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Projects

Use of the CHeReL's linkage services has increased steadily since the unit was established in 2006. A list of completed projects and published research is available below.

Projects have been carried out for a broad range of purposes using data from a variety of sources. Some of the research applications of linked data have included:

  • Follow-up of cohorts of people with rare conditions or outcomes reported through population health datasets (eg. infective endocarditis, childhood cancer)
  • Morbidity and mortality associated with infectious diseases (eg. Hepatitis C, influenza) 
  • Follow up of researcher-supplied cohorts to obtain information on service utilisation or health-related outcomes (eg. 45 and Up study, the Australian Longitudinal Study on Women's Health and the HIV Observational Study Database)
  • Case control studies of cancer screening behaviour and outcomes
  • Validation of the accuracy of screening tests by linkage with outcome information (eg. antenatal serum screening and pregnancy outcomes)
  • Incidence of diseases and conditions by the identification of first-time events (eg. first admissions for stroke and heart failure)
  • Reporting of outcomes of health care adjusted for co-morbidity using historically linked data (eg. outcomes for stroke care in NSW hospitals)
  • Studies of health care safety, utilisation and costs (eg. adverse events in hospital, cancer patterns of care)
  • Validation studies of the accuracy of information held in population health datasets
  • Improved ascertainment of health information (eg. Aboriginality, diagnoses) using multiple data sources

Other purposes include population health surveillance and health system performance monitoring, where data linkage has enabled the development and monitoring of new performance indicators and strengthened the capacity of government to develop and evaluate policies and track performance over time.

Research publications using linked NSW data can be found on the PHRN website. Please select NSW under the jurisdiction filter. 

 Lists and descriptions of completed linkage projects are available below:

2007-2010 Linkage Projects

2011-2019 Linkage Projects

Examining continuity of care between Community Mental Health, Emergency Departments and MBS services before and after ED self-harm presentations - NSW Ministry of Health, Mental Health Branch (InforMH) 

This project examines continuity of care before and after mental health or self-harm presentations to NSW EDs and hospitals. The self-harm flag in NSW was supplied to AIHW for linkage to the National Health Data Hub (NHDH).  

 

Data driven insights for maximising ambulance secondary triage - NSW Ambulance 

The aim of this project is to correlate emergency department and admitted patient outcomes with ambulance point of call computer dispatch factors with a focus on low acuity (non-urgent patients) for improved and targeted secondary triage by identifying these patients better and earlier. 

 

Enhancing prison-to-community mental healthcare for First Nations people - University of New South Wales 

The project aims to identify existing gaps in outcomes between Aboriginal and/or Torres Strait Islander patients and non-Indigenous patients of the Community Transition Trial (CTT) who have transitioned from custody to community by linking health and justice data collections.   

 

ABS Life Course Data Initiative - Australian Bureau of Statistics 

This project aims to provide an evidence-base on the prevalence of childhood disadvantage and any predictive and protective factors relating to it, including potential pathways out of childhood disadvantage for those who are experiencing it using ACT data.  

 

Genomics of adverse events of special interest following COVID-19 vaccination - Study protocol for recruitment of cases via Notifiable Conditions Incident Management system (NCIMS)  - The Childrens Hospital at Westmead 

This study aims to contribute to a global study on genomics of COVID-19 induced Adverse Events of Special Interest (AESI). This will provide important management information for treating clinicians and will assist government and expert advisory bodies in providing guidance around appropriate vaccine use.  

 

Caesarean section, interpregnancy interval and subsequent pregnancy outcomes. - Western Sydney University 

Rates of caesarean section (especially repeat caesarean section) in Australia exceed the World Health Organisation's recommendation. This project aims to determine the effect that the interval between two pregnancies have on the outcomes and adverse events of both mothers and babies after caesarean section across NSW. 

 

Healthcare Resource Utilisation Pre- and Post-ECMO in Australia - Monash University 

Patients that receive extracorporeal membrane oxygenation (ECMO) contribute to some of the highest healthcare costs in Australia’s healthcare system and are more likely to have increased healthcare resource utilisation. This study will help to understand healthcare resource utilisation, associated costs before and after ECMO, and its impact on patient outcomes. 

 

Working together: innovation to improve emergency department performance, and patient outcomes and experience for five complex consumer cohorts - Macquarie University 

This project will examine circumstances and temporal tends in health service use (i.e. emergency department (ED) visits, hospital admissions, non-admitted patient and ambulatory mental health occasions of service), along with factors predictive of clinical and patient health outcomes in NSW for 5 patient cohorts.  

 

Mental Health Community Living Supports for Refugees (MH-CLSR) impact evaluation - Agency for Clinical Innovation 

This project is an evaluation to assess the impact of the Mental Health Community Living Supports for Refugees (MH-CLSR) program on improving mental health and wellbeing outcomes for refugees and people seeking asylum, alongside assessing program reach, effectiveness, and value for money. 

Curtailing Harm and Navigating Growth, Evidence for change pathways of young people who have engaged in harmful sexual behaviour - University of Wollongong 

Research indicates that harmful sexual behaviour (HSB) displayed by children and young people constitutes 20-33% of child sexual abuse. This study aims to map characteristics and compare long-term health and wellbeing outcomes of young people who completed and did not complete specialist interventions. 

 

Dropping out (of offending): The impact of schooling on crime - NSW Bureau of Crime Statistics and Research 

Recent estimates suggest that two-thirds of prison entrants had an education attainment level of Year 10 or below (compared to one fifth in the general population). This project aims to estimate the impact of the 2010 increase in the NSW Minimum School Leaving Age on the completion of schooling and on the probability that a student engages in criminal behaviour. 

 

Management of Urinary Tract Infections and Oral Contraceptive Pill supply by Community Pharmacists - The George Institute for Global Health 

The aim of this research is to evaluate the implementation, clinical and economic impact of new service delivery models delivered by community pharmacists in NSW and ACT with a focus on two different conditions or services: 1) treatment of uncomplicated urinary tract Infections (UTI); 2) supply of the oral contraceptive pill (OCP) to people who already have a prescription from their GP.  

 

An exploration of variations in community treatment orders across Australia - University of Queensland 

This study will be the first to investigate the justifications for community treatment orders (CTOs) across Australia to allow greater understanding of the variance in rates of CTOs and enable appropriate action by stakeholders.  

 

Concord Hospital Secondary Fracture Prevention Program: Long-term follow-up study - Concord Repatriation General Hospital 

Between 2005-2010, over 560 patients with incident fragility fractures were enrolled into an secondary fracture prevention (SFP) program and managed by a clinical team at Concord Repatriation General Hospital. After 10 years of follow-up, this project aims to determine the predictors of refracture and mortality and compliance with pharmacotherapy in this cohort.  

 

Strengthening Healthcare Systems and Clinical Decision Making with Patient Reported Outcome Measures (PROMs) - University of Sydney 

The first is to identify patient- and service-level predictors of non-completion of Patient Reported Outcome Measures (PROMs). The study will also investigate health service use following PROMs administration. 

 

Health economic evaluation to optimise prevention strategies for primary liver cancer in NSW - University of Sydney 

This project will conduct a retrospective, observational cohort study of liver disease using linked data to explore patterns of hospital service use and patient journeys, and economic burden over time.  

 

Safeguards evaluation - NOUS 

The Safeguards program aims to improve mental health outcomes for children, adolescents, and families experiencing distress. This project aims to conduct a three-year process, outcome, and economic evaluation of Safeguards.  

 

Smarter hospitals: Unlocking the promise of virtual care through infrastructure innovation in Australian healthcare facilities - Macquarie University 

This retrospective cohort study aims to describe and examine the association of virtual care use in outpatient hospital services and subsequent hospital admissions in public hospitals in NSW, Victoria and Queensland. The study focuses on four adult patient cohorts: those accessing oncology, renal care, rehabilitation or mental health services.  

 

Postoperative Delirium incidence and risk factors in Post Anaesthetic Care Units (PACU) - University of Wollongong 

This study aims to determine the peri-operative prevalence and risk factors of delirium for older surgical patients in Post Anaesthetic Care Units (PACU). 

 

Advancing knowledge of the drivers of fatal overdose in Australia in the context of changing drug markets - Burnet Institute 

This program aims to investigate the relationship between non-fatal and fatal overdose among opioid-related deaths and will also explore the relationship between non-fatal overdose and other factors occurring prior to death.  

The Impact of the NSW Drug Court on Health and Social Functioning - University of New South Wales 

The aim of the project is (1) to examine the impact of the NSW Drug Court on health and social functioning through comparing matched samples of defendants referred to the Drug Court and whether they were admitted to the program or not, and (2) to examine the correlates of program completion.  

 

Assessing the safety of COVID-19 vaccines using routinely collected health surveillance data - The Childrens Hospital at Westmead 

This project aims to evaluate the relative incidence of various adverse events of special interest (AESIs) including myocarditis and pericarditis, GBS and VITT following COVID-19 vaccination in New South Wales (NSW). 

 

RuralKidsGPS - delivering equitable care to children in rural NSW - University of New South Wales 

This project aims to evaluate an integrated model of technology enabled care called RuralKidsGPS. The service is focussed on children with increased care coordination needs, and reduced accessibility to appropriate services across four rural sites: Murrumbidgee, Southern, Western and Northern New South Wales (NSW) Local Health Districts (LHDs). 

 

Investigating the burden of morbidity and mortality among sepsis survivors - Macquarie University 

This project proposes to investigate the burden of amputations, mortality, developmental delay, and hospital readmissions of Australian sepsis survivors using large, linked population data. 

 

Are calcium channel blockers associated with breast cancer? Assessing the impact of long-term use in large longitudinal cohorts - Curtin University 

This project aims to investigate whether the use of calcium channel blockers (CCBs) increase the risk of cancer. The researchers will undertake a retrospective observational study in three international longitudinal cohorts (the Sax Institute’s 45 and Up Study, the Australian Longitudinal Study on Women’s Health, and The Rotterdam Study). 

 

Adverse Childhood Experiences in ACT Kindergarten Children - Australian National University 

This study aims to broadly understand the profile of children in the ACT in regard to their 'Adverse Childhood Experiences' scores. The study will examine the characteristics of the children, their mother’s perinatal characteristics, and identify any perinatal factors predictive of high risk in this cohort. 

 

Centre of Research Excellence: Implementation Science in Oncology - Macquarie University 

This project will involve 5 cancer-related population-based retrospective cohort studies that will examine temporal trends in health service use and factors predictive of patient health outcomes in NSW including: end of life care, characteristics of emergency hospital admissions for those with cancer, age related hospital resource use following colorectal cancer diagnosis, and hospital resource use following metastatic lung cancer diagnosis and treatment. 
 

 

Future Directions for Housing and Homelessness in NSW - NSW Department of Communities & Justice 

The primary aim of this program of work is to examine the impact of NSW government housing and homelessness programs on a range of outcome domains. The analysis will determine how NSW government housing and homelessness programs were implemented (process evaluation), how effective they were (outcome evaluation) and whether the economic value of the benefits they produced exceeded their economic costs (economic evaluation).  

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