Incentivising prevention in adolescent healthcare

Summary An opportunity to conduct health economic research alongside a trial that tests incentives for preventive primary care for adolescents. Potential projects include decision analytic modelling, inequality analysis, and econometric analysis of primary care data linked to the trial data.

Project Details

Context: The Rebate for an Adolescent Health Assessment Trial (RAd Health Trial) is an NHMRC-funded trial led by Prof. Jane Hocking, examining the impact of offering GPs a rebate to conduct adolescent health checks for preventive care. Adolescence is a key opportunity for GPs to conduct preventive care and is a time when risky behaviours such as substance use emerge, sexual activity commences, and many mental health conditions arise. Interventions at this time can provide benefits for adolescent health now, into future adult life, and potentially for the next generation of children. Evidence-based clinical practice guidelines recommend GPs to conduct a range of preventive healthcare activities for adolescents, but few do. Consultation time is the key barrier, which could be overcome by a Medicare rebate payment to fund longer consultations and allow a nurse to assist the GP. Similar rebates for health checks in other population groups exist in the Medical Benefits Schedule (MBS) but it is not known whether offering such a payment would be cost-effective. This trial will determine whether a rebate payment for an adolescent health check is effective and cost effective at increasing the detection and management of risk behaviours and health conditions, providing evidence to inform MBS policy.

Project outline: The trial offers an opportunity to conduct research to inform priority setting for preventive primary care for adolescents. There is capacity for the candidate to develop their own ideas,  but possible projects linked to the trial include: 1) developing a decision analytic model of one (or possibly more) adolescent health outcomes for use in modelling cost-effectiveness beyond the trial period; 2) conducting inequality analysis of adolescent health outcomes and/or healthcare costs, and/or distributional cost-effectiveness analysis of the intervention; 3) examining how incentive payments change primary care activities, distribution of care, and quality of care; 4) identifying the optimal level for this type of incentive payment.