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Priority funding for PCDS implementationA strength of the current PCDS is that it allows governments to fund new programs as they arisewhen the chronic disease services case has been already clearly spelt out in the PCDS Strategy.For example: cardiac rehabilitation – offered through Healthy Living NT – began as a project withthe Divisions of General Practice. However it was eventually funded from the NT budget becauseit was a best buy of PCDS. At the Departmental level, the S100 funding of the PCD Program wassupplemented by rolling a number of other existing positions into the program including „TotalRecall‟ nurses.Assessment against objectiveCurrently only a minority of areas are funded using the Health Zone model, and the actualbenefits of this for chronic disease have not been clearly demonstrated. This model of careappears administratively complex, and implies the involvement of an increased number ofdecision-making bodies in chronic disease care.Many projects addressing chronic disease paradoxically suffer from short timelines in which theyare funded to operate and a lack of funds to arrange follow up. For example, in June 2004,Healthy Living NT received funding from NTDH&CS out of unspent S100 money to provideeducation and training to selected non-government health clinics throughout the NorthernTerritory. This program was only conducted until December 2004 (39) . During this time, theyarranged for cardiac and diabetes educators to visit 11 non-government health services acrossthe NT. A total of 40 health professional staff, and 48 clients, received diabetes and cardiaceducation in education sessions ranging from one to three hours duration. Both clients and staffregarded these education sessions positively.In another example, in 2003 the Darwin Diabetes and Education Resource Centre for HealthyLiving NT received a $60,000 NDIP Grant from the Department of Health and Ageing to employan Aboriginal Health Worker to identify barriers in access to diabetes education for urbanIndigenous people in the Darwin area. This project commenced in October 2003 but wascompleted in July 2004, and produced exceptional results. Where before 2003, the Darwin officesof Diabetes Australia NT had seen few Aboriginal people, by early 2004 this situation hadchanged considerably and they reported seeing between 34 and 66 Aboriginal and Torres StraitIslander people per month. Unfortunately, this fell back to between 1 and 4 Indigenous peopleper month for the last few months of the year after the program stopped (71) .Chapter 3: Progress Against PCDS Objectives – Evaluation of the NT Preventable Chronic Disease Strategy 2007 72
CHAPTER 4. CLINICAL OUTCOMES OF THE NTPCDSThis section of the report utilises published data available in the public domain and reportsfurnished by NTDH&CS regarding the clinical goals of NTPCDS. It covers relevant data forIndigenous populations in the NT, from 1999. It does not cover the urban and non-Indigenouspopulation specifically.The 3-year goal (2002)The three-year goal of the NTPCDS was to reduce the projected impact – hospitalisations, deathsand financial costs – of the five common chronic diseases in the Northern Territory (13) .1. Renal disease2. Type 2 diabetes3. Hypertension4. Ischaemic heart disease and5. Chronic obstructive airways disease.The 10-year goal (2009) was not assessed in 2002 therefore the most recent data that can befound is up to 2006 and is limited.4.1 End Stage Renal Disease (ESRD)Trends in incidence of End Stage Renal Disease (ESRD) are modified by demographic changes,disease control (effectiveness of prevention and treatment of progressive kidney disease),competing risks (including dying from untreated uraemia or non-renal co-morbidity), lead-timebias and classification bias (79) .There appears to be a relatively constant number of new cases for Renal Replacement Therapy(RRT) reported in the NT to 2003 (Figure 4.1). It is unclear from these data whether recentdisease control measures have had an impact on the incidence of treated ESRD in the NT.Chapter 4: Clinical Outcomes – Evaluation of the NT Preventable Chronic Disease Strategy 2007 73
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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
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chronic disease activities funded t
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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 and 86: maintenance group for people with l
Page 87 and 88: Rebates for participating or arrang
Page 89: Use of Medicine Programmes. Althoug
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? /
Page 137 and 138: An important background to this stu
Page 139 and 140: 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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