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 ...
Subsequent Federal Budgets reflected these proposals. In 1996-97, allocations were developed toimprove access to health care in rural and remote areas, and to address the perceived ruralhealth workforce crisis. (15) In 1997-98, additional funds were directed to improving healthservices in regional Australia, including development of innovative models of service delivery andspecific purpose payments for States and Territories. Examples included the coordinated caretrials. In 1999-2000, funding was developed for Primary Health Care Access Program (PHCAP)zones. Under these arrangements health „zones‟ could be set up in the Northern Territory inwhich a single funding agreement could be established between the Commonwealth, NTGovernment and the zonal ACCHOs to allow all health-care funding to that community to bepooled (21) .Five key focus areas that were identified in the Territory Health Services 1996-97 Annual Reportwere congruent with the new Federal policy initiatives. These were: increased access toCommonwealth funding particularly for health services to rural and remote communitiespreventive health, increased emphasis upon chronic disease including renal disease, communitycare and community based services, and workforce recruitment and retention. Limited funding,was a major issue. The 1996-97 Annual Report for Territory Health Services noted:The NT is further challenged by the need to fund services in rural and remotecommunities that the Commonwealth Government directly funds in other States andTerritories. This anomaly happens as a result of the low number of private medicalpractitioners servicing the Territory‟s rural and remote areas. Territory Health Servicesprovides these communities with medical services that would otherwise be provided byprivate medical practitioners directly billing the Commonwealth. This results in asubstantial shortfall of funds (approximately $45M per year) and presents the NT with amajor financial barrier to the provision of health services at a level equal to that of otherStates and Territories (68) .3.5.1 Greater community control over health servicesObjective 7: There will be a greater degree of community control over health services,through a variety of mechanisms.The primary method used by the NTDH&CS to increase the degree of community control overhealth services, since the Coordinated Care Trials, is through the roll out of the Primary HealthCare Access Program (PHCAP), which was announced in the 1999-2000 Commonwealth budget.Chapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 60
The level of funding provided by the Commonwealth was to be based on the average AustralianMedicare expenditure multiplied by two, in acknowledgement of higher Indigenous needs, and byanother factor of two, if remote.Sunrise Health Service is a Community Controlled Health Service that was established in 2002based on a funds pooling model. In the early years of the establishment of the service Medicarefor the region was cashed out, but following the establishment phase in 2005, the fundingarrangement changed with the service required to generate Medicare income to supplement theNTDH&CS and specific DoHA program funding.A total of 21 Health zones were defined and priority zones were nominated in the Barkly andCentral Australia: Anmatjere, Eastern Arrernte-Alyawarra, Luritja-Pintubi, Northern Barkly andWarlpiri, and two health zones in the Top End: South East Top End and Darwin, as well as theformer Aboriginal Coordinated Care Trial sites at Katherine West and in the Tiwi Islands.Figure 3.5 NT Primary Health Care Access Program Zones 2003 (69) .The structure and process adopted for the implementation of PHCAP was complex, involvingthree layers of decision-making processes, across 21 zones, to a population of around 50,000Chapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 61
- Page 27 and 28: Year * Action Outcome1999 S NT Prev
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- 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
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- Page 57 and 58: career development, and retention i
- Page 59 and 60: are. Indigenous employment is NTDH&
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- 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
- Page 75 and 76: There has been a significant growth
- Page 77: about 25 per cent of the hospital b
- Page 81 and 82: Central Australia and two zones cur
- Page 83 and 84: The diabetes education teams at HLN
- Page 85 and 86: maintenance group for people with l
- Page 87 and 88: Rebates for participating or arrang
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- Page 93 and 94: improvements have been made to serv
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- Page 97 and 98: The NTDH&CS also collect birthweigh
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- Page 101 and 102: It is also important to note that k
- Page 103 and 104: eported that 50 per cent of the Ind
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- Page 107 and 108: The availability and cost of health
- Page 109 and 110: Hoy et al in 1995-2000 (100) , and
- Page 111 and 112: 5.6 Best practice management5.6.1 P
- Page 113 and 114: disease care in urban areas regardi
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- Page 117 and 118: emote staff can access training and
- Page 119 and 120: In the Top End there appeared to be
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- Page 123 and 124: 2.10 Generally speaking, on a scale
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Subsequent Federal Budgets reflected these proposals. In 1996-97, allocations were developed toimprove access to health care in rural and remote areas, and to address the perceived ruralhealth workforce crisis. (15) In 1997-98, additional funds were directed to improving healthservices in regional Australia, including development of innovative models of service delivery andspecific purpose payments for States and Territories. Examples included the coordinated caretrials. In 1999-2000, funding was developed for Primary <strong>Health</strong> Care Access Program (PHCAP)zones. Under these arrangements health „zones‟ could be set up in the Northern Territory inwhich a single funding agreement could be established between the Commonwealth, <strong>NT</strong>Government and the zonal ACCHOs to allow all health-care funding to that community to bepooled (21) .Five key focus areas that were identified in the Territory <strong>Health</strong> Services 1996-97 Annual Reportwere congruent with the new Federal policy initiatives. These were: increased access toCommonwealth funding particularly for health services to rural and remote communitiespreventive health, increased emphasis upon chronic disease including renal disease, communitycare and community based services, and workforce recruitment and retention. Limited funding,was a major issue. The 1996-97 Annual Report for Territory <strong>Health</strong> Services noted:The <strong>NT</strong> is further challenged by the need to fund services in rural and remotecommunities that the Commonwealth Government directly funds in other States andTerritories. This anomaly happens as a result of the low number of private medicalpractitioners servicing the Territory‟s rural and remote areas. Territory <strong>Health</strong> Servicesprovides these communities with medical services that would otherwise be provided byprivate medical practitioners directly billing the Commonwealth. This results in asubstantial shortfall of funds (approximately $45M per year) and presents the <strong>NT</strong> with amajor financial barrier to the provision of health services at a level equal to that of otherStates and Territories (68) .3.5.1 Greater community control over health servicesObjective 7: There will be a greater degree of community control over health services,through a variety of mechanisms.The primary method used by the <strong>NT</strong>DH&CS to increase the degree of community control overhealth services, since the Coordinated Care Trials, is through the roll out of the Primary <strong>Health</strong>Care Access Program (PHCAP), which was announced in the 1999-2000 Commonwealth budget.Chapter 3: Progress Against <strong>PCD</strong>S Objectives – <strong>Evaluation</strong> of the <strong>NT</strong> Preventable Chronic Disease <strong>Strategy</strong> 2007 60
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