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Introduction
Luke Connelly is Professor of Health Economics at The University of Queensland, Centre for the Business and Economics of Health and Professor at The University of Bologna, Department of Sociology and Business Law.
https://cbeh.centre.uq.edu.au/profile/6/luke-connelly
https://www.unibo.it/sitoweb/luke.connelly/en
Current institution
Additional affiliations
March 2016 - February 2017
January 2003 - December 2011
January 1995 - present
Publications
Publications (180)
The UK Biobank (UKB) is a population-based resource of genetic, health, lifestyle, sociodemographic, and linked clinical data for ~500,000 volunteers. Previous analyses of health determinants have shown that the UKB is not representative of the population from which it is drawn. However, representativeness from a general health-outcomes perspective...
In this study we use a unit record, panel dataset, to examine the behaviour of clinicians under a chronic disease management program (CDMP) that is designed to improve care and slow the progression of chronic kidney disease (CKD). Using 8 years of quarterly data on the population of CKD patients (n = 44,686) in the Emilia-Romagna region of northern...
Objectives
In Australia, although there have been some improvements, child oral health continues to be a major public health issue. The Australian Government introduced the means-tested Child Dental Benefits Schedule (CDBS) in 2014 to support access to dental services for children and adolescents aged 0–17 years from low-income families. There is a...
This study investigates various common medical conditions affecting Australian children aged 4–14 years and the impact of prenatal and early-life conditions on these health conditions using a large national data set (n = 4122) with 15 years of follow-up. Consistent with the developmental origins of health and diseases hypothesis and the life-course...
Purpose
There is increasing recognition of monogenic aetiologies for kidney disease. We sought to identify whether genetic kidney disease (GKD) has distinct hospitalization patterns compared to other forms of chronic kidney disease (CKD).
Methods
Health service utilization analysis was undertaken in a CKD cohort study across public hospital servic...
The examination of the causal impact of health insurance coverage on healthcare utilisation is a critical endeavour in both academic research and policy formulation. However, this endeavour faces challenges, notably the endogenous selection into coverage and prevalent misreporting of coverage status. This study pioneers an investigation into the ef...
The examination of the causal impact of health insurance coverage on healthcare utilisation is a critical endeavour in both academic research and policy formulation. However, this endeavour faces challenges, notably the endogenous selection into coverage and prevalent misreporting of coverage status. This study pioneers an investigation into the ef...
In this paper we use the synthetic control method (SCM) to estimate the causal effects of a national legislative reform accompanied by mandatory gun buy‐backs in Australia on both suicide and homicide rates. Using a rich international dataset, we are able to separate not only these two death types, but also to distinguish deaths by firearm and by o...
Studies on health insurance coverage often rely on measures self-reported by respondents, but the accuracy of such measures has not been thoroughly validated. This paper is the first to use linked Australian National Health Survey and administrative population tax data to explore the accuracy of self-reported private health insurance (PHI) coverage...
Purpose
Skeletal dysplasias are rare genetic disorders that are characterized by abnormal development of bone and cartilage. There are multiple medical and non-medical treatments for specific symptoms of skeletal dysplasias e.g. pain, as well as corrective surgical procedures to improve physical functioning. The aim of this paper was to develop an...
Current pathways of care for whiplash follow a "stepped care model," result in modest treatment outcomes and fail to offer efficient management solutions. This study aimed to evaluate the effectiveness of a risk-stratified clinical pathway of care (CPC) compared with usual care (UC) in people with acute whiplash. We conducted a multicentre, 2-arm,...
Inconsistent reporting of outcomes in clinical trials of treatments for whiplash associated disorders (WAD) hinders effective data pooling and conclusions about treatment effectiveness. A multidisciplinary International Steering Committee recently recommended 6 core outcome domains: Physical Functioning, Perceived Recovery, Work and Social Function...
Veterans with posttraumatic stress disorder (PTSD) commonly exhibit associated gastrointestinal (GI) symptoms. We compared upper GI endoscopy and abdominal ultrasound rates in veterans with and without PTSD. Veterans with PTSD were 77-81% more likely to undergo these procedures than those without PTSD. PTSD symptomatology influences GI investigatio...
Purpose:
Previous studies showed that unfavourable weather conditions discourage physical activity. However, it remains unclear whether unfavourable weather conditions have a differential impact on physical activity in children compared with adults. We aim to explore the differential impact of weather on time allocation to physical activity and sl...
Studies on health insurance coverage often rely on measures self-reported by respondents, but the accuracy of such measures has not been thoroughly validated. This paper is the first to use linked Australian National Health Survey and administrative population tax data to explore the accuracy of self-reported private health insurance (PHI) coverage...
We estimate the effects of a chronic disease management program (CDMP) which adapts various supply-side interventions to specific demand-side conditions (disease-staging) for patients with chronic kidney disease (CKD). Using a unique dataset on the entire population of the Emilia–Romagna region of Italy with hospital-diagnosed CKD, we estimate the...
Objectives
To systematically identify, synthesise and appraise studies on the measurement properties of patient reported outcome measures (PROMs) for anxiety, depression, fear of movement, pain catastrophizing, posttraumatic stress, self-efficacy, and stress in people with whiplash associated disorders (WAD).
Study design and setting
PsycINFO, Med...
Background:
Post-traumatic stress disorder (PTSD) is associated with extensive physical comorbidities, including lower gastrointestinal symptoms. Diagnostic uncertainty and poor therapeutic responses may result in more frequent colonoscopies than clinically necessary. Polypectomy is standard practice when polyps are identified, and if PTSD is a ri...
The relationship between physical activity and child health and development is well-documented, yet the extant literature provides limited causal insight into the amount of physical activity considered optimal for improving any given health or developmental outcome. This paper exploits exogenous variations in local weather conditions observed acros...
The relationship between physical activity and child health and development is well-documented, yet the extant literature provides limited causal insight into the amount of physical activity considered optimal for improving any given health or developmental outcome. This paper exploits exogenous variations in local weather conditions observed acros...
Introduction
Musculoskeletal (MSK) conditions constitute the highest burden of disease globally, with healthcare services often utilised inappropriately and overburdened. The aim of this trial is to evaluate the effectiveness of a novel clinical PAthway of CarE programme (PACE programme), where care is provided based on people’s risk of poor outcom...
Ex post moral hazard arises when the insured has an unobservable influence on the size of a loss after its occurrence. In automobile (property) insurance, ex post moral hazard could increase in the scope of the repairs and/or the value of the repairs. Both vehicle owners and auto repairers could gain from increasing the scope of repairs, while auto...
Chronic kidney disease (CKD) is one of the most common chronic diseases in the western world. In Australia, around 1.7 million Australians aged 18 years and over (about one in ten) have indicators of CKD, and 1.8 million hospitalisations were associated with CKD in 2017–18. There is currently very little understanding of the impact of CKD on health...
Objective
To explore factors behind inpatient admissions by high-cost users (HCUs) in pre-end-stage chronic kidney disease (CKD).
Design
Retrospective analysis of CKD.QLD Registry and hospital admissions of the Queensland Government Department of Health recorded between 1 July 2011 and 30 June 2016.
Setting
Queensland public and private hospitals...
This study explores the differential impact of weather on time allocation to physical activity and sleep by children and their parents. We use nationally representative data with time use indicators objectively measured on multiple occasions for more than 1,100 child-parent pairs. Employing an individual fixed effects regression model to estimate t...
Background
Readmissions to hospital due to medication-related problems are common and may be preventable. Pharmacists act to optimise use of medicines during care transitions from hospital to community.
Objective
To assess the impact of pharmacist-led interventions, which include communication with a primary care physician (PCP) on reducing hospit...
There are few effective treatments for acute whiplash-associated disorders (WAD). Early features of central sensitisation predict poor recovery. The effect of pregabalin on central sensitisation might prevent chronic pain after acute whiplash injury. This double blind, placebo-controlled randomised controlled trial (RCT) examined feasibility and po...
Background
Statistical analysis plans describe the processes of data handling and analysis in clinical trials; by doing so they increase the transparency of the analysis and reporting of studies. This paper reports the planned statistical analysis plan for the Whiplash ImPaCT study. For individuals with whiplash injury, Whiplash ImPaCT aims to asse...
This paper presents the first causal estimates of the effect of weather on children’s time allocation. It exploits exogenous variations in local weather observed during the random diary dates of two nationally representative cohorts of Australian children whose time-use diaries were surveyed biennially over 10 years. Unfavourable weather conditions...
Objective:
To investigate whether integrating pharmacists into general practices reduces the number of unplanned re-admissions of patients recently discharged from hospital.
Design, setting:
Stepped wedge, cluster randomised trial in 14 general practices in southeast Queensland.
Participants:
Adults discharged from one of seven study hospitals...
This paper provides the first evidence on the determinants of uptake of two recent public dental benefit programs for Australian children and adolescents from disadvantaged families. Using longitudinal data from a nationally representative survey linked to administrative data with accurate information on eligibility and uptake, we find that only a...
In most English-speaking countries, the children of Asian immigrants have better academic outcomes than other children, yet the underlying causes of their advantages are unclear. Using decade-long time-use diaries on two cohorts of children, we present new evidence that children of Asian immigrants spend more time than their peers on educational ac...
There has been a rapid increase in the use of behavioural economics (BE) as a tool for policy makers to deploy, including in health-related applications. While this development has occurred over the past decade, health care systems have continued to struggle with escalating costs. We consider the potential role of BE for making improvements to heal...
Since the outbreak of the COVID-19 pandemic, discussions about the capabilities of health and social systems to control and contain infectious diseases have been reignited. In Resilient Managed Competition During Pandemics: Lessons from the Italian Experience , Costa-Font, Turatti and Levaggi ask whether or not institutional differences between the...
Objective
The aim of this study was to estimate the difference between treatment costs in acute care settings and the level of funding public hospitals would receive under the activity-based funding model.Methods
Patients aged ≥16 years who had sustained an incident traumatic spinal cord injury (TSCI) between June 2013 and June 2016 in New South Wa...
Rationale:
The National Lung Screening Trial (NLST) reported a 20% reduction in lung cancer mortality with low-dose CT (LDCT) screening, however important questions on how to optimize screening remain, including: which selection criteria are most accurate at detecting lung cancers, and what nodule management protocol is most efficient. The PLCOm20...
Recent economic literature has advanced the notion that cognitive biases and behavioural barriers may be important influencers of uptake decisions in respect of public programs that are designed to help disadvantaged people. This paper provides the first evidence on the determinants of uptake of two recent public dental benefit programs for Austral...
Background
Deep-brain stimulation (DBS) can be effective in controlling medically intractable symptoms of Tourette’s syndrome (TS). There is no evidence to date, though, of the potential cost-effectiveness of DBS for this indication.
Objective
To provide the first estimates of the likely cost-effectiveness of DBS in the treatment of severe TS.
Me...
Abstract
Objectives: The purpose of this systematic review is to identify and synthesize studies evaluating performance-based functional outcome measures designed to evaluate the functional abilities of patients with neck pain.
Design: Systematic review
Data Sources: A literature search using PubMed, Scopus, CINAHL, EMBASE, COCHRANE, Google Scholar...
In most multi-cultural Anglo-Saxon countries, children of Asian immigrants have higher academic achievement than children of native-born parents. Yet, little is known about their relative non-cognitive performance. This study is the first to compare the non-cognitive skills of children of Asian immigrants and children of native-born Australian pare...
Objective
The purpose of this systematic review was to critically appraise and synthesise the psychometric properties of Global Rating of Change (GROC) scales for assessment of patients with neck pain.
Design
Systematic review.
Data sources
A search was performed in four databases (MEDLINE, EMBASE, CINAHL, SCOPUS) until February 2019.
Data extra...
Kidney supportive care (KSC) is a patient-centered model of multidisciplinary care designed for patients with advanced chronic kidney disease (CKD) and end-stage kidney disease (ESKD). Our goal was to characterize the types, frequencies, and costs of services accessed by patients enrolled in a KSC program. We analyzed health care utilization data p...
Background:
Lung cancer screening can reduce lung cancer mortality. Australian cost estimates are important to inform policy but remain uncertain.
Aims:
to describe the first direct medical costs associated with lung cancer screening in Australia.
Methods:
single centre prospective screening cohort. Healthy volunteers (age 60-74 years, current...
Objective:
Inconsistent reporting of outcomes in clinical trials of treatments for Whiplash Associated Disorders (WAD) hinders effective data pooling and conclusions that can be drawn about the effectiveness of tested treatments. The aim of this study was to provide recommendations for core outcome domains that should be included in clinical trial...
Background
Movement disorders (MDs) are increasingly being managed with deep brain stimulation (DBS). High‐quality economic evaluations (EEs) are necessary to evaluate the cost‐effectiveness of DBS. We conducted a systematic review of published EEs of the treatment of MDs with DBS. The review compares and contrasts the reported incremental cost‐eff...
Introduction
Prostate cancer is the most common cancer in men. Prostatectomy is the most common treatment. Morbidity from prostatectomy is high—80% of men experience urinary incontinence which negatively impacts the quality of life. Postsurgical pelvic floor muscle training is commonly prescribed but recent systematic reviews found no evidence of e...
Study design:
Record linkage study using healthcare utilization and costs data.
Objective:
To identify predictors of higher acute-care treatment costs and length of stay for patients with traumatic spinal cord injury (TSCI).
Summary of background data:
There are few current or population-based estimates of acute hospitalization costs, length o...
Time is an extremely valuable resource, especially for children, as their time allocation among different activities has been found to affect their development outcomes. This study contributes to a broader understanding of children’s time allocation and provides insights into the effects of an unexplored channel through which poor weather condition...
We provide the first empirical evidence that better economic performances by immigrants' countries of origin, as measured by lower consumer price index (CPI) or higher gross domestic product, improve immigrants' mental health. We use an econometrically-robust approach that exploits exogenous changes in macroeconomic conditions across immigrants' ho...
Background
Whiplash-associated disorders (WAD) are an enormous and costly burden to Australian society. Up to 50% of people who experience a whiplash injury will never fully recover. Whiplash is resistant to treatment and no early management approach has yet been shown to prevent chronic pain. The early presence of central sensitization is associat...
Purpose
To evaluate the cost-effectiveness of BRCA testing in women with breast cancer, and cascade testing in family members of BRCA mutation carriers.
Methods
A cost-effectiveness analysis was conducted using a cohort Markov model from a health-payer perspective. The model estimated the long-term benefits and costs of testing women with breast c...
This study examines the trend and determinants of health expenditures in OECD countries over the 1975-2004 period. Based on recent developments in the economic growth literature we propose and test the hypothesis that health care expenditures in countries of similar economic development level may converge. We hypothesise that the main drivers for g...
Synopsis
Whiplash is a compensable injury in many jurisdictions, but there is considerable heterogeneity in the compensation arrangements that apply across jurisdictions, even within some countries. These compensation schemes have, however, been subject to a common set of interrelated concerns, chiefly concerning the incentives, behaviors, and outc...
This study contributes to a small literature on the dynamics of informal care by examining the informal care provision choices of working-age Australians. We focus on the impact of previous work characteristics (including work security and flexibility) on subsequent care provision decisions and distinguish between care that is provided to people wh...
Introduction:
A model of general practitioner (GP) and pharmacist collaboration in primary care may be an effective strategy to reduce medication-related problems and provide better support to patients after discharge. The aim of this study is to investigate whether a model of structured pharmacist and GP care reduces hospital readmissions in high...
The disentanglement of adverse selection from ex ante moral hazard remains an empirical challenge. Our comment dissects a natural experiment proposed by Chiappori and Salanié (2000) to test for ex ante moral hazard. Firstly, we argue that their test, as proposed, is too simple and too general to enable reliable inferences about the existence of ex...
Background: Tourette’s syndrome (TS) is a neuropsychiatric movement disorder. Symptoms of severe TS include involuntary tics, vocalizations and coprolalia, which can progress to affect adversely health related quality of life. Comorbidities include attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD) and affective di...
Aim: To provide a first year progress report on the NHMRC CKD.CRE. Background/Methods: The Centre is dedicated to improving knowledge of CKD and its management across the health care spectrum. Although based at The University of Queensland, the Centre includes collaborators in almost every Australian state/territory. Its core research streams are C...
This study examines the efficiency of schools in Australia and its determinants using the gain in NAPLAN test scores of students in 6,774 schools in 2009–2011. The results show that, based on empirical input–output combinations, the growth of NAPLAN test scores in Australian schools could be improved by 64 per cent by learning from best practice, o...
Empirically separating the phenomena of moral hazard and adverse selection in insurance markets has occupied researchers in this field for decades. Recently, the potential benefits of using survey data instead of claims data to control for the different dimensions of private information when testing for evidence of asymmetric information have been...
Background and Aim: Clostridium difficile is the most common cause of hospital-acquired diarrhea in Australia. In 2013, a randomized controlled trial demonstrated the effectiveness of fecal microbiota transplantation (FMT) for the treatment of recurrent Clostridium difficile infection (CDI). The aim of this study is to evaluate the cost-effectivene...
Introduction
Whiplash-associated disorders (WAD) are a huge worldwide health and economic burden. The propensity towards developing into chronic, disabling conditions drives the rise in health and economic costs associated with treatment, productivity loss and compulsory third party insurance claims. Current treatments fail to address the well-docu...
Background: Parkinson’s disease (PD) is a debilitating neurological condition, which can be effectively managed with Deep
Brain Stimulation (DBS). High-quality economic evaluations
(EEs) are necessary to test the cost-effectiveness of DBS. However,
the quality of the economic literature is mixed. A systematic
review of EEs, which compared DBS with...
Background and aim:
Clostridium difficile is the most common cause of hospital-acquired diarrhoea in Australia. In 2013, a randomised controlled trial demonstrated the effectiveness of faecal microbiota transplantation (FMT) for the treatment of recurrent Clostridium difficile infection (CDI). The aim of this study is to evaluate the cost-effectiv...
One of the arguments that is advanced in support of paid maternity leave policies is that the mother’s time away from work, around childbirth, is expected to improve child health and development. However the research evidence on these links is scarce and, until recently, little was known about the link, if any, between child health and parental lea...
This study combines an economic production framework with a latent risk theory framework to examine improvements in road safety performance of 13 Organisation for Economic Co-operation and Development (OECD) countries for the period 1975–2004. We find that, on average, total factor productivity in road safety increased by 2 per cent per annum over...
Background
Human papillomavirus (HPV) vaccines and their widespread adoption have the potential to relieve a large part of the burden of cervical cancer morbidity and mortality, particularly in countries that have low screening rates or, like Japan, lack a cohesive universal screening program. An economic evaluation was conducted to assess the cost...
Aim: To describe the newly established NHMRC Chronic Kidney Disease Centre of Research Excellence (CKD.CRE).
Background: Globally, CKD is a significant health problem. It is associated with a greatly increased risk of non-renal death and is the pathway to development of end stage kidney failure (ESKF). In Australia, the costs of renal replacement t...
To determine the cost-effectiveness of corticosteroid injection, physiotherapy and a combination of these interventions, compared to a reference group receiving a blinded placebo injection.
165 adults with unilateral lateral epicondylalgia of longer than 6 weeks duration from Brisbane, Australia, were randomised for concealed allocation to saline i...
This randomized controlled trial investigated the effectiveness and cost-effectiveness of dry-needling and exercise compared with sham dry-needling and exercise for chronic whiplash-associated disorders (WAD). The setting was a single university centre and 4 physiotherapy practices in Queensland, Australia. Eighty patients with chronic WAD (>3 mont...
This paper investigates the effects of primary school choices on cognitive and non-cognitive development in children using data from the Longitudinal Study of Australian Children (LSAC). We militate against the measurement problems that are associated with individual unobserved heterogeneity by exploiting the richness of LSAC data and applying cont...
The literature to date shows that children from poorer households tend to have worse health than their peers, and the gap between them grows with age. We investigate whether and how health shocks (as measured by the onset of chronic conditions) contribute to the income-child health gradient and whether the contemporaneous or cumulative effects of i...
To date research investigating how mental health impacts physical recovery following a road traffic crash (RTC) has focused on cohorts with severe injuries. The UQ SuPPORT study aims to study the physical and psychological outcomes of claimants with minor injuries following an RTC under the Queensland common law compulsory insurance scheme.
This pa...
Evidence suggests that brief physiotherapy programmes are as effective for acute whiplash-associated disorders as more comprehensive programmes; however, whether this also holds true for chronic whiplash-associated disorders is unknown. We aimed to estimate the effectiveness of a comprehensive exercise programme delivered by physiotherapists compar...
It is well acknowledged that the intensity of caregiving affects the labour force participation of caregivers. The literature so far has not, however, been able to control effectively for the endogeneity of caregiving intensity. This paper contributes by dealing with the endogeneity of unpaid caregiving intensity when examining its impact on the la...
Using data from Australian Taxation Statistics and Household Expenditure Surveys we analyze the distribution of health care financing in Australia over almost four decades. We compute Kakwani Progressivity indices for four sources of health care financing: general taxation, Medicare Levy payments, Medicare Levy Surcharge payments, and direct consum...
The study examines health-care accessibility in eastern Europe through the lens of individual-level unmet needs for examination or treatment. Investigated are the magnitude and nature of access barriers as well as the structure of inequality.
This article examines the trends of road traffic crash (RTC) fatality rates in OECD countries over the past four decades. Based on recent developments in the economic growth literature we propose and test the hypothesis that RTC fatality rates initially increase with economic development, peak, and then gradually decrease. The theory predicts that,...
We used five National Health Surveys (NHSs) in order to measure horizontal inequity (equal health care for equal need) in health-care utilization in Australia over five time points from 1983 to 2005. The direct standardization method was used to estimate the horizontal inequity indices for six measures of health-care utilization. The results sugges...
The term “moral hazard” when interpreted literally has a strong rhetorical tone, which has been used by stakeholders to influence public attitudes to insurance. In contrast, economists have treated moral hazard as an idiom that has little, if anything, to do with morality. This article traces the genesis of moral hazard, by identifying salient chan...