PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...
PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ... PCD Strategy Evaluation 2007.pdf - NT Health Digital Library ...
Figure 3.3Number of accredited practices participating in the PIP and the proportion ofGeneral Practice services provided by these practices. (66)The report also looked at the proportion of people with diabetes mellitus who have received anannual cycle of care within general practice. Australia wide, there were an estimated 744,975people with known diabetes mellitus whose condition was managed by PIP practices during 2002.Of these people, 18.2 per cent received an annual cycle of care for diabetes. Large rural areashad the highest proportion of people who had received an annual cycle of care (20.1 per cent ),closely followed by other metropolitan areas (19.5 per cent ). The proportion was lowest forremote centres (9.3 per cent ) eligible for claims not receiving services? Because the NT had farfewer accredited practices compared to the rest of Australia, the proportion of people receivingan annual cycle of care in diabetes would probably be even smaller than these figures suggest.DiscussionThe growth in positions funded by the NTDH&CS to deliver chronic disease programs has largelybeen in nursing with a slight change in skills mix to target people with public health skills to takeon the PCD program role. There has been very few Aboriginal Health Worker positions orAboriginal specific positions. In fact over the last 7 years there has been a decline in the numberof health workers employed in remote communities, due to recruitment and retention issues,with many positions reported as being vacant. This has compromised the effectiveness of thePCD program particularly in their capacity to deliver regular screening and an active chronicdisease recall system in communities.Chapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 56
There has been a significant growth in the number of people employed in health services thatwere funded in round 1 of the Healthy for Life program and increases will also occur in the nearfuture for round 2 sites as funding for their implementation plan is released. These willpredominantly be in ACCHOs. There has also been growth in staff in the PHCAP zones. InCentral Australia this has included 2 medical officers, 2 additional community nutritionists, apublic health nurse (as identified previously).While there is some coordination across all these bodies and some shared use of resources, suchas the CARPA guidelines used by all AHSs, there is the potential for any organisation to developits own separate guidelines and policies. Similarly, the ability to audit what is done acrossdifferent organisations is also limited, unless services participate in programs such as the Auditand Best Practice for Chronic Disease extension project (ABCD) and the NPCC, but thisinformation is only released with the permission of the serviceWithin the NTDH&CS, there is a need for coordination of a large number of programs directed atchronic disease management scattered across most Divisions. Interviews revealed thatcoordination between the PCD team and the remote health services could improve, particularly inCentral Australia where communication, coordination and planning between these services is lessthan optimal. It appeared better in the Top End and this may be assisted by the collocation ofthe PCD with the Remote Health Services. Whereas, in Central Australia the PCD team and theRemote Health services are accommodated in 2 distinct locations.There are also a number of general practice representative bodies, which have policies aboutchronic diseases or programs in this area. General practices are largely reimbursed by federalfunding arrangements with support from programs offered through the Divisions to assist withsystems and professional development. The Australian Government has attempted to increasemultidisciplinary care and continuity of care, by providing reimbursement for these activities butthe uptake in general practice and community controlled organisation has been lower than otherareas because of the lack of access to allied health professionals, who can claim the EPC items orincentives offered. This was identified as being a particularly acute problem in Katherine as mostof the services in and around Katherine have chronic disease programs with people on care planswho need access to allied health services. Priority areas for action included access to dieticiansand podiatrists.Chapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 57
- Page 23 and 24: Table 1.1Key Result Areas + Best Bu
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- Page 27 and 28: Year * Action Outcome1999 S NT Prev
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- Page 33 and 34: 2.2 Evaluation StagesThe NTPCDS eva
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- Page 37 and 38: internal project team. It was very
- Page 39 and 40: Situation at Baseline1. The Guideli
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- Page 43 and 44: Ferret Miwatj, Numbulwar, Marngarr,
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- Page 69 and 70: 1 x AHW Central Australia 2001 S100
- Page 71 and 72: One clinic stated it had no care pl
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- Page 93 and 94: improvements have been made to serv
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- Page 113 and 114: disease care in urban areas regardi
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Figure 3.3Number of accredited practices participating in the PIP and the proportion ofGeneral Practice services provided by these practices. (66)The report also looked at the proportion of people with diabetes mellitus who have received anannual cycle of care within general practice. Australia wide, there were an estimated 744,975people with known diabetes mellitus whose condition was managed by PIP practices during 2002.Of these people, 18.2 per cent received an annual cycle of care for diabetes. Large rural areashad the highest proportion of people who had received an annual cycle of care (20.1 per cent ),closely followed by other metropolitan areas (19.5 per cent ). The proportion was lowest forremote centres (9.3 per cent ) eligible for claims not receiving services? Because the <strong>NT</strong> had farfewer accredited practices compared to the rest of Australia, the proportion of people receivingan annual cycle of care in diabetes would probably be even smaller than these figures suggest.DiscussionThe growth in positions funded by the <strong>NT</strong>DH&CS to deliver chronic disease programs has largelybeen in nursing with a slight change in skills mix to target people with public health skills to takeon the <strong>PCD</strong> program role. There has been very few Aboriginal <strong>Health</strong> Worker positions orAboriginal specific positions. In fact over the last 7 years there has been a decline in the numberof health workers employed in remote communities, due to recruitment and retention issues,with many positions reported as being vacant. This has compromised the effectiveness of the<strong>PCD</strong> program particularly in their capacity to deliver regular screening and an active chronicdisease recall system in communities.Chapter 3: Progress Against <strong>PCD</strong>S Objectives – <strong>Evaluation</strong> of the <strong>NT</strong> Preventable Chronic Disease <strong>Strategy</strong> 2007 56