Primary purpose

The Centre for Health Service Development (CHSD) is a research centre of the Sydney Business School, University of Wollongong. We were established in 1993 "to undertake a continuing program of active research into methods to improve the management and provision of health services with the goal of making a significant contribution to improving the funding and delivery of health services in Australia". Our ideas of improvement include achieving greater equity in the distribution of resources, promoting fairer access to services, better continuity within and across the health and community care sectors, and basing management decisions on evidence.

The CHSD consists of approximately 15 research and support staff from a variety of academic disciplines and career backgrounds. This diversity of experience – including health service management, policy, administration and clinical work – brings a unique ‘real‐world’ focus to our research. CHSD is held in high regard for its health service research, as indicated by the fact that the centre generated over $2m in research funding over approximately 15 projects in 2019.

To the end of 2010, the CHSD carried out 335 health service research, development and evaluation projects. Between 2010 and 2018, the CHSD carried out 300 projects. These have ranged in size from under $10,000 to $1.5 million and last from several weeks to over three years. This body of work supports a core team of CHSD staff plus additional researchers who contribute specific skills required for each project. Project funds are supplemented by an infrastructure contribution from the University of Wollongong.

In addition to producing standard academic output, our work results in a range of practical advice to a variety of government and non-government agencies and interest groups. We design research and information-based strategies for program coordination to help allocate resources on the basis of need, as well as tools to support decision-making and to help managers develop funding models.

 

Historical context

After considering its strategic position within the academic and commissioned research fields, the CHSD made a decision in 2006 to begin a period of significant growth. Since that time, CHSD has expanded the range of disciplines in which it specialises and established sub-centres to focus on strategic aspects of health services research and development. 

A natural consequence of this growth was to expand CHSD’s organisational structure to better reflect the requirements of the growth strategy. The CHSD now continues as the arm of the Australian Health Services Research Institute (AHSRI) that nurtures new research themes and programs. It serves as the ‘generalist health and community’ research group doing strategic project-based research as an AHRSI ‘centre’. The other research centres within the AHSRI structure focus on specific areas of health system activities and specialised areas of expertise. CHSD maintains its flexibility and encourages staff to work across centres and projects depending on their interests and skills.

A 'Brief History' describes what was achieved by CHSD in the period up to the formation of AHSRI, and a presentation on that historical review was given at the Australasian Evaluation Society conference in 2011. These are available to download below:

 

Objectives and research direction

At its beginning in 1993, the CHSD focused its efforts in the areas of sub-acute and non-acute casemix classification and its implications for hospital and community care financing, resource distribution and service delivery. The focus has expanded since that time but the core of our work remains on practical and rigorous approaches to addressing questions of health equity, effectiveness and efficiency, as well as evaluation tools based on consumer outcomes.

We have been able to build these questions into our various evaluation frameworks and research and development projects – in emergency departments, mental health, community aged care and disability services, palliative care - to better understand strategies for capacity building and getting a fairer balance of care for different levels of individual need.

Each year CHSD undertakes ten to fifteen research and development projects from a variety of funding sources: Commonwealth departments, State and Territory departments, local health and community care authorities, and non-government and not-for-profit organisations. CHSD also undertakes projects arising from competitive Australian Research Council (ARC) and National Health and Medical Research Council (NHMRC) grant processes. This diversity of funding sources means we are not dependent on any individual partnership or funder. It allows a level of independence that is helpful to the health system, and at the same time, it requires considerable collaboration and multiple partnerships at all levels.

 

CHSD developed tools

The CHSD has developed a number of screening tools that prompt assessment, referral and broader needs identification. These tools have been implemented in a series of projects, beginning with functional screening and assessment in Home and Community Care and Aged Care Programs. At the national level, these tools are known as the Australian Community Care Needs Assessment (ACCNA) and the Carer Eligibility and Needs Assessment (CENA).

SNAPshot is software designed primarily to collect “SNAP” (Sub-Acute and Non-Acute Patient) information. CHSD was commissioned by the Independent Hospital Pricing Authority to develop AN-SNAP version 4 in December 2013.