PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...

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3. Chronic disease programs – There will be chronic disease programs operating in allhealth centres and general practices, aiming at early detection and best practicemanagement, and staff will be designated to run these programs. (programs)4. Best practice guidelines – All clients will be offered care based on locally producedand up-to-date best practice guidelines. (clinical)5. Population lists and recall systems – There will be updated population lists in allcommunity health centres and a recall system, either paper-based or computerised,in all community health centres and general practices. (systems)6. Health promotion programs – Programs aimed at encouraging healthy living will beoperating in urban, rural and remote communities. They may be run from healthcentres, schools, women‟s centres, community councils or elsewhere, but will besupported by health centre staff taking a primary health care approach and using ahealth promotion model. (prevention)7. Community Control – There will be a greater degree of community control overhealth services, through a variety of mechanisms.8. NGO prevention funding – Non-government organisations in the wider society will befunded to deliver specific preventive programs. (prevention funding)9. ACCHO preventative funding – Aboriginal community controlled health services willbe funded to deliver key preventive programs, and early detection and best practiceclinical management services, to defined segments of the population in specificlocations. (funding)10. Intersectoral action – There will be intersectoral action promoting good nutrition,adequate environmental health standards, greater physical activity, safe alcoholconsumption and non-smoking. (prevention)11. Whole of government approach – Whole of government approach will lead to bettereducational outcomes and improved employment opportunities for the Indigenouspopulation (13) . (workforce)1.3 Summary of factors impacting on the NTPCDS development andimplementationAt the time the NTPCDS was launched in 1999 the Minster flagged that the strategy would needto be dynamic and modifiable (10) . He outlined a number of national and Northern Territoryinitiatives that offered opportunities to integrate the lessons learnt from activities that occurredChapter 1: Introduction – Evaluation of the NT Preventable Chronic Disease Strategy 2007 6
prior to the launch of NTPCDS, such as the Coordinated Care Trials, into programs planned forthe future.To provide a context for the NTPCDS evaluation, a summary of events that facilitated or informedthe development of the NTPCDS in 1999, plus the key actions that have occurred since that timethat have contributed to achieving its objectives, have been summarised into Table 1.2. The tableincludes major clinical studies, policy changes, programs funded, health reports, programinitiatives and workforce information and their outcomes.Table 1.2Summary of events leading to PCDS development and achievement of goals.* P – Policy • R – Review/Clinical Study • W – Workforce • F – Funded Programs • S - ReportsYear * Action Outcome1995 F CoAG – Council of AustralianGovernments introduces a 3-yearreform plan in response to chronicdisease.It introduces• Outcome / output funding• Broad banding of programs• Allocates capital to care streams –including CC trial with incentives.1995 P NT Food and Nutrition Policy andStrategic Plan 1995-2000 weredeveloped.1996/97 F CoAG Funding allocated. Funding allocated to:1997 R NT Chief Health Officer convenes aworking party (12) to develop anintegrated response to the extremelyhigh incidence of chronic renal failureand chronic disease.The Territory Food project developedresources to promote healthy eating. It alsosupports community nutritionists andcommunity nutrition workers in selectedcommunities.• Improve access to health care inrural/remote areas,• Address the perceived rural healthworkforce crisis• Establish nationally consistent paymentand information systems (15) .The development of the NT PreventableChronic Disease strategy is commissioned.1997 P The Commonwealth-funded NTAboriginal and Torres Strait IslanderCoordinated Care Trials (IndigenousCCT) two new health servicescovering Tiwi Islands and KatherineWest areas. Additional fundsprovided a platform for developingand testing models of coordinatedcare.During these trials, the under-utilised PBS andMBS funds for these areas were “cashed out”on a per capita arrangement (16) and pooledwith funds from NT and other sources to bedirected towards health-care in these regions(17) .Chapter 1: Introduction – Evaluation of the NT Preventable Chronic Disease Strategy 2007 7
Page 1 and 2: Pty LtdABN 82 147 637 101AN EVALUAT
Page 3 and 4: TABLE OF CONTENTSList of figuresLis
Page 5 and 6: 6.6 Indigenous workforce 996.7 Prev
Page 7 and 8: List of AbbreviationsABCDACCHOsACIC
Page 9 and 10: ACKNOWLEDGEMENTSWe would like to ac
Page 11 and 12: However the extraordinary number of
Page 13 and 14: the establishment of the Sunrise He
Page 15 and 16: RECOMMENDATIONSGeneral recommendati
Page 17 and 18: Exploration of joint funding arrang
Page 19 and 20: CHAPTER 1. INTRODUCTION1.1 Backgrou
Page 21 and 22: Choosing the 5 chronic conditionsTh
Page 23: Table 1.1Key Result Areas + Best Bu
Page 27 and 28: Year * Action Outcome1999 S NT Prev
Page 29 and 30: Year * Action Outcome2005 P Aborigi
Page 31 and 32: CHAPTER 2.EVALUATION METHODOLOGYThe
Page 33 and 34: 2.2 Evaluation StagesThe NTPCDS eva
Page 35 and 36: chronic disease activities funded t
Page 37 and 38: internal project team. It was very
Page 39 and 40: Situation at Baseline1. The Guideli
Page 41 and 42: 3.1.2 Patient information and recal
Page 43 and 44: Ferret Miwatj, Numbulwar, Marngarr,
Page 45 and 46: Medicare information is not for pub
Page 47 and 48: was in place in Central Australia i
Page 49 and 50: What orientation and ongoing traini
Page 51 and 52: programs focus on chronic disease p
Page 53 and 54: The information collected as part o
Page 55 and 56: Assessment against objectiveMost se
Page 57 and 58: career development, and retention i
Page 59 and 60: are. Indigenous employment is NTDH&
Page 61 and 62: NTDH&CS Programs that encourage Hea
Page 63 and 64: 2002 Aboriginal and Torres Strait I
Page 65 and 66: delivering any prevention and healt
Page 67 and 68: The Community Services Division - A
Page 69 and 70: 1 x AHW Central Australia 2001 S100
Page 71 and 72: One clinic stated it had no care pl
Page 73 and 74: Identifies priority practices to in
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There has been a significant growth
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about 25 per cent of the hospital b
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The level of funding provided by th
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Central Australia and two zones cur
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The diabetes education teams at HLN
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maintenance group for people with l
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Rebates for participating or arrang
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Use of Medicine Programmes. Althoug
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CHAPTER 4. CLINICAL OUTCOMES OF THE
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improvements have been made to serv
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A recent ten-year follow-up of a co
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The NTDH&CS also collect birthweigh
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Figure 5.3 Vaccination coverage for
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It is also important to note that k
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eported that 50 per cent of the Ind
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The current action plan identifies
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The availability and cost of health
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Hoy et al in 1995-2000 (100) , and
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5.6 Best practice management5.6.1 P
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disease care in urban areas regardi
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PCIS was developed by NTDH&CS as th
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emote staff can access training and
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In the Top End there appeared to be
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APPENDIX 1EVALUATION OF THE NT PREV
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2.10 Generally speaking, on a scale
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4.4 Briefly recount any anecdotes y
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5.9 Generally speaking, on a scale
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Section 8 • Summary questions8.1
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Preventable Chronic Disease Program
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Year Type Background What is it? /
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Year Type Background What is it? /
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An important background to this stu
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New beliefs do not replace the old,
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Other services are provided to the
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ecame the main priority in many peo
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to be healthy, how to get rid of di
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(Draft Version - © August 2006 Jan
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References1. Dunham, H., Ministeria
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35. Smith, J.D., Progress report fo
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Research Centre for Aboriginal Heal
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114. Senior, K., 'A Gudbala Laif? h
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