Completed projects
The following linkage projects were completed in 2011. A
list of projects completed in previous years is also
available.
Mortality rates after major surgery in New South Wales
Professor Ian Harris, Liverpool Hospital
It is important for clinicians and patients to be aware of
surgical risks and the chance of adverse effects such as mortality,
particularly when making the decision to undertake surgical
treatment. Few studies have explored postoperative mortality rates
in Australia. This study will be an original retrospective
investigation exploring 30-day and 12-month post-operative
mortality for a group of selected high volume procedures. Data from
the NSW Admitted Patient and Emergency Department collections,
along with mortality data from the Registry of Births Deaths and
Marriages and the Australian Bureau of Statistics will be linked,
extracted and analysed to investigate the relationship between
mortality and institution, age and other sociocultural factors, for
each procedure.
Cancer comorbidity, treatment, survival and end of life care
for Aboriginal people in NSW
Professor Dianne O'Connell, Cancer Council NSW
Cancer is the second biggest killer of Aboriginal people and
their cancer death rate in NSW is approximately 60% higher than for
non-Aboriginal people. The Aboriginal Patterns of Cancer Care
project (APOCC) has collected medical treatment records for over
1300 Aboriginal people diagnosed with cancer in NSW between 2000
and 2010. This study will link datasets from APOCC, the NSW Central
Cancer Registry (CCR), hospital and emergency department episodes
and deaths, allowing for the first time, a description of the
relationships between cancer treatment, comorbidities, survival and
end of life care for Aboriginal people in NSW. This will
allow better planning, allocation and monitoring of cancer and
palliative care services for Aboriginal people.
Cause of death in men with prostate cancer: a population-wide
data linkage study
Dr David Smith, Cancer Council NSW
Too little is known about prostate cancer including its causes,
the merits of screening for it or the outcomes of treatment. Much
uncertainty stems from a lack of evidence about how deadly the
disease is. Each year approximately 3,000 Australian men die from
prostate cancer and a further 100,000 are living with the disease.
This project will answer important questions regarding prostate
cancer outcomes. It will 1) evaluate the hypothesis that "Men die
with prostate cancer rather than of prostate cancer", 2) Determine
whether the risk of death from suicide or heart disease is raised
in men after prostate cancer diagnosis, 3) investigate whether men
treated with hormone therapy are at higher risk of death from heart
disease and 4) Determine whether men who report having PSA tests
have lower risks of death from prostate cancer, 5) explore
associations between statin use and outcomes for prostate
cancer.
Each of these questions will be answered using linked data from
the NSW Central Cancer Registry, the NSW Department of Health
Admitted Patient Data Collection, Medicare, Pharmaceutical benefits
scheme, the Register of Births Deaths and Marriages and Australian
Bureau of Statistics mortality data, the 45 and Up Study and the
NSW Prostate Cancer Care and Outcomes Study.
An evaluation of the effectiveness of a statewide program of
free pertussis vaccination of household adult close contacts for
protecting infants against pertussis (the "cocoon strategy") in
NSW
Professor Peter McIntyre, National Centre for Immunisation Research
and Surveillance of vaccine preventable diseases
This study aims to evaluate the effectiveness of a
state-wide program of free pertussis (whooping cough) vaccinations
to parents, siblings and other household carers in providing
protection against severe pertussis in infants too young to be
immunised themselves. Using linked data from the Notifiable
Conditions Information Management System, Perinatal Data Collection
and mortality records, this research is required to provide
direct evidence of a protective benefit from cocooning and to
provide an estimate of the size of the benefit.
The results of this research are of direct interest to the NSW
Ministry of Health, as part of their evaluation of the 'cocoon
strategy'. The results are also expected to inform national
immunisation policy decisions on pertussis control by the
Australian Government, which takes advice from the Australian
Technical Advisory Group on Immunisation. If found to be effective,
this vaccination strategy may be considered for adoption as a
long-term measure for population pertussis control, with the
possibility of public funding under the National Immunisation
Program.
Investigating the elements of care and health care costs
associated with implementing chemotherapy protocols in NSW
hospitals: Linkage to NSW data sets
Dr Sallie-Anne Pearson, University of Sydney
The Pharmaceutical Benefits Scheme (PBS) is a federal program
providing public subsidies for medicines based on their efficacy
and cost effectiveness. The ecomonic evidence used to
determine PBS-listing is not acessible to health professionals and
other decision makers however, despite their vital role in the
efficient and equitable distribution of medicines, whether or not
these are PBS-listed. The aim of this study is to address
this through building a publically available economic evidence base
to assist decision-makers at hospitals and area health services
make evidence-based decisions about funding cancer medicines.
Participants in this study are patients undergoing chemotherapy
for breast, colorectal or lung cancer who consent to linkage of
their data from the NSW Cancer Registry, Admitted Patient Data
Collection, Registry of Births, Deaths and Marriages, Emergency
Department data collection, Medicare and medical records.
This linkage will enable the researchers to identify the
individual care elements involved in administering specific
chemotherapy treatment protocols, and estimate the costs associated
with each care element. The models developed will be publicly
available and have the flexibility to establish cost-effectiveness
of deploying cancer treatments in specific locations
Development of Diabetes Following Gestational Diabetes: A
Population Data Linkage Project
Associate Professor Wah Cheung, Westmead Hospital
Gestational diabetes (GDM) is a transient form of diabetes
which occurs in pregnancy, but is associated with a higher risk of
diabetes later in life. This study aims to determine the relative
likelihood of developing diabetes for women who had GDM compared to
those who had normal glucose tolerance in pregnancy, in an entire
population. This will be achieved through linkage of data from the
NSW Perinatal Data Collection and the National Diabetes Services
Scheme.
Investigating best practice primary health care for older
Australians with diabetes using record linkage
Associate Professor Elizabeth Comino, Centre for Primary Health
Care and Equity, University of NSW
In Australia most people access health care through community
based primary care settings such as general practice, community
health services, pharmacy, and allied health. However, as
there is no comprehensive source of data on service use in these
settings, primary care is underrepresented in health statistics,
and there has been limited exploration of processes of care for
people with chronic health care needs. The aim of this study is to
explore processes of primary health care (PHC) for people with
diabetes using record linkage. Records from a cohort of
diabetic participants enrolled in the 45 and Up study were linked
to the admitted patient, emergency department and mortality data
collections, and compared to a comparison group of participants who
did not have diabetes. The data are also being linked to the
Medicare Australia data through the Sax Institute. Analysis of the
linked dataset will allow investigation of primary health care
provision for older people with diabetes, identify the predictors
of provision of care, and explore the relationship between primary
health care and measures of health outcomes including quality of
life and hospitalisation.
Hormone therapies for early breast cancer: health outcomes and
policy implications in Australian clinical practice
Assoc Prof David Preen, The University of Western Australia
Breast cancer is one of the most common cancers and the second
leading cause of cancer-related mortality in Australian women.
Clinical trials have shown that use of hormone-blocking drugs for
five years after removal of the initial tumour significantly
reduces breast cancer recurrence and mortality. However, there is
no evidence regarding the use of these therapies in Australian
practice. It is not known which hormone therapies or combinations
of therapies are used by Australian women, how adherent and
persistent women are with these therapies, or the effects on
long-term health outcomes such as cancer recurrence or mortality at
the population level. It is also unknown nationally or
internationally to what extent planned and unplanned switching
occurs between different endocrine therapies, or the impact on
outcomes.
This project will use demographic and health data from the 45
and Up Study, linked to NSW (Admitted Patient Data Collection,
Central Cancer Register, Register of Births, Deaths and Marriages,
and the Australian Bureau of Statistics mortality data) and
Commonwealth (MBS and PBS) health records, to examine how hormone
therapies are being used outside of trial conditions, in real-world
clinical practice. This study will evaluate the effectiveness of
the current National Health and Medical Research (NHMRC) guidelines
for treatment of breast cancer with hormone therapies in the early
and longer-term.
What are the clinical and biochemical determinants of health
service use by participants in the Hunter Community Study?
Professor John Attia, University of Newcastle
The Hunter Community Study is a population-based prospective
cohort study established to assess factors important in the health,
wellbeing, and social functioning of older Australians. The
participants were drawn from the Hunter Region of NSW, aged 55 to
85 years and have provided health data in the form of clinic
assessments, surveys and blood samples. The current study
will link the records of over 2500 of the participants to the
Admitted Patient Data Collection, the Emergency Department Data
Collection, the Central Cancer Registry and mortality
datasets. This linked dataset will allow the researchers to
identify and test the clinical and biochemical predictors of acute
public and private hospital service utilisation, and the reasons
for these visits in a representative sample of ageing
Australians.
An individual-level study of suicide method substitution over
time
Dr Matthew Spittal, Melbourne School of Population Health, The
University of Melbourne
This study will investigate patterns in the methods used in
suicidal acts (attempts and completions) in New South Wales, with a
view to advancing understanding about the potential for restricting
access to means to prevent suicide.
The cohort consists of individuals admitted to hospital for a
suicide attempt who survived, individuals admitted to hospital for
a suicide attempt who ultimately died by suicide, and individuals
who have never been admitted for a suicide attempt but have
completed suicide. Using this information the researchers
will be able to identify whether an individual uses the same or
different method for each successive suicide attempt, the number of
attempts made by each person, the time between each attempt, and
whether these vary by socio-demographic or clinical characteristics
of the individual. The study will inform questions about
optimal regulatory, health service and other interventions to
reduce suicide by restricting access to deadly means.
Risk management and funding structures: an econometric panel
data analysis of health insurance in Australia
Professor Elizabeth Savage, Economics Discipline Group, UTS
Business School, The University of Technology Sydney
Individuals differ in their health status and access to health
care, yet current funding arrangements take very limited account of
individuals' risk of high health expenditures. A series of
government reports have proposed taking greater account of
expenditure risk in the allocation of health subsidies
(Commonwealth of Australia, 2000, 2008 and 2009; Productivity
Commission, 2002). By estimating models of individual
risk and investigating deviations between current health care
subsidies and predicted risk, this study will produce the empirical
results necessary to guide health funding in the future.
Linkage of data from the 45 and Up Study to administrative health
records will be completed to enable these analyses.
Validation study of Aboriginal identification algorithms in the
APDC and ABS Mortality Data using the 45 and Up Study.
Professor Louisa Jorm, University of Western Sydney
Indigenous status is known to be under-reported in hospital and
deaths data, creating difficulties for research which aims to
describe and understand Indigenous health issues using
administrative data.
The aim of this study is to develop an algorithm to improve
Aboriginal identification in hospital and death data by linking
them to the 45 and Up Study, a questionnaire with self-reported
Aboriginal status. Comparing identification in the APDC and
NSW mortality data with Aboriginal status in the 45 and Up Study
will allow the researchers to develop and test a set of algorithms
and investigate which performs best to increase identification
without resulting in too many false positives.
Commonly performed interventions in childbearing women and
related short and long term complications: An eight year data
linkage study
Associate Professor Hannah Dahlen, University of Western
Sydney
The aim of this project is to determine the rate of maternal and
neonatal morbidity and the economic consequences of commonly
performed interventions such as induction of labour, labour
augmentation and caesarean section.
The cohort for this study is all women who gave birth in NSW
during July 2000 and June 2008, with linked records for these
mothers and their babies extracted from the midwives, admitted
patient, mortality and congenital condition data collections.
This dataset will be used to examine short term outcomes such as
maternal death, type of delivery and reason for caesarean section,
and long term outcomes including death and readmission to hospital.
The results of this study will provide a better understanding of
the short and long term effects of medical and surgical
intervention in labouring women.
An analysis of the long term costs of disability arising from
the Vietnam War
Dr Philip Clarke, Applied Economics
This study involves the linkage of administrative data held by
the Department of Veterans Affairs with service information from
the Nominal Roll of the Vietnam War.
The research project has two main objectives:
- To gain an understanding of factors (including war service
history, age at and duration of deployment) that influence the rate
and progression of veterans applying for war-related disability
pensions; and
- To estimate the lifetime health and pension costs of Vietnam
veterans and separate these costs by level of disability.
Such estimates are intended to inform long-term resources
requirements associated with the Vietnam War and potentially, more
recent deployments.
The maternal health predictors of adverse birth outcomes
Dr Deborah Loxton, Research Centre for Gender, Health and Ageing,
University of Newcastle
Adverse birth outcomes such as premature birth, low birth weight
and congenital conditions can have a lasting deleterious effect on
both the infant and their families. While numerous
biologically based studies have investigated these outcomes, the
rate of stillbirth in Australia has remained unchanged over the
last 20 years and only small gains have been made in reducing the
rate of low birth weight and premature birth. This project
seeks to uncover both the long and short term risk factors for
adverse birth outcomes by utilizing a large representative
population survey dataset (the Australian Longitudinal Study on
Women's Health ) linked to hospital administrative data (the NSW
Midwives Data Collection, NSW Register of Congenital Conditions,
NSW Admitted Patient Data Collection, NSW Perinatal Death
Review, and mortality data from the NSW Registry of Births,
Deaths and Marriages and the Australian Bureau of Statistics.
Health record linkage is required so that a full range of risk
factors can be examined. While the ALSWH can provide the mother's
health, lifestyle and health behaviour history, the administrative
datasets provide additional health data and birth details that are
not available from the ALSWH. The findings of this project
will have important health policy implications at both a state and
national level, enabling better allocation of resources to those
most at risk of experiencing an adverse birth outcome.
Understanding the factors related to health care use associated
with falling in older people in NSW
Dr Rebecca Mitchell, NSW Injury Risk Management Research Centre,
University of NSW
Falls are one of the leading causes of injury morbidity and
mortality in older Australians, however there has been limited
exploration of rehabilitation outcomes following a fall - from the
circumstances of the injury event through to the injuries received,
the treatment provided and the use of rehabilitation services and
rehabilitation outcomes.
The aim of this research is to investigate and describe the
sub-acute and non-acute health service use of fallers and
non-fallers following emergency department presentation and/or
hospital admission. The study involves linking the Australian
National Sub-Acute and Non-Acute Patient NSW data collection to the
Admitted Patient and Emergency Department data collections.
The resulting deidentified dataset will be analysed to describe the
pattern of use of rehabilitation and other health-related extended
services by individuals who have experienced a fall-related injury
compared to non-fall related injuries.
Patterns of care study for treatment of cervical cancer in
Australia and construction of a detailed model of invasive cervical
cancer
Dr Karen Canfell, The Cancer Council NSW
This project aims to describe patterns of care and costs of
treatment for invasive cervical cancer in
NSW, and to use the information to develop a comprehensive model
of treatment, survival, and mortality from invasive cervical
cancer. The project will also involve hospital audits for
patients who have been treated in two large volume hospitals in NSW
and Victoria to define disease status by the most comprehensive
FIGO staging system, information which is not available in the
Central Cancer Registry.
Identifying predisposing factors for, and the consequences of,
common and emerging infectious diseases: A prospective cohort
study of adults
Dr Bette Liu, Faculty of Medicine, University of New South
Wales
This project aims to investigate the factors that predispose
adults to common 'notifiable' infections, and the impact these
infections have on health many years after the initial infection
occurred. The study will follow participants recruited into the 45
and Up Study, and use data linkage to determine whether a history
of exposure to different infectious agents affects risk of
hospitalisations, death from different causes or risk of cancer. It
will also investigate whether modifiable behavioural factors
increase the risk of developing such infections. The results
of the study should lead to a better understanding of the role of
many important infectious diseases on the health of Australian
adults.
The role of maternal cancer history in the occurrence of
stillbirth, adverse perinatal outcomes and the incidence of
childhood cancer in their offspring
Associate Professor Christine Roberts, University of Sydney
Improvements in cancer treatments have contributed to a growing
population of cancer survivors, however evidence about the impact
following cancer treatment for girls and women is limited.
This study, linking data from the NSW Central Cancer Registry,
perinatal data and admitted patient data will enable the
researchers to investigate the extent to which maternal cancer
history influences the occurrence of stillbirth, adverse birth
outcomes and early pregnancy loss in NSW. The study will also
determine whether children of mothers with a history of cancer are
at higher risk of developing childhood cancer than offspring of
mothers with no cancer history.
Incidence of blood borne viruses and cancer and related
mortality among opioid dependent persons in pharmacotherapy
A/Prof Claire Vajdic, University of NSW
Opioid-dependent persons in pharmacotherapy in NSW have an
excess rate of death due to cancer, but little is known about
cancer incidence or the role of blood-borne viruses in risk of
cancer or death. This study will use linked data from the NSW
Pharmaceutical Drugs of Addiction System, the National Death Index
(NDI), Australian Cancer Database (ACD), NSW Notifiable Conditions
Information System, National Aids Registry and the National HIV
database to investigate cancer and blood borne virus (hepatitis,
HIV) incidence among treatment-seeking opioid dependent persons in
NSW. This knowledge will allow the development of appropriate
interventions and prevention strategies in this vulnerable and
marginalised population.
A second aim of this study is to quantify the sensitivity and
specificity of name-code versus full-name data linkage to the NDI
and ACD, the results of which will inform the interpretation of
future health data linkage based on name-coded records.
Establishing the factors that contribute to a
shortfall in evidence-based radiotherapy
Professor Geoff Delaney, Liverpool Hospital and University of
NSW
Previous studies by this research group indicate
that 52% of all cancer patients should receive at least one course
of radiotherapy during their illness. In NSW however, 37% of all
cancer patients receive radiotherapy annually, suggesting that
there is a significant shortfall between what is considered optimal
and what is actually delivered.
The current study aims to establish and analyse a state-wide
database linking radiation oncology records from each NSW Radiation
Oncology Department to the NSW Central Cancer Registry data.
This will enable a better understanding of the areas of greatest
shortfall, characterisation of under−served groups, identification
of possible issues that might need to be addressed to improve the
uptake of radiotherapy, and more rigorous assessment of our model
of optimal radiotherapy utilisation, particularly where
discrepancies between our "ideal model of care" differs
substantially from current practice.
Modelling multiple radiotherapy treatment episodes for
benchmarking and service planning
Professor Geoff Delaney, Liverpool Hospital and University of
NSW
Many cancer patients require multiple
radiotherapy treatments during their illness. Little is known about
retreatment rates however, due to difficulties following patients
over time to learn about the incidence and time course of relapse
events that would require retreatment. This study aims to
address this issue through the linkage of retreatment data from
Liverpool and Campbelltown Hospitals with the NSW Central Cancer
Registry. This will provide information about the number,
distribution and time course of radiotherapy retreatment episodes,
allowing the researchers to predict demand for retreatment and
allow more accurate and targeted planning for provision of these
services.
Optimal methods to be used when linking datasets that contain a
Statistical Linkage Key
Sanja Lujic, NSW Department of Health
The Home and Community Care (HACC) program is a major provider
of essential community care services to frail aged people, younger
people with disabilities, and their carers. A number of
researchers have expressed interest in using linked data from the
HACC minimum dataset (MDS) and the Admitted Patient Data Collection
(APDC) to examine issues including opportunities for intervention
to prevent potentially avoidable hospitalisations and improve
transitions of care between home−based and hospital services.
The ability to produce high quality linkages using these data is
unknown however, as the HACC MDS does not contain full names or
addresses, the personal identifiers usually used to produce high
quality probabilistic linkages. Instead, the HACC MDS contains
identifiable information in the form of a Statistical Linkage Key
(SLK). It is not known whether linkage using the SLK is adversely
affected by the limited availability of personal information, and
quantifying this effect is important for accurately interpreting
the results of future research using HACC data.
This study linked data from the APDC to a dataset resembling the
HACC MDS - the Registry of Births Deaths and Marriages (RBDM) death
registration data. RBDM data was used as a proxy for the HACC
MDS since it contains a large number of records, and like the HACC
MDS, is a person record-based database with a similar age
structure. Using this linked dataset the researchers
will:
- Determine the optimal strategy to be used when linking datasets
that contain limited identifiers
- Provide a recommended strategy to be used when linking HACC MDS
to the APDC
- Quantify the extent to which the recommended strategy may bias
the estimate of rates of hospitalisation for a range of conditions
among HACC clients
Augmenting date and cause of death information in the AHS
Clinical Cancer Registries using the NSW Central Cancer
Registry
Professor Geoff Delaney, Liverpool Hospital and University of
NSW
The objective of this linkage is to augment date
and cause of death information in the Area Health Service (AHS)
Clinical Cancer Registries using information held by the NSW
Central Cancer Registry. This will enable AHS Clinical Cancer
Registries to achieve a range of operational and strategic
objectives, including monitoring survival outcomes for patients
included in each Registry by stage, treatment, facility and
clinician. This information will be used to will inform best
practice, plan and manage cancer services and support health system
change
Linkage of population health datasets to examine outcomes of
health care and for population surveillance of diseases and
conditions in NSW
Dr David Muscatello, NSW Department of Health
Linked NSW administrative datasets have become a critical
resource for the public health system to be able to carry out its
core business. These linkages allow the public health system
to better identify issues of population health importance, to plan
services or interventions to address these problems, and provide an
improved source of data allowing monitoring and evaluation of the
effectiveness of services and interventions.
Specifically, the linked datasets allow studies
including examination of clinical care pathways for stroke,
diabetes, asthma and other chronic diseases, surveillance of
infectious diseases, and patterns of re-presentation to ED,
readmission to hospital and mortality associated with particular
medical conditions and procedures.
Place of birth and perinatal outcomes in New South Wales
Associate Professor Elizabeth Sullivan, University of New South
Wales
This project aims to examine perinatal outcomes of women who
intend to give birth in different settings: birth centres, primary
maternity units, at home and in hospital labour wards. The
study will also evaluate whether place of birth has an influence on
the diagnosis and outcome of congenital anomalies, and examine
fetal growth parameters in relation to place of birth.
Records from the NSW Perinatal Data Collection, Admitted Patient
Data Collection, Register of Congenital Conditions, Perinatal Death
Reviews, ABS mortality data and the Registry of Births, Deaths and
Marriages death registration data will be linked for the period
2001-2009.
Epidemiology and outcomes in Ambulance treated patients in NSW:
the Australian Prehospital Outcomes Study of Longitudinal
Epidemiology (APOStLE)
Associate Professor Paul Middleton, Ambulance Research
Institute
Ambulance data in NSW is not currently linked with other
Health Department data, and therefore the outcomes for patients
treated by and/or transported by ambulance services are not
possible to assess. This study aims to address this by
linking the Ambulance Computer Aided Dispatch and the Patient
Health Care Record data to the NSW Emergency Department Data
Collection, the Admitted Patient Data Collection and mortality data
from the Registry of Births, Deaths and Marriages and the
Australian Bureau of Statistics.
The linked dataset will enable investigation into the
characteristics of patients suffering sentinel conditions, and to
develop performance metrics for the major problems paramedics
encounter: trauma, cardiac arrest and falls. This project
will illuminate the nature and extent of these issues to inform
decisions regarding performance measurement and safety and quality
improvement.
Best practice procedures and associated outcomes in
oesophageal, liver, pancreas and stomach cancer.
Deborah Baker, Cancer Institute NSW
This study linked data from the NSW Central Cancer Registry,
Admitted Patient Data collection and NSW Pancreatic Cancer Network
to investigate mortality, morbidity and clinical outcomes of
surgical treatment of oesophageal, liver, pancreas and stomach
cancer. In particular the researchers will examine:
- factors associated with best practice procedures occurring
versus not occurring for oesophageal, liver, stomach and pancreatic
cancer
- how certain outcomes (morbidity, mortality, five−year survival,
length−of−stay, adverse events and re−admission rates) differ
between patients undergoing best−practice procedures and those who
do not undergo recommended best−practice procedures
- how geographic location, hospital type, hospital patient volume
and patient characteristics (such as age, sex, socio−economic
disadvantage, country of birth, area of residency, cancer stage
type and morphology) impact on the outcomes of interest
The Prism Study: A Program of Research Informing Stroke
Management
Dr Melina Gattellari, University of New South Wales
Approximately 50,000 strokes occur in Australia each year.
Stroke is the third most common cause of death and the most common
cause of disability. There have been a number of recent innovations
in stroke management, including the implementation of
multidisciplinary acute stroke units and new methods of clinical
treatment. Using linked data from the New South Wales Admitted
Patient, Emergency Department and mortality datasets, this study
aims to identify and assess the effect of such healthcare
characteristics on patient mortality, discharge destination,
recurrence of stroke and readmission to hospital. This program of
research will provide insight into the current management of stroke
in NSW, identify gaps in current care and outcomes, and inform
future initiatives for improving health service delivery,
organisation of stroke services and patient care.
Comprehensive linkage of maternal and infant health data for
monitoring health outcomes and planning of maternity services in
NSW
Dr Christine Roberts, NSW Department of Health; Kolling Institute
of Medical Research, University of Sydney
This study aims to make a complete assessment of maternity care
services in NSW for births up to one year following
delivery. The study aims to investigate maternal and infant
health outcomes for initial and subsequent pregnancies. Areas
to be assessed include:
- effectiveness of health services in reducing preventable
morbidity and mortality;
- impact of regionalised maternity care services on maternal and
infant morbidity and mortality;
- role of within-labour factors on outcomes for low risk
women;
- role of antenatal transfer in maternity care;
- recurrence of pregnancy conditions in a subsequent pregnancy,
and associated risk factors; and
- patterns of readmission and morbidity associated with
particular obstetric procedures, pregnancy conditions and
outcomes.
The CHeReL linked the following NSW datasets to enable this
program of research: the Midwives Data Collection, Registry of
Births, Deaths and Marriages birth, death and perinatal death
registration data, Australian Bureau of Statistics mortality data,
Admitted Patient Data Collection, Birth Defects Register and the
Perinatal Death Review Database.
