Background: When researchers' careers are disrupted by life events-such as illness or childbirth-they often need to take extended time off. This creates a gap in their research output that can reduce their chances of winning funding. In Australia, applicants can disclose their career disruptions and peer reviewers are instructed to make appropriate adjustments. However, it is not clear if and how applicants use career disruption sections or how reviewers adjust and if they do it consistently. Methods: To examine career disruption, we used surveys of the Australian health and medical research community. We used both a random sample of Australian authors on PubMed and a non-random convenience sample. Results: Respondents expressed concerns that sharing information on career disruption would harm their chances of being funded, with 13% saying they have medical or social circumstances but would not include it in their application, with concerns about appearing 'weak'. Women were more reluctant to include disruption. There was inconsistency in how disruption was adjusted for, with less time given for those with depression compared with caring responsibilities, and less time given for those who did not provide medical details of their disruption. Conclusions: The current system is likely not adequately adjusting for career disruption and this may help explain the ongoing funding gap for senior women in Australia. Funding: National Health and Medical Research Council Senior Research Fellowship (Barnett).
Background:
Evaluating integrated care programs is complex. Integration benefits may not become apparent within short evaluation timeframes, and many programs provide a wide variety of health and non-health benefits. To address these challenges, we illustrate a mixed methods approach for evaluating multiple integrated care programs using multi-criteria decision analysis.
Methods:
We adapted a decision support tool used by local decision makers to compare data extracted from 17 different integrated care evaluations. Criteria included impact on health services capacity, patient outcomes, integration of care, workforce development and implementation risk, weighted based on stakeholder preferences. Program benefits were compared to their implementation costs, and assessed using cost-effectiveness methods. Sensitivity analysis examined the impact of different criteria weights.
Results and discussion:
This method captured a diverse range of benefits provided by integrated care programs and provided an accessible heuristic to compare many projects simultaneously. However, this approach may not be sensitive to the appropriateness of each criterion to the health system, the magnitude of difference in individual criteria, equity considerations or socio-political factors. Internal and external validation, especially for subjective criteria such as implementation risk, are needed.
Conclusions:
This work offers a feasible, flexible and pragmatic approach for evaluating integrated care programs.
This article details a correction to: Blythe R, Carter H, Abell B, Brain D, Dyer C, White N, et al. Application of a Mixed Methods Multi-Criteria Decision Analysis Framework in Integrated Health Care.
International Journal of Integrated Care
. 2022; 22: 19. DOI:
http://doi.org/10.5334/ijic.5997
.
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