up to a maximum of 3 years, with a possible 6 month completion scholarship. Applicants are determined via a competitive selection process and will be notified of the scholarship outcome in November 2023. 

For detailed information, visit: Research Training Program (RTP) Scholarships | Curtin University, Perth, Australia.

Scholarship Details
Maximum number awarded

1

Eligible courses

All applicable HDR courses

Eligibility criteria

We are looking for a self-motivated PhD candidate with excellent organisation, problem solving, analytical, and project management skills. Candidates with strong quantitative skills, including familiarity with economic evaluation, basic econometrics and any data analysis software such as Stata, R, or SPSS are desired for this project. Must be eligible to enrol in PhD programs at Curtin. 

Application process

This project has identified a preferred candidate and is no longer available.  Please review remaining scholarships projects .

Enrolment Requirements

Eligible to enrol in a Higher Degree by Research Course at Curtin University by March 2024.

Recipients must complete their milestone 1 within 6 month of enrolment and remain enrolled on a full-time basis for the duration of the scholarship.

Enquiries

The Project lead has identified a preferred candidate and is no longer accepting applications. Please click here to review remaining scholarships projects.

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