Health Services Research Centre
There has been a long tradition of health services research in the former Department of Public Health Medicine and Epidemiology, now UCD School of Public Health and Population Science. This research has encompassed cross-university and inter-institutional research and has been funded through a range of international and national funding agencies. Currently the health services research hub holds grants totalling €2,387,779.
The Health Research Centre
In 1999 the Health Research Centre was established by the Academic Council to carry out interdisciplinary research, with Professor Leslie Daly of the former Department of Public Health Medicine and Epidemiology as Director. The objectives of this Centre were to enhance health research, specifically health services research, within UCD and to facilitate collaboration in health services research within the University by providing a focus and a structure for collaboration and interdisciplinary communication. The members of the centre were drawn from the Faculties of Medicine, Arts and Commerce. The Centre was closely allied to ISSC. It became clear that under the revised structures in UCD the Centre could have a valuable cross-school and college role. The Centre moved to the new UCD School of Public Health and Population Science, within the College of Life Sciences.
Current research
Current funded research in the UCD School of Public Health and Population Science falls under seven major headings, as follows:
- Health services manpower / medical training
- Cancer
- Blood transfusion services
- Injury
- Smoking cessation services
- Occupational
- Maternity services
- Health information systems
Research is funded through international agencies, including the EU and the Cochrane Collaboration, through national agencies, including the Health Research Board, and through commission from Government Departments. Two Health Services Research Fellowships have been awarded by the HRB, one completed and the other nearing successful completion.
Manpower/ Medical training
The School has been to the fore in health services research related to manpower and medical training. In 2004 we were commissioned by the Medical Manpower Taskforce of the Department of Health and Children to undertake a major career tracking study of Irish medical graduates. This study was carried out in anticipation of major changes in the structure and delivery of medical education and training in Ireland and, the European Working Time Directive (EWTD), which has applied to doctors in training as of the 1st August 2004. It provided a comprehensive insight into the careers of two recent cohorts of Irish medical graduates and the issues surrounding medical education and training. The report “Career Tracking Study. Factors affecting career choices and retention of Irish Medical Graduates” was published in conjunction with the Final Report of the Postgraduate Medical Education and Training Group “Preparing Ireland’s doctors to meet the Health Needs of the 21st Century” in August 2005.
In 2004, we undertook a Postgraduate Medical and Dental Board-funded study of postgraduate training requirements in the area of research methods, with creation of on-line support materials. We were also funded through the Health Promoting Hospital Association to examine health promotion activities in hospitals countrywide, and to undertake a needs assessment in the area of staffing requirements for health promotion.
Cancer HSR In 2004, in collaboration with the National Cancer Registry, we were awarded a major HRB Research and Development Grant for a major study of cancer economics. The aim is to carry out a comprehensive assessment of the economic impact of cancer and cancer services in the island of Ireland. In an innovative association between the National Cancer Registry and University College Dublin, we propose to build on UCD's recent appointment of a highly experienced health economist, and the strong tradition of cancer epidemiology here, to carry out an ambitious and highly innovative economic study of the burden of cancer in Ireland.
The Prostate Cancer Consortium is a major Irish Cancer Society funded collaborative research initiative in the area of prostate cancer, incorporating most of the major Dublin Teaching Hospitals, UCD, Trinity College Dublin and the Dublin Molecular Medicine Consortium. As part of this consortium specific funded research in the School is addressing attitudes to tumour banking and genetic profiling among urological patients.
Blood Transfusion HSR – Establishment of TRNI
Maintenance of an adequate and safe blood supply is essential in a modern health care system. Availability of blood for clinical use depends on the maintenance of donation levels, efficient blood bank stock management, and appropriate clinical usage. However, evidence that there is substantial variation in transfusion practice has been produced recently in Ireland (NBSIG report 2004). The reasons for this variation are unclear.
UCD School of Public Health & Population Science in association with the Irish Blood Transfusion Service (IBTS) and the National Blood Strategy Implementation Group has undertaken a major series of interrelated surveys of transfusion activity, surgical transfusion practice and hospital blood stock management, funded through a major HRB North-South Co-operative Grant and other funding. These highlighted the need for good quality data to inform practice change and the planning blood transfusion services. Participation rates by stakeholders were high and good working relationships have been established between academic and service partners (NBSIG 2004). The common interests of these groups were instrumental in establishing the Transfusion Research Network in Ireland (TRNI). This network will provide resources to assist with the design and conduct of research in all aspects of transfusion medicine, including clinical trials.
The overall aim of the Network is to contribute to the knowledge base of transfusion medicine and to improve the quality of transfusion practice for the benefit of donors and recipients. The current work of the Network is in applying operations research techniques to model donor behaviour and blood flows in the transfusion system.
Injury HSR
Injury mortality is the fourth commonest cause of death in Ireland. The treatment of injuries has a major impact on our hospitals and on our budget for health. Long term disability following accidents is a serious problem. We undertook the first major reports on injury in Ireland, funded by the HRB. The aim of this report was to examine the impact of accidents and injuries on the Irish population by analysing routine mortality and morbidity data, and to identify in turn those areas where preventive measure could have an impact. The School established a national injury network of researchers, launched in 2002.
The Department of Preventive Medicine and Health Promotion, St Vincent’s University Hospital is run by the UCD School of Public Health and Population Science. This is a uniquely placed department with a long tradition in cardiovascular health services research. The department provides a wide range of clinical and smoking cessation services, informed by health services research conducted within the department.
We are currently leading an EU-funded international collaborative study assessing the impact of providing a nurse specialist. The research addresses best practice in relation to both patients and hospital staff. Working in co-operation with the Departments of Occupational Health and Pharmacy, smoking cessation support and free nicotine replacement therapy were offered to staff.
We have received funding through the cardiovascular strategy for health services research. We have recently conducted an innovative qualitative study addressing the patient and staff perceptions of health and safety issues related to the workplace smoking ban. This funding has also facilitated a smoking discharge study, aimed at the determination of factors related to success in smoking cessation in patients post acute hospital discharge, with a view to informing health promotion activities
Occupational HSR We have been commissioned by the Department of Defence to undertake a study of army and garda personnel who may have been exposed to depleted uranium during the course of peacekeeping duties in Bosnia-Herzegovina and Croatia. A baseline survey is currently being carried out on all potentially exposed personnel and control group personnel with long term follow up potential.
The former Department of Public Health Medicine & Epidemiology were funded by Teagasc in 1989 to undertake an epidemiological investigation of mortality, particularly cancer-related deaths, among their employees. An excess of mortality from bladder and brain tumours was found. Currently Teagasc are in discussions with the UCD School of Public Health and Population Science regarding a further follow-up of the cohort.
Maternity Services
Two PhD students have successfully undertaken major studies of Dublin Maternity Services funded by the Health Research Board; a review of the processes of public maternity services across the three Dublin maternity hospitals and patient satisfaction with the services (funded through a Health Services Research Fellowship) and a study of needs and care of asylum seekers and refugees presenting for maternity care (funded through a project grant).
Health Information Systems for HSR
Health information systems are essential to health services research. The School was critical to the drafting and development of the National Health Information Strategy, funded by the Department of Health and Children.