Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/10281
Title: Determinants and Gaps in Preventive Care Delivery for Indigenous Australians: A Cross-sectional Analysis.
Authors: Bailie, Christopher
Matthews, Veronica
Bailie, Jodie
Burgess, Paul
Copley, Kerry
Kennedy, Catherine
Moore, Liz
Larkins, Sarah
Thompson, Sandra
Bailie, Ross Stewart
Affiliation: School of Medicine, University of Queensland , Brisbane, QLD , Australia..
Menzies School of Health Research, Charles Darwin University , Darwin, NT , Australia..
Menzies School of Health Research, Charles Darwin University , Darwin, NT , Australia..
Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; Primary Health Care Branch, Top End Health Service, Northern Territory Government, Darwin, NT, Australia..
Aboriginal Medical Services Alliance NT (AMSANT) , Darwin, NT , Australia..
Maari Ma Health Aboriginal Corporation , Broken Hill, NSW , Australia..
Aboriginal Medical Services Alliance NT (AMSANT) , Darwin, NT , Australia..
College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia; Anton Breinl Research Centre for Health Systems Strengthening, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia..
Western Australian Centre for Rural Health, School of Primary, Aboriginal and Rural Health Care, University of Western Australia , Geraldton, WA , Australia..
Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; School of Population Health, University of Queensland, Brisbane, QLD, Australia..
Issue Date: 2016
Citation: Frontiers in public health 2016; 4: 34
Abstract: Potentially preventable chronic diseases are the greatest contributor to the health gap between Aboriginal and Torres Strait Islander peoples and non--Indigenous Australians. Preventive care is important for earlier detection and control of chronic disease, and a number of recent policy initiatives have aimed to enhance delivery of preventive care. We examined documented delivery of recommended preventive services for Indigenous peoples across Australia and investigated the influence of health center and client level factors on adherence to best practice guidelines. Clinical audit data from 2012 to 2014 for 3,623 well adult clients (aged 15-54) of 101 health centers from four Australian states and territories were analyzed to determine adherence to delivery of 26 recommended preventive services classified into five different modes of care on the basis of the way in which they are delivered (e.g., basic measurement; laboratory tests and imaging; assessment and brief interventions, eye, ear, and oral checks; follow-up of abnormal findings). Summary statistics were used to describe the delivery of each service item across jurisdictions. Multilevel regression models were used to quantify the variation in service delivery attributable to health center and client level factors and to identify factors associated with higher quality care. Delivery of recommended preventive care varied widely between service items, with good delivery of most basic measurements but poor follow-up of abnormal findings. Health center characteristics were associated with most variation. Higher quality care was associated with Northern Territory location, urban services, and smaller service population size. Client factors associated with higher quality care included age between 25 and 34 years, female sex, and more regular attendance. Wide variation in documented preventive care delivery, poor follow-up of abnormal findings, and system factors that influence quality of care should be addressed through continuous quality improvement approaches that engage stakeholders at multiple levels (including, for example, access to care in the community, appropriate decision support for practitioners, and financial incentives and context appropriate guidelines).
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/10281
DOI: 10.3389/fpubh.2016.00034
ISSN: 2296-2565
Type: Journal Article
Subjects: Aboriginal and Torres Strait Islander
adherence to best practice guidelines
indigenous
preventive healthcare
quality of care
variation
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