Using big data to improve surgical procedures and outcomes
More than two million surgical procedures are performed annually in Australia. Many of these involve use of medical devices such as implants and prostheses.
Around 50,000 hip replacement and 60,000 knee replacement surgeries are performed each year in Australia. More than 17,000 cardiac pacemakers are implanted every year.
Our research in surgery and devices uses multiple sources of big data, including hospital, Medicare and pharmaceutical records to tackle questions including:
What are the comparative long-term outcomes of open surgical versus minimally invasive heart valve replacement?
What are the comparative long-term outcomes of open surgical versus endovascular repair of abdominal aortic aneurysms?
How common are infections following joint replacement procedures?
Do outcomes of hip replacement vary according to the surgical approach used?
What are the trends in surgery for back pain, and how do these vary according to source of funding?
Project: Post-surgery care fragmentation: impacts and implications - NHMRC Project Grant (2019–2022)
Hospital readmissions are common after major surgery. Newly emerging international evidence shows that mortality and morbidity outcomes are worse for surgical patients who are readmitted to a different hospital, rather than to the index hospital where their surgery was done.
These studies are limited but likely to be replicated and have a major international impact due to the generalisability and face validity of their results. The very limited available data indicate that rates of readmission to a non-index hospital (‘care fragmentation’) are markedly higher in Australia than in other countries, likely reflecting our public-private mix of hospital services and vast geography.
We’ll use linked hospital admission, Medicare and mortality data for more than 10 million surgical procedures on around 4.5 million Australian patients to quantify and characterise care fragmentation following common surgical procedures. This includes cardiac, orthopaedic, thoracic, vascular, abdominal, colorectal, urological, neurosurgical and gynaecological interventions). We will evaluate the impact on outcomes in Australia and identify the factors that influence care fragmentation—including features of the index hospital, index admission, post-discharge care, patient and payer.
Our findings will have important implications for Australian health policy, including identification of possible adverse impacts of centralisation of surgical services and of incentives to switch between private and public hospitals.
We’ll work with health system stakeholders to synthesise these implications and identify potential policy responses, which might include a focus on coordination of care transitions and better clinical integration and data exchange among private and public sectors.