Chronic disease profiles in remote Aboriginal settings and implications for health services planning

Hoy, Wendy E., Davey, Rebecca L., Sharma, Suresh, Hoy, Phillip W., Smith, Joanna M. and Kondalsamy-Chennakesavan, Srinivas (2010) Chronic disease profiles in remote Aboriginal settings and implications for health services planning. Australian and New Zealand Journal of Public Health, 34 1: 11-18. doi:10.1111/j.1753-6405.2010.00467.x

Author Hoy, Wendy E.
Davey, Rebecca L.
Sharma, Suresh
Hoy, Phillip W.
Smith, Joanna M.
Kondalsamy-Chennakesavan, Srinivas
Title Chronic disease profiles in remote Aboriginal settings and implications for health services planning
Journal name Australian and New Zealand Journal of Public Health   Check publisher's open access policy
ISSN 1326-0200
Publication date 2010-02
Sub-type Article (original research)
DOI 10.1111/j.1753-6405.2010.00467.x
Volume 34
Issue 1
Start page 11
End page 18
Total pages 8
Editor Jeanne Daly
John Lowe
Priscilla Robinson
Sandra Thompson
Alistair Woodward
Place of publication Carlton, VIC, Australia
Publisher Blackwell Publishing
Collection year 2011
Language eng
Formatted abstract
Objective: To report the short-term experiences and outcomes of a program to support chronic disease management in three remote communities in Top End Northern Territory and in two Aboriginal Medical Services (AMSs) in Western Australia, and to discuss the implications of findings for health service delivery and policy.

Methods: Programs were health-worker centred. They espoused regular screening of all adults for chronic disease, initiation and modification of treatment where indicated and rigorous documentation. Process measures were documented and rates of hypertension, renal disease and diabetes among adults were calculated.

Results: Rates of hypertension, proteinuria and diabetes rose throughout adult life and multiple diagnoses were common. Most people with these conditions were young or middle age adults. Rates were uniformly excessive relative to AusDiab data, but varied greatly among settings. Adherence to protocols improved, many new diagnoses were made, treatments were started or modified and blood pressures in treated hypertensive people fell. In the NT, productivity was seriously limited by lack of health workers and their absenteeism. In the WA AMSs, executive and staff support carried the programs forward to a sustainable future, despite various challenges.

Conclusions: Integrated chronic disease testing must be repeated throughout adult life for timely diagnosis. Health workers can perform all tasks well, with appropriate supports. Blood pressure outcomes alone predict lower cardiovascular and renal mortality. The findings support incorporation of chronic disease into lifetime health care plans.
© 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia
Keyword Chronic disease
Health profiles
Health services
Health services funding
Cardiovascular risk
Australian Aborigines
Excess risk
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 15 times in Thomson Reuters Web of Science Article | Citations
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Created: Sun, 28 Feb 2010, 00:06:27 EST