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 ...
In the regional health zones in Central Australia the revenue raised through Medicare ismonitored and transferred back to communities. A similar transparent process is not in place forother NTDH&CS clinics and as such there are no incentive for the local team to be more diligentin completing chronic disease activities to claim EPC items.Assessment against objectiveThere has been a definite shift in the general understanding across the Northern Territory of theneed for dedicated and focused chronic disease activities. The PCD program has been taskedwith the development of chronic disease programs and activities, and there is evidence of strongleadership in this endeavour. Where additional resources have been provided dedicated staff andstrategies have been implemented to address chronic disease issues, but chronic diseaseprograms with dedicated staff are not consistently in place in all remote clinics. The key barrieridentified in achieving this is financial resources, community infrastructure and the decliningAboriginal Health Worker workforce numbers.3.5 FUNDING & INDIGENOUS GOVERNANCEThe provision of resources is key to enhancing the core range of services required forcomprehensive primary health care and building capacity in communities. There are 4 objectivesrelated to funding that will be discussed in this section. They include: financing objectives tosupport community control of health services, funding community controlled health services andnon government agencies to deliver prevention and health promotion programs and investmentin intersectoral action to support health promoting actions.In addition to providing an overview of the activities related to these objectives, other fundingstrategies that have contributed to the chronic disease activities are discussed in this section.They include S100, the use of EPC items and NT growth funding for priority servicedevelopments.Funding arrangements at baselineIn 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. Altogether it was estimated that chronic disease accounted forChapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 58
about 25 per cent of the hospital budget in 1997, about 40 per cent in 1999 and, if uncontrolled,was predicted to consume 56 per cent of the budget by 2004 (10) . Figures in 2005 show that inthe three years between 2000/01 and 2002/03, excluding renal dialysis, about 7 per cent ofhospital resources were used for hospitalisations directly caused by acute manifestations ofchronic diseases, and including renal dialysis about 45 per cent of hospital resources were due tochronic disease related hospitalisations (11) .Figure 3.4 below taken from the 2006 NTDH&CS Annual Report indicates the realities of thesepredications, where the budget for same day renal hospital treatment cost $18M.Figure 3.4 Same-day renal treatments, 1996-97 to 2005-06Changes in Commonwealth health policy in the late 1990s influenced the NT‟s response tochronic disease. In 1995, CoAG proposed a three-year plan to reform health and communityservices. Key aspects included: movement towards outcome/output funding and „broad-banding‟ of programs; allocation of capital to care streams including coordinated care; proposals for trials of new care arrangements with built-in incentives for the most costeffectiveuse of funds; multilateral and bilateral agreements to cover all relevant services and the establishment of nationally consistent payment and information systems (67) .Chapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 59
- Page 25 and 26: prior to the launch of NTPCDS, such
- Page 27 and 28: Year * Action Outcome1999 S NT Prev
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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,
- Page 45 and 46: Medicare information is not for pub
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- Page 53 and 54: The information collected as part o
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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
- Page 73 and 74: Identifies priority practices to in
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- Page 83 and 84: The diabetes education teams at HLN
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- Page 93 and 94: improvements have been made to serv
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- Page 103 and 104: eported that 50 per cent of the Ind
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- Page 109 and 110: Hoy et al in 1995-2000 (100) , and
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about 25 per cent of the hospital budget in 1997, about 40 per cent in 1999 and, if uncontrolled,was predicted to consume 56 per cent of the budget by 2004 (10) . Figures in 2005 show that inthe three years between 2000/01 and 2002/03, excluding renal dialysis, about 7 per cent ofhospital resources were used for hospitalisations directly caused by acute manifestations ofchronic diseases, and including renal dialysis about 45 per cent of hospital resources were due tochronic disease related hospitalisations (11) .Figure 3.4 below taken from the 2006 <strong>NT</strong>DH&CS Annual Report indicates the realities of thesepredications, where the budget for same day renal hospital treatment cost $18M.Figure 3.4 Same-day renal treatments, 1996-97 to 2005-06Changes in Commonwealth health policy in the late 1990s influenced the <strong>NT</strong>‟s response tochronic disease. In 1995, CoAG proposed a three-year plan to reform health and communityservices. Key aspects included: movement towards outcome/output funding and „broad-banding‟ of programs; allocation of capital to care streams including coordinated care; proposals for trials of new care arrangements with built-in incentives for the most costeffectiveuse of funds; multilateral and bilateral agreements to cover all relevant services and the establishment of nationally consistent payment and information systems (67) .Chapter 3: Progress Against <strong>PCD</strong>S Objectives – <strong>Evaluation</strong> of the <strong>NT</strong> Preventable Chronic Disease <strong>Strategy</strong> 2007 59
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