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…fostered an increased level of trust and the development of a relationshipbetween Territory Health Services and non-government organisations. Membersidentified the fact that there now exists a viable and sustainable basis forworking collaboratively .… (18)This view was endorsed by interview participants. Since this time, the CDN largely develop andcirculate The Chronicle, a two-monthly newsletter addressing chronic disease issues, andconvene a yearly chronic disease conference. By 2005, the numbers attending the conferencehad increased to greater than 400, involving members and non-members of the CDN. In late2005 the CDN began attempts to provide a better forum for intersectoral action, and plans forthis are currently in progress.Assessment against objectiveThere has been some increase in the community control of health services with the establishmentof Sunrise Health Services and Aboriginal Health Boards in the PHCAP zones. Very little progresshas been made with allocating sustainable NT funding to Aboriginal Community Controlled HealthServices, however the Australian Government has provided these additional resources. Similarlyit was difficult to find many examples of specific ongoing prevention and health promotionprograms that were being delivered by non-government agencies.Some evidence of intersectoral action was identified, but without a clear implementation plan totarget the social determinants of health, there was not a mechanism to tie other government andnon-government services into action, or to monitor their progress.3.5.5 Funding sources for NTDH&CS PCDS activitiesEPC ItemsIn November 1999, the Australian Government introduced a range of Medicare items that wereintended to provide a framework for the multidisciplinary care of chronic conditions. The EPCitems provide a Medicare rebate when GPs undertake or participate in specific clinical activities,such as care planning and case conferencing for people with complex needs. EPC items ofrelevance to preventable chronic diseases include: Rebates for undertaking comprehensive annual health assessments for older people - over 75years for non-indigenous and over 55 years for indigenous people Rebates for developing multidisciplinary care plans for patients with chronic, complex orterminal conditions and complex care needsChapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 68
Rebates for participating or arranging multidisciplinary case conferences for patients withcomplex care needsFrom May 2004, an additional item for two-yearly health checks for Aboriginal and Torres StraitIslander people aged 15-45 years was introduced (Item 710). In May 2006 this list was extendedto include a child health screening (Item 708) and work is currently underway in 2007, todevelop a Medicare item for antenatal care.EPC items can be claimed by NTDH&CS remote health services and Aboriginal health services. Inthese cases the rebates do not go back to the practitioner, since practitioners are usuallysalaried, but instead go back to their employer. This has allowed increased Medicare funding toreturn to the Territory, potentially addressing imbalances pointed out in the 1996-07 THS AnnualReport quoted above.The uptake of Medicare EPC items by GPs increased from 23 per cent in quarter four in 2000, to46 per cent in quarter two in 2002, and remained at 44 per cent during the following twoquarters Figure 3.6. The lowest uptake was in the NT. In 2004 the estimated Divisional take upwas 33 per cent in the Top End and 46 per cent in Central Australia, accounting for a total of 394adult health checks, item 710, claimed for NT Aboriginal adults during this year (76) . Data afterthis date is not published or is labelled by Medicare as „not for publication‟.Figure 3.6Percentage of „active' GPs using Medicare EPC items by State and Territory,December quarter 2002. (66)The need to maximise funding opportunities and provide better chronic disease care has lead theremote services of the NTDH&CS to increase their use of the EPC care planning items. Dataavailable does not tease out whether these items have been used more remotely or in urbanenvironments, however between the March quarter of 2004 and the December quarter of 2004the uptake of these items in the NT more than doubled from 313 to 662. Additional sourcingChapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 69
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Pty LtdABN 82 147 637 101AN EVALUAT
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TABLE OF CONTENTSList of figuresLis
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6.6 Indigenous workforce 996.7 Prev
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List of AbbreviationsABCDACCHOsACIC
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ACKNOWLEDGEMENTSWe would like to ac
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However the extraordinary number of
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the establishment of the Sunrise He
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RECOMMENDATIONSGeneral recommendati
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Exploration of joint funding arrang
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CHAPTER 1. INTRODUCTION1.1 Backgrou
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Choosing the 5 chronic conditionsTh
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Table 1.1Key Result Areas + Best Bu
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prior to the launch of NTPCDS, such
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Year * Action Outcome1999 S NT Prev
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Year * Action Outcome2005 P Aborigi
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CHAPTER 2.EVALUATION METHODOLOGYThe
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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
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 and 78: about 25 per cent of the hospital b
Page 79 and 80: The level of funding provided by th
Page 81 and 82: Central Australia and two zones cur
Page 83 and 84: The diabetes education teams at HLN
Page 85: maintenance group for people with l
Page 89 and 90: Use of Medicine Programmes. Althoug
Page 91 and 92: CHAPTER 4. CLINICAL OUTCOMES OF THE
Page 93 and 94: improvements have been made to serv
Page 95 and 96: A recent ten-year follow-up of a co
Page 97 and 98: The NTDH&CS also collect birthweigh
Page 99 and 100: Figure 5.3 Vaccination coverage for
Page 101 and 102: It is also important to note that k
Page 103 and 104: eported that 50 per cent of the Ind
Page 105 and 106: The current action plan identifies
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
Page 115 and 116: PCIS was developed by NTDH&CS as th
Page 117 and 118: emote staff can access training and
Page 119 and 120: In the Top End there appeared to be
Page 121 and 122: APPENDIX 1EVALUATION OF THE NT PREV
Page 123 and 124: 2.10 Generally speaking, on a scale
Page 125 and 126: 4.4 Briefly recount any anecdotes y
Page 127 and 128: 5.9 Generally speaking, on a scale
Page 129 and 130: Section 8 • Summary questions8.1
Page 131 and 132: Preventable Chronic Disease Program
Page 133 and 134: Year Type Background What is it? /
Page 135 and 136: 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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