title: The health outcomes and costs of people attending an interdisciplinary chronic disease service in regional Australia: protocol for a longitudinal cohort investigation.
abstract: BACKGROUND
  Rates of chronic disease are escalating around the world. To date health service evaluations have focused on interventions for single chronic diseases. However, evaluations of the effectiveness of new intervention strategies that target single chronic diseases as well as multimorbidity are required, particularly in areas outside major metropolitan centres where access to services, such as specialist care, is difficult and where the retention and recruitment of health professionals affects service provision.
  
  
  METHODS
  This study is a longitudinal investigation with a baseline and three follow-up assessments comparing the health and health costs of people with chronic disease before and after intervention at a chronic disease clinic, in regional Australia. The clinic is led by students under the supervision of health professionals. The study will provide preliminary evidence regarding the effectiveness of the intervention, and evaluate the influence of a range of factors on the health outcomes and costs of the patients attending the clinic. Patients will be evaluated at baseline (intake to the service), and at 3-, 6-, and 12-months after intake to the service. Health will be measured using the SF-36 and health costs will be measured using government and medical record sources. The intervention involves students and health professionals from multiple professions working together to treat patients with programs that include education and exercise therapy programs for back pain, and Healthy Lifestyle programs; as well as individual consultations involving single professions.
  
  
  CONCLUSIONS
  Understanding the effect of a range of factors on the health state and health costs of people attending an interdisciplinary clinic will inform health service provision for this clinical group and will determine which factors need to be controlled for in future observational studies. Preliminary evidence regarding changes in health and health costs associated with the intervention will be a platform for future clinical trials of intervention effectiveness. The results will be of interest to teams investigating new chronic disease programs particularly for people with multimorbidity, and in areas outside major metropolitan centres.
  
  
  BACKGROUND
  Australia and New Zealand Clinical Trials Registry: ACTRN12611000724976.
authors.affiliation: Institute of Health and Biomedical Innovation and School of Public Health & Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia. steven.mcphail@health.qld.gov.au.
authors.forename: Zephanie
authors.initials: Z
authors.lastname: Tyack
authors.forename: Kerrie-Anne
authors.initials: KA
authors.lastname: Frakes
authors.forename: Petrea
authors.initials: P
authors.lastname: Cornwell
authors.forename: Suzanne S
authors.initials: SS
authors.lastname: Kuys
authors.forename: Adrian G
authors.initials: AG
authors.lastname: Barnett
authors.forename: Steven M
authors.initials: SM
authors.lastname: McPhail
mesh_terms: D001315:Australia; D002908:Chronic Disease / Q000191:economics / Q000628:therapy*; D002985:Clinical Protocols; D003695:Delivery of Health Care / Q000191:economics / Q000379:methods* / Q000458:organization & administration; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D010348:Patient Care Team / Q000191:economics / Q000458:organization & administration