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

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22. Indigenous specific positions are identified and funded for prevention and healthpromotion programs, supported by a training and travel budget.23. The composition of PCD Program team is reviewed to ensure each regional team includesa member with health promotion qualifications and experience, and an Indigenousmember.24. The role of AHW participation in chronic disease programs across all Government andnon-government sectors be reviewed, prioritised and invested in.25. A benchmark for AHW participation in chronic disease programs is established, forexample: 30 per cent to reflect the population. This is reviewed annually and trienniallyto ensure the benchmark is being met.26. A resource strategy is developed to fund an increased remote area workforce.27. Barriers to program activity are identified and addressed in a comprehensive way.Evaluation of the NT Preventable Chronic Disease Strategy 2007xviii
CHAPTER 1. INTRODUCTION1.1 BackgroundIn the late 1990s, it became apparent that the economic and social costs of chronic diseases inthe Northern Territory were escalating, and that the current health system had limited capacity todeal with these increasing costs. Between 1992-93 and 1997-98 renal dialysis service in the NTdoubled, with an associated financial burden (9) . In 1997 it was estimated that chronic diseaseaccounted for about 25 per cent of the hospital budget, about 40 per cent in 1999 and, ifuncontrolled, was predicted to consume 56 per cent of the budget by 2004 (10) . Between 2000/01and 2002/03, excluding renal dialysis, about 7 per cent of hospital resources were used forhospitalisations directly caused by acute manifestations of chronic diseases. Renal dialysisaccounts for about 45 per cent of hospital resources when included, due to chronic diseaserelated hospitalisations (11) .The Northern Territory Preventable Chronic Disease Strategy (NTPCDS) was launched in August1999 by the NT Minister for Health, Family and Children‟s Services (1 p 2) . It is a strategic attemptto bring about change in the prevention, early detection and management of chronic diseases atall levels of the health care system in the NT. The strategy has a three-year goal, a ten-year goal,and a number of objectives it aims to achieve in key result areas.An evaluation of the NTPCDS was intended in 2002 to assess progress against achieving the 3-year goals, but this did not occur. In 2005-06 the community physician, supported by a projectofficer, undertook an evaluation process that consisted of a document review and thedevelopment of a draft report. In 2006, a gaps analysis was undertaken to identify those areasthat needed more information.In March 2007 RhED Consulting Pty Ltd was commissioned by the NT Department of Health andCommunity Services (NTDH&CS) to complete the evaluation of the NTPCDS.Terms of referenceThe terms of reference to complete the evaluation of the NTPCDS required the RhED consultingteam to:Chapter 1: Introduction – Evaluation of the NT Preventable Chronic Disease Strategy 2007 1
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: Exploration of joint funding arrang
Page 21 and 22: Choosing the 5 chronic conditionsTh
Page 23 and 24: Table 1.1Key Result Areas + Best Bu
Page 25 and 26: prior to the launch of NTPCDS, such
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
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1 x AHW Central Australia 2001 S100
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One clinic stated it had no care pl
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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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