Review of Nationally Funded Centres Pancreas Transplant Program
Project Type - Acute Care, Health technology assessment
The South Australian Department for Health and Ageing appointed Health Outcomes International (HOI) in January 2014 on behalf of the Nationally Funded Centres (NFC) Reference Group to undertake a review of the NFC Pancreas Transplantation Program.
The objectives of the NFC Program are to ensure that there is optimal access to certain high cost, low demand, new and emerging technologies regardless of geographical location, in the context of workforce and resource availability.
Currently two sites are funded by the NFC to provide the Pancreas Transplantation Program are:
- Westmead Hospital, New South Wales
- Monash Medical Centre, Victoria.
The objective of this current review is to provide the NFC Reference Group with a report that includes recommendations on the need for, and benefits of, continued service concentration under the NFC Program.
The review methodology designed by HOI included quantitative and qualitative analysis to address the review criteria as outlined in the NFC Guidance for Governance, Management, Funding, Establishment, Review, September 2011 (the NFC Guidance). This included:
- analysis of the submissions provided by each of the NFC pancreas transplantation sites to the NFC Reference Group
- a comprehensive literature review of international trends in Pancreas Transplantation
- case study visits to the NFC sites
- telephone consultations with jurisdictional representatives and stakeholders
- an online survey of referrers and
- an analysis of the cost of pancreas transplantation care pathways
HOI completed a comprehensive assessment of the performance of the NFC PT reporting on:
- access to the NFC, including: criteria for patient selection; analysis of patient numbers and referral sources of patients; equity of access and outcomes of accepted referrals.
- the health outcomes achieved with respect to: care pathway; patient and graft survival; quality of life.
- the model of care and service delivery, including: the continuum of care; service elements supporting the continuous; referrer perspectives; and patient perspectives.
- the non-inpatient (outpatient) services provided
- the quality and safety in terms of complications and adverse events.
- teaching training and research activities in terms of: ongoing teaching and training requirements and activities; research achievements.
- future clinical practice to be considered for the NFC Pancreas Transplantation Program, including a comparison of outcomes for Simultaneous Pancreas-Kidney Transplantation (SPK), Pancreas after kidney transplantation (PAK) and Pancreatic Transplantation alone (PTA).
- assessment of existing and future demand taking into account changes in clinical practice
- the costs of delivering the NFC PT Program for both care pathways, and recommended a price per procedure for pancreas transplantations funded by the NFC Program.