Professor Leonie Segal

As Foundation Chair in Health Economics, Health Economics & Social Policy Group, at the University of South Australia, I am keen to build research capacity in health economics at the University but also in the state. My research interests are broadly concerned with allocative efficiency, firstly how to determine the optimal mix of health services and secondly analysis of the drivers or incentives that can facilitate evidenced-based resource shifts. The former research interest has resulted in a large research program to develop and apply a population-based approach to priority setting, together with large scale cost-effectiveness analysis. The latter involes an on-going research program into health system issues and health reform.

CURRENT NATIONALLY COMPETITIVE RESEARCH GRANTS

‘Priority Setting in Child Protection: developing an evidence-based strategy to reduce child abuse and neglect and associated harms’. ARC Linkage Grant, with Dept of Families & Communities SA, Child, Youth & Women’s Health Service SA, Dept of Education SA, Premier & Cabinet, Social Inclusion Unit and the Dept of Health SA, with Prof Dorothy Scott, Australian Centre for Child Protection, Uni of SA and Assoc Prof Paul Delfabbro, Adelaide Uni.

'Development and implementation of an evidence-based primary healthcare workforce planning model to support best practice chronic disease management’. ARC Linkage Grant, with Dept of Health SA, Prof Robyn McDermott, Uni of SA, Prof Ester May, Dr John Glover, Adelaide Uni and Dr Rosalie Boyce, Queensland Uni.

'Methodological advancement in economic evaluation for the area of child protection’. Australian Research Alliance for Children & Youth (ARACY). Completed 31 August 2008

CDM-Net – A Broadband Health Network for Transforming Chronic Disease Management’. Clever Networks with Australian Govt, Dept of Communications, IT & the Arts; Dept of Human Services Victoria, and Clinical Investigators: Prof Leon Piterman, Monash Uni, Profs John Catford, Trisha Dunning, Deakin Uni, Prof Bruce Rasmussen, Victoria Uni, Prof Colin Chapman, Victorian College of Pharmacy, et al.

‘Building a cohort of Indigenous research leaders in community health development’ NHMRC Capacity Building in Population Health Research, with Prof. Robyn McDermott, Prof Adrian Esterman A., Prof John Buckley J., A/Prof P d’Abbs P., Dr K. Tsey

'Evaluation of Tai Chi in at-risk elderly persons' NH&MRC Project Grant, with Dr Lesly Day, Prof Leon Flicker, A/Prof Keith Hill, A/Prof Damian Jolly

‘Modelling cost effectiveness of falls interventions in the Elderly to inform a national falls strategy’, with Dr Lesley Day, et al

'PEACH study - Patient Engagement and Coaching for health: An intensive treatment intervention for patients with type 2 diabetes in disadvantaged communities' NHMRC General Practice Program, Project Grant, with Prof. Doris Young, Prof. James Best, Dr John Furler et. al.

'Validation of the Transfer to Utility technique for mapping health status onto a utility score'. NHMRC Project Grant, with Prof Graeme Hawthorne, A/Prof Tony Harris, Dr Jonothan Sturm.

Minister for Health's National Preventative Health Task Force, May 2008 -

Professional Programs and Services Advisory Committee, Evaluation Steering Committee, 2007 -

Australian Medical Council, Strategic Policy Advisory Committee, 2006 -

International Health Economists Association, 1998 -

Australian Health Economics Association, 1992 -

Advisory Committee, Public Health, Department of Human Services, Victoria. 2007

Ph.D. (in Health Economics, Monash University)

M. Econ (Monash University)

B. Econ (hons) Monash University

• My research interests concern allocative efficiency from two perspectives:- 1) What is the optimal mix of health services and; 2) What drivers or incentives will facilitate evidence-based resource shifts? The former research interest involves a large research program to develop and apply a population-based priority setting model. This has included large scale cose-effectiveness analyses of interventions to reduce disease burden associated with harmful life style behaviours, with arthritis, diabetes and neural tube defects.
• Economic theory of the health market; including an understanding of sources and nature of market failure and implications for the health service mix. Also consideration of the role of the patient/consumer in the health system potentially challenging the conventional health economics model of provider as the patients'agent.
• Priority setting - Development and application of prioity setting that supports comparison across disease stages, modalities and agencies. Economic evaluation of both simple health interventions and complex health policy initiatives, such as the National Coordinated Care Trials; using a combined qualitative and quantitative techniques and a program theory framework. Refinement of methods for cost-effectiveness analysis, such as in the translation of disparate health outcomes into quality of life utility values, and the extension of impacts beyond the individual and beyond the health sector.
• Policy analysis and contribution to the policy debate¡ especially concerning the role of private health insurance within a universal health insurance system.
• Health promotion and illness prevention, inclduing the role of life style behaviours in health and means to reduce associated disease burden and the policy options for achieving behaviour change in providers and consumers.
• Workforce planning for allied health - developing an evidenced-based model for determining the optimal level of allied health services and associated funding and workforce implications.
• Analysis of Health system reform options and exploration of reform possibilities for Australia. My health system research program has been wide-ranging and has included a critique of universal health insurance, of options for fundholding, approaches to the achievement of best practice care in the primary care setting, the value of an enhanced patient role in health care decision making and the evaluation of large health reform experiments such as the coordinated care trials.

Watts J, Segal L, 'Market failure, policy failure and other distortions in chronic disease markets', Journal of Health Research & Services, Vol 9:102, June 2009

Segal L, Dalziel K, Mortimer D, 'Fixing the game: Are between-silo differences in funding arrangements handicapping some interventions and giving others a head-start?', Health Economics, June 2009

Segal L, Bolton T, 'Issues facing the future health care workforce: the importance of demand modelling', Australia and New Zealand Health Policy, Vol 6:12, May 2009

Segal L, 'The Place of Prevention in the Health Care System: An economics perspective', Public Health Bulletin, Department of Health SA, Vol 6:1, pp22-26, March 2009

Dalziel K, Segal L, 'Economic Evaluation in Child Protection: What are the Special Challenges?’ Economic Evaluation in Child Health, Book Chapter, Oxford Press, In Press 2009

Day L, Finch C, Segal L, ‘Reducing injuries from falls' New England Journal of Medicine. Vol 359:1626 No 15, Letter to the Editor, October 2008

Hawthorne G, Densley K, Pallant J, Mortimer D, Segal L, ‘Deriving utility scores from the SF-36 using ordinal Rasch analysis, Quality of Life Research, Vol 17:9, pp 1183-1193, September 2008

Segal L, ‘A new Model of Primary Care’ A paper for the National Health Hospital Reform Commission, September 2008, available at www.nhhrc.org.au

Watts J, Segal L, ‘Vouchers for chronic disease care’, Australian Health Review 2008, Vol 32:3, pp 451-458, August 2008

Segal L, Dalziel K, ‘A Workforce model to support the adoption of best practice care in Chronic Diseases – A missing piece in clinical guidelines implementation’, Implementation Science, Vol 3:35, June 2008

Dalziel K, Segal L, Mortimer D, ‘Review of Australian Economics Evaluation - 245 interventions: What can we say about cost-effectiveness?’, Cost Effectiveness and Resource Allocation 2008, Vol 6:9, May 2008

Mortimer, D, Segal, L, ‘Is the value of a life or life-year saved context specific? Further evidence from a discrete choice experiment’, Cost Effectiveness and Resource Allocation, Vol 6:8, May 2008

Dalziel K, Segal L, Ratcliffe J, ‘Economic evaluation in the area of child protection – Past, Present and Future’ ARACY briefing paper, April 2008

Mortimer D, Segal L, ‘Comparing the incomparable? A systematic review of competing techniques for converting descriptive measures of health status into QALY-weights’, Medical Decision Making, Vol 28:1, pp66-89, February 2008

Dalziel K, Segal L, ‘Time to give nutrition interventions a higher profile: Cost-utility analysis of 10 nutrition interventions’, Health Promotion International, Vol 22:4, pp271-283, December 2007

Mortimer D, Segal L. Hawthorne G, Harris A, ‘Item-based versus subscale-based mappings from the SF-36 to a preference-based quality of life measure’ Value in Health, Vol 10:5, pp398-407, November 2007

Segal L, Dalziel K ‘Analysis and interpretation of child protection data: a comment on Ainsworth and Hansen (2006;11:33-41)’, Child and Family Social Work, Vol 12:4, pp434-35, 2007

Segal L. ‘Multidisciplinary care plans improve care for patients with type 2 diabetes: Is it the care plans or the multi-disciplinary care?’ Comment; Australian Family Physician, Vol 36:9 p.679, May 2007

Young D, Furler J, Vale M, Walker C, Segal L, Dunning P, Best J, Blackberry I, Audehm R, Sulaiman N, Dunbar J, Chondros P, ‘Patient Engagement and Coaching for Health: The PEACH study - A cluster randomised controlled trial using the telephone to coach people with type 2 diabetes to engage with their GPs to improve diabetes care: A Study Protocol’ BMC Family Practice, Vol 8:20,(open access journal), April 2007

Segal L, Dalziel K, ‘Economic evaluation of obesity interventions in children and adults’ International Journal of Obesity, Vol 31, pp1183-1184, March 2007

Segal L, Dalziel K, 'Analysis and interpretation of child protection data: a comment on Ainsworth and Hansen (2006; 11:33-41), Child and Family Social Work, Vol 12:4, pp434-435, 2007

I am able to provide media comment in the following areas of expertise:

Discipline: health sciences

• Health Economics
• Primary Health
• Child Protection
• Workforce Planning
• Public Health