RURAL HEALTH SUPPORT,EDUCATION AND TRAINING PROGRAM (RHSET): WHERE TO NOW?

ABSTRACT: The Rural Health Support Education and Training (RHSET) Program is a Commonwealth Government grants program established in 1990 to enhance the access of rural communities to effective health services. The emphasis has been on professional workforce issues. Up until December 1997, 431 applications for funding had been approved and close to $37 million allocated. This article considers the grants awarded in that period according to their main topic of interest within three broad groupings: policy and tertiary service provision; health discipline-specific groups; and special interest groups such as Aboriginal and Torres Strait Islanders and community organisations. Each subgroup is introduced and its contents outlined. It also suggests that despite heightened government interest in rural and remote health, a niche can still be found for RHSET. It further argues that the time has come for a major evaluation of project activity to ensure non-duplication and to develop performance indicators for evaluating projects addressing rural and remote area workforce issues.     

DIFFERENCES IN LENGTH OF STAY FOR HIP REPLACEMENT BETWEEN PUBLIC HOSPITALS,SPECIALISED TREATMENT CENTRES AND PRIVATE PROVIDERS: SELECTION OR EFFICIENCY?

We investigate differences in patients’ length of stay between National Health Service (NHS) public hospitals, specialised public treatment centres and private treatment centres that provide elective (non‐emergency) hip replacement to publicly funded patients. We find that the specialised public treatment centres and private treatment centres have, on average, respectively 18% and 40% shorter length of stay compared with NHS public hospitals, even after controlling for differences in age, gender, number and type of diagnoses, deprivation and regional variation. Therefore, we interpret such differences as because of efficiency as opposed to selection of less complex patients. Quantile regression suggests that the proportional differences between different provider types are larger at the higher conditional quantiles of length of stay. Copyright © 2012 John Wiley & Sons, Ltd.     

SURROGATE,FRIEND OR FOE? THE NEED FOR CASE STUDIES OF THE USE OF SURROGATE OUTCOMES IN COST‐EFFECTIVENESS ANALYSES

We comment on a recent article by Hawkins et al. presenting different analytic approaches for the inclusion of surrogate and final outcomes in cost‐effectiveness analyses. This methodological case study provides a timely and valuable contribution to build on the debate about the use of evidence based on surrogate outcomes in health technology assessment. Copyright © 2012 John Wiley & Sons, Ltd.