Melbourne School of Population and Global Health - Research Publications
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ItemThe Development of the EQ-5D-5L and its Value Sets(Springer International Publishing, 2022)Abstract This chapter introduces the EQ-5D-5L questionnaire and its development by the EuroQol Group. The availability of the EQ-5D-5L, and the growing evidence of its pivotal role as a measurement system, generated a demand for ‘values’ to accompany it that would enable the use of EQ-5D-5L data in the estimation of quality-adjusted life-years (QALYs) and other applications where EQ-5D-5L profile data needs to be summarised by a single number. Chapter 1 sets out the main aim of the book: to provide an accessible source of information and guidance to support users of EQ-5D-5L and its value sets. Specifically, the book aims to improve users’ understanding of how EQ-5D-5L value sets are generated using the internationally standardised EQ-VT protocol; to raise awareness of the characteristics and properties of value sets; and to inform users’ choice of which value set to select for which purpose, and how that choice may affect analysis. The chapter concludes with an overview of the content of the book.
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ItemWhere Next for EQ-5D-5L National Value Sets and the EQ-VT Protocol?(Springer International Publishing, 2022)Abstract The purpose of this chapter is to reflect on the future of EQ-5D-5L valuation studies, going beyond the value sets summarised in this book. This includes a number of linked themes. First, the EQ-5D-5L valuation research programme has allowed the continued evolution of methods, as methodological studies have demonstrated that aspects of the EQ-VT protocol could be strengthened or improved. This chapter describes some of the key candidates for future refinement of the methods for valuing EQ-5D-5L. Second, while the standardisation of valuation methodology is important, it is anticipated that many countries may require a less resource-intensive, but still rigorous version of the valuation protocol. This chapter outlines the progress towards developing a ‘lite’ version of the EQ-VT protocol, and considers the future possibility of valuation protocols based exclusively on discrete choice experiments, with accompanying strengths and weaknesses. Finally, the ‘shelf-life’ of value sets is considered, along with how demographic and other societal changes may manifest in how people value health, and the implications of that for the need to update EQ-5D-5L value sets.
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ItemGuidance to Users of EQ-5D-5L Value Sets(Springer International Publishing, 2022)Abstract One of the most common questions that the EuroQol Group is asked by users of the EQ-5D-5L is: ‘Which value set should I use?’. The aim of this chapter is to provide guidance on this issue for users. There are two principal ways that EQ-5D-5L value sets are applied and used. The first is for summarising health-related quality of life to estimate quality-adjusted life-years (QALYs) and changes in QALYs that result from the health care use. This kind of evidence is often part of health technology assessment (HTA). The second category of use is when value sets are employed as a way of summarising and statistically analysing EQ-5D-5L profile data without the aim of estimating QALYs. In each case, the stated requirements of those who use this evidence in decision making is a key consideration. This chapter summarises the relevant considerations to be taken into account when choosing a value set for QALY estimation purposes; and the considerations which are relevant to choosing a value set to use in other, ‘non-QALY’ applications.
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ItemNo Preview AvailableThe Continuum of Gender-Based Violence Across the Refugee Experience(Springer, 2021)This chapter considers refugees’ experiences of gender-based violence (GBV) across contexts of conflict, displacement, transit and resettlement. We outline various forms of GBV experienced by refugees and challenge the characterisation of GBV as an individual or series of discrete traumatic acts. Rather, GBV is often experienced as a spectrum of violations that are not static or temporally confined to conflict and transit spaces, but instead can permeate the refugee experience into resettlement, forming a continuum of violence. We explore how structural and symbolic factors shape individuals’ experiences of and responses to GBV and can be forms of gendered violence in themselves. Opportunities for social workers and healthcare professionals to effectively respond to and prevent GBV in resettlement contexts are discussed, including creating safe spaces, providing trauma-informed, culturally responsive care and promoting community-led interventions.
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ItemIntroduction(Springer International Publishing, 2021)In China, conceptions of mental health and illness, and the mental health systems developed to respond to mental illness, have changed dramatically from the second half of the nineteenth century to the present, the historical period that is the focus of this book. As is the case in every other country, these changes have been fundamentally influenced by the particular political, economic, social and cultural contexts that have been dominant at different historical periods. During the same period, there has been large-scale emigration from China, mostly to countries in Southeast Asia but also at smaller scale to much of the rest of the world. The objectives of this book are to examine mental health system development in China and the historical and cultural contexts in which this has occurred, and the mental health of Chinese immigrant communities in selected Southeast Asian and Pacific countries that have large populations of Chinese origin.
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ItemNo Preview AvailableMental Health of Chinese Immigrants in Australia(Springer International Publishing, 2021)The Chinese are among the earliest immigrants to Australia, with substantial numbers coming from the middle of the nineteenth century, fully half a century before Federation of the states to form the Commonwealth of Australia. The White Australia Policy, established immediately after Federation in 1901 specifically to prevent migration from China, was not dismantled until 1972, when Australia was among the first Western nations to recognise the People’s Republic of China. Since that time, large-scale migration from China has recommenced, and the Chinese are now the fastest growing immigrant community in Australia. Substantial differences between the culture that Chinese immigrants bring with them and the dominant Australian culture contribute to risks for development of mental disorder, as a result of the challenges associated with settlement in a new country and culture. While there have been no adequate epidemiological studies of mental disorders in Australia’s Chinese communities, it is probably the case that the overall prevalence of mental disorders is not substantially different to that in the overall Australian population and in other immigrant communities. Despite this, Chinese immigrants with mental disorder substantially underutilise public mental health services, largely as a result of the lack of culturally appropriate, acceptable and effective mental health services. In recent years, the political and economic tensions between Western countries – primarily the United States – and China have become prominent also in Australia, with the possibility that these may be undermining Chinese immigrants’ sense of security and wellbeing.
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ItemNo Preview AvailableThe National Mental Health Work Plan 2015–2020(Springer, 2021)Development of the contemporary mental health system in China has been a work in progress since the late nineteenth century. Until the late 1970s, this has been in a context of conflict, and social and economic disruption. Despite such a difficult environment for attention to an already neglected field, progress was made, both during the Republican period and during the first three decades after the foundation of the People’s Republic. The same period saw a major transition from largely traditional approaches to mental disorders to Western conceptions of mental illness and medical and other interventions and the institutional arrangements for the delivery of such interventions. It was not until the economic and social reforms that commenced in the late 1970s and early 1980s that mental health began to receive sustained government attention and investment, for the first time in a context of political stability, spectacular economic growth, growing international engagement and rapidly expanding internal capacity in all fields. In a very short historical time span, only four decades, a great deal has been achieved in population health and in mental health. The National Mental Health Work Plan 2015–2020
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ItemNo Preview AvailableMental Health in Multicultural Australia(Springer, 2021)Cultural and linguistic diversity is a core feature of the Australian population and a valued element of national identity. The proportion of the population that will be overseas-born is projected to be 32% by 2050. While a very active process of mental health system reform has been occurring for more than two decades – at national state and territory levels – the challenges presented by cultural and linguistic diversity have not been effectively met. A review of Australian research on mental health of immigrant and refugee communities and their patterns of mental health service use reveals many gaps. Although lower rates of utilization of specialist public mental health services by immigrants and refugees are repeatedly reported, the lack of adequate population data prohibits conclusions about whether the observed patterns constitute underutilization. There are virtually no data on quality of service outcomes. A review of studies published in four key Australian journals reveals considerable neglect of cultural and linguistic diversity in Australia’s mental health research. The purpose of this chapter, which is an abbreviated and updated version of Minas et al. (Int J Mental Health Syst 7(1):23, 2013), is to examine what is known about the mental health of immigrant and refugee communities in Australia, whether Australian mental health research pays adequate attention to the fact of cultural and linguistic diversity in the Australian population, and whether national mental health data collections support evidence-informed mental health policy and practice and mental health reform in multicultural Australia. A set of strategic actions is suggested to improve knowledge about, and policy and service responses to, mental health problems in immigrant and refugee communities.
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ItemNo Preview AvailableModelling the Economic Impacts of Epidemics in Developing Countries Under Alternative Intervention Strategies(Springer, 2020)Modern levels of global travel have intensified the risk of new infectious diseases becoming pandemics. Particularly at risk are developing countries whose health systems may be less well equipped to detect quickly and respond effectively to the importation of new infectious diseases. This chapter examines what might have been the economic consequences if the 2014 West African Ebola epidemic had been imported to a small Asia-Pacific country. Hypothetical outbreaks in two countries were modelled. The post-importation estimations were carried out with two linked models: a stochastic disease transmission (SEIR) model and a quarterly version of the multi-country GTAP model, GTAP-Q. The SEIR model provided daily estimates of the number of persons in various disease states. For each intervention strategy the stochastic disease model was run 500 times to obtain the probability distribution of disease outcomes. Typical daily country outcomes for both controlled and uncontrolled outbreaks under five alternative intervention strategies were converted to quarterly disease-state results, which in turn were used in the estimation of GTAP-Q shocks to country-specific health costs and labour productivity during the outbreak, and permanent reductions in each country’s population and labour force due to mortality. Estimated behavioural consequences (severe reductions in international tourism and crowd avoidance) formed further shocks. The GTAP-Q simulations revealed very large economic costs for each country if they experienced an uncontrolled Ebola outbreak, and considerable economic costs for controlled outbreaks in Fiji due to the importance of the tourism sector to its economy. A major finding was that purely reactive strategies had virtually no effect on preventing uncontrolled outbreaks, but pre-emptive strategies substantially reduced the proportion of uncontrolled outbreaks, and in turn the economic and social costs.
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ItemDisaster mental health research(World Health Organization, 2021)