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healthcare resources assignment on the designing process of health worker training programs


Task: how health worker training programs be better designed using healthcare resources assignment research techniques?


Assessment 4- (35%)
• Due: 3 November 2022 (by 4:00pm)
• Word limit: 1,500 words (a margin of 10% of the word count is acceptable)

In this healthcare resourcesassignment, you are expected to draft a protocol to generate economic evidence alongside a proposed clinical study

Suppose that policy makers in Australia wish to know whether it would be an efficient use of healthcare resources to train and fund community health workers (CHW)to better manage frailty in the primary care setting.

Given the clinical scenario provided (See below for full details), you need to submit a protocol for the economic evaluation of a CHW-led intervention alongside a randomised clinical trial. Assuming that the proposed intervention has not been publicly funded in Australia, your proposalaims to generate economic evidence to inform recommendations by national funding bodies.
Using the template provided, you need to accurately and clearly reporta number of issues required to generate economic evidence, aligned with the recommendations taught in this topic.

Clinical scenario
Frailty is a state of low physiological reserves and increased vulnerability to stressors. Considered as an age-related condition, frailty is associated with increased risk of important health events (such as hip fracture, disability) leading to multiple hospital admissions and use of aged care services with consequential impact on quality of lifeof older people and health care expenditures.Frailty status is commonly measured using the Frailty Phenotype (FP) approach, consisting of five variables (i.e., unintentional weight loss, self-reported exhaustion, weak grip strength, slow walking speed, and sedentary behaviour), and classifies frailty into frail (individuals with three or more factors) and pre-frail (individuals with one or two factors). Pre-frail individuals are at increased risk of progression to frailty and, compared with frail people, have an intermediate risk of adverse health outcomes. With no effective interventions, frailty is a progressive condition. Emerging evidence suggests that timely nutrition and exercise interventions in the community setting have a positive impact on frailty progression (i.e., delay in transitioning form pre-frailty to frailty or increase the likelihood of transitioning from frailty to pre-frailty), and hence reducing the risk of health events including hospital admissions

Frailty is a major health issue identified on this healthcare resources assignmentin countries such as Australia. Given the projected growth in the number of older people with frailty, it is critical to better manage frailty, and general practices are best positioned toscreen and manage frailty. Suppose that one approach to address this health problem is the use of trained community health workers (CHW) in general practicesto provide nutritional advice and physical exercise.CHW-led models of care are generally attractive because, if effective, trained laypersons deliver the intervention at a lower cost relative to healthcare professionals (such as nurses).

To evaluate effects and economic value of the proposed intervention, a two-arm randomised clinical trial has been proposed. In this clinical trial, 10Adelaide metropolitan general practices will be recruited and evenly assigned to the study arms. CHWs will receive training from Adelaide Primary Health Network (PHN) ( During the clinical trial, CHWs will receive ongoing support and mentoring from general practitioners in practices and healthcare professionals (e.g., physiotherapists and dietitians) based at Adelaide PHN.

The intervention (which will be delivered by trained CHWs within general practices) includes the on-site healthcare resources assignmentof older people to identify potentially eligible participants using the FP approach. The target population includes older people (65 years and older) with pre-frailty. Patients with a life limiting diseaseor cognitive impairment will be excluded.After identifying eligible participants, the new intervention delivered by CHWs will include 16 weekly sessions (in general practices) to create action plans with individual participants, offering nutritional advice and exercise programs (including brochure and other written documents). Subsequently, CHWs schedule follow-up calls (and home visits if needed) for ongoing support at 9, 15 and 24 months when the clinical trial ends.

Note 1: To address the key issues in thehealthcare resources assignment template, you may need to review the background information on the condition (i.e., frailty).

Note 2:You do not need to consider resources (e.g., budget, expertise) required to conduct the proposed economic evaluation

Note 3: Referencing
If you do any outside reading and incorporate elements of this into your work, a reference list should be included
• References are not included in the word count
• The Vancouver system of referencing is recommended (If you are not familiar with this system, please see):

Note 4: Assessment Criteria
Each element of the healthcare resources assignmentproposed economic evaluation • Is accurately and clearly described, demonstrating clear understanding of the concept (High distinction)
• Is sufficiently described (but missing some details), demonstrating clear understanding of the concept (Distinction)
• Is described (but providing few details and/or some levels of inaccuracy and/or missing a few important details), demonstrating some understanding of the concept (Credit)
• Is insufficiently described (missing some important details and with some levels of inaccuracy), demonstrating a low level of understanding of the concept (Pass)
• Is not described or not clear, demonstrating minimal understanding of thehealthcare resources assignment concept (Fail)

Key issues to address

Your proposal

The primary aim of the proposed economic evaluation

Answer: For the purpose of this healthcare resources assignmentthe key aim of the economic evaluation is to inform funding decisions assuming that the proposed intervention has not been publicly funded in Australia

What is the preferred type of economic evaluation? (Given the primary aim of the economic evaluation is to inform public funding decisions) (5 points)


In this economic evaluation healthcare resources assignment, cost effective analysis will be used. In order to evaluate the costs and health effects of one or more interventions, cost-effectiveness analysis will be appropriate. By evaluating how much it costs to obtain a unit of a health outcome, like a life year gained or a death prevented, it compares an intervention to another intervention (or the status quo). In general, CHW-led care models are appealing because, if successful, educated laypeople can provide the intervention at a lesser cost than trained healthcare professionals (such as nurses).A two-arm randomised clinical study has been suggested to assess the effects and financial worth of the suggested intervention. This will be only achieved by using Cost effective analysis for this project.


What is the decision problem? (10 points)

Note: A well-defined decision problem question in economic evaluation should cover the following key components

-          Setting and location

-          Target population (i.e., key characteristics of the population),

-          New healthcare intervention

-          Existing intervention (comparator)

A "decision problem" is intended to be approached methodically using economic evaluations. In each choice problem, the question of which option from a group seems to be the most efficient is asked. This comparison is made in terms of both costs and benefits.Here the decisions problems are:

-          Setting and location: Metropolitan general practices

-          Target population:Adults over the age of 65, and also having pre frailty symptoms.

-          New healthcare intervention: A clinical trial which is two armed and randomized

-          Existing intervention: CHW-led care models delivered by nurses and other healthcare professionals.

What is the perspective of the economic evaluation identified on this healthcare resources assignment? (Given the primary aim of the economic evaluation) (5 points)


In the frailty care perspectives, there is a proper need of economic evaluation from the Australians. The perspectives of economic evaluation in case of frailty are Societal perspectives. This is mainly the traditional method of evaluating the profitability of societal investments—as well as the health benefits of investments in other economic sectors which is considered as the formof standpoint in the society. This will only help in raising social awareness associated with the need of economic evaluation for treating patients above 65 years of age and dealing with frailty. Therefore, by taking into account the primary aim associated with the economic evaluation revolves around the decisions making on public funding associated with social perspective, health care system and patient perspective as well. This is because at the end the funds will be received from public for increasing health intervention of pre frailty cases.

What is an appropriate time horizon? (10 points)

Note: Explain whether decision analytic modelling is required? Why?


The healthcare resourcesassignment research shows The length of time employed to determine health outcomes and costs is referred to as the time horizon in economic evaluations. For economic modelling, selecting a time horizon is a crucial choice that is influenced by the analysis's goals, the nature of the disease and intervention under consideration, and the time horizon itself (Nghiem et al. 2020). In case of building a proper time horizon for frailty care health intervention, exercise, proper nutrition, and exercise combined with nutrition are all interventions that should be covered in specific time span. The physical results of pre-frail and/or frail older persons who will undergo interventions will mainly include one or more physical exercise components for better improvement.

In this aspect decision analytic model is required as it necessary for further economic evaluation by public funding for the health intervention from Australians (Taylor et al. 2019). By combining healthcare resources assignmentdata from various sources and employing mathematical approaches, decision analytical modelling will evaluate the anticipated costs and effects of decision options, typically using computer software. It is needed as Decision tree modelling technique in health economics mainly helps in extrapolating the price and performance of rival therapies over time. As there is a need of two intervention so approximately a 12 months’ time excluding the follow up period is required here.

Identify the most appropriate health outcome measure for your proposed economic evaluation (given the proposed aim and type of economic evaluation)

-          What other important and relevant health outcome measures do you propose?  (15 points)


The most appropriate heath outcome measures in Frailty include:

Supportive Care: There are numerous ways to administer care and support planning, but in general, it entails a conversation between patients, families, and healthcare professionals on an equal footing.

Physical activity interventions: According to a recent scoping review of trials on interventions to prevent or lower the level of frailty in older people living in the community, those that involve physical activity largely slowed the rise in frailty among older people (Taylor et al. 2019).

Medication review: older persons who are fragile frequently take multiple medications, and this is linked to an increased risk of predicted and avoidable adverse drug events.

Nutritional support: A 2017 comprehensive research revealed a high correlation between malnutrition and frailty (Nghiem et al. 2020).

Other important and relevant health outcome measures include:

Geriatric assessment: The current gold standard for detecting frailty and directing care for persons who are frail is a thorough geriatric assessment.68 This evaluation includes multidimensional tests to ascertain the medical, functional, social, and psychological aspects.


Identify all important and relevant cost items including averted/induced costs (if relevant) (15 points)


Here the important healthcare resources assignmentcosts include:

Assessment stage includes initial cost of assessments associated with interdisciplinary participants, nurse fees, case discussion of conference associated with pre participants.

While in the intervention stage, the cost includes programs of exercise, pamphlets and brochures, cost of psychiatrist, visits of home for follow ups, costs of keeping rehabilitation specialists and dietician for maintain proper diets. These are some of the most important implementations associated with the costs.

Explain whether discounting is needed for this healthcare resources assignment(10 points)

-          If needed, briefly explain your proposal for discounting


Economic analyses based on trials frequently track and evaluate expenses and results across many years of patient follow-up. In this case, expenses and results that occur beyond the first year of follow-up are often discounted by a factor to allow for fair comparison (Roberts, and Collins,2021). Some economists have argued for using distinct discount rates to account for future expenses and health outcomes (Taylor et al. 2019). In such aspect, as according to the time horizon, approximately 12 months are kept, in that case there will be a current discount of zero as it is associated with the present value system. Therefore, no discounting will be given in this proposal of health intervention.

Explain what methods/instruments and sources you will use to collect key cost data and health outcomes to generate economic evidence (10 points)


In this proposal, the sources of collecting key cost data and health outcomes are mainly identification, measurement, and appraisal. In this there are several other sources that are also taken into being consideration. These are like

The evaluation of health technology; the adoption of a perspective; techniques for locating objects to cost; techniques for validating and piloting data gathering instruments for resource utilisation; techniques for gathering data on resource consumption; data collection timing in respect to trial length and lastly the Costs per unit's sources. These are the basic ways I will be using for gathering or collecting healthcare resources assignmentdata associated with economic evaluation in order to generate economic evidences. In such aspect the net cost is divided by variations in health outcomes to get a cost-effectiveness ratio. Examples include the cost per sickness case avoided or the cost per death avoided. Net cost savings, on the other hand, are stated when the net costs are negative (i.e., when a more effective intervention is less expensive) (Nghiem et al. 2020).

The internal records that will be collected are:

·         Outpatient

·         Primary Care

·         Public hospitals

·         Inpatient

·         ED

·         Private nursing homes

·         Medicare

Explain your proposal to analyse data and report the key measure of economic evidence required to inform funding decisions (10 points)

The proposal mainly aims submitting a protocol for the economic evaluation of a CHW-led intervention alongside a randomised clinical trial. The proposal will be calculated based on Incremental cost effectiveness ratio. In this proposal we will be considering deductive method. In order to reach a specific result or conclusion using this method, a person must first accept factual information and then proceed logically. Deductive reasoning is utilised in the scientific method to arrive at an accurate and logical conclusion. Therefore, in this proposal of public funding requirement deductive method will best suit the work (Karnon and Pekarsky, 2020).

The improvement in this proposal will be measured by using QALYs. Here the plan which is new will be kept effective and the domain of the treatment will be clear as well. Lastly, ICER sensitivity analysis will help in measuring the validity of the proposal.

Explain your healthcare resources assignmentproposal for uncertainty analysis (10 points)

In order to assess the output variability that results from input variability, uncertainty analysis is used. The statistical quantities of interest that are most frequently estimated during the quantification process include mean, median, and population quantiles. The estimation makes use of approaches for uncertainty propagation. In our proposal uncertainty analysis is a must as it requires funding decisions (Alkhodaryet al. 2020). Therefore, proper analysis of uncertainty will quantify the overall interest that will be gained at the end of the public funding decisions.  The three categories of uncertainty that are seen in projects are modal, empirical, and normative, and they are based on the sort of assessment we can make of the challenges, we encounter or the type of inquiry we can pose about those challenges. Structural uncertainty, the using of sensitivity analysis in order to parameter measuring independently and also calculated with the outcome on results and models. Multiway sensitivity analysis can be considered as the changing parameter in this healthcare resources assignment proposal.


Alkhodary AA, Aljunid SM, Ismail A, Nur AM, Shahar S. The economic burden of frailty among elderly people: A review of the current literature. Malaysian Journal of Public Health Medicine. 2020 Oct 1;20(2) resources assignment
Karnon J, Pekarsky B. Should Health Economic Evaluations Undertaken from a Societal Perspective Include Net Government Spending Multiplier Effects. Applied Health Economics and Health Policy. 2020 Aug;18(4):467-75.
Nghiem S, Sajeewani D, Henderson K, Afoakwah C, Byrnes J, Moyle W, Scuffham P. Development of frailty measurement tools using administrative health data: a systematic review. Archives of gerontology and geriatrics. 2020 Jul 1; resources assignment
Roberts S, Collins P, Rattray M. Identifying and managing malnutrition, frailty and sarcopenia in the community: a narrative review. Nutrients. 2021 Jul 5;13(7):2316.
Taylor D, Barrie H, Lange J, Thompson MQ, Theou O, Visvanathan R. Geospatial modelling of the prevalence and changing distribution of frailty in Australia–2011 to 2027. Experimental gerontology. 2019 Aug 1; resources assignment


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