NACCHO Aboriginal Health :Report : Perils of place: identifying hotspots of health inequality

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Hospitalisation rates for diabetes, tooth decay and other conditions that should be treatable or manageable out of hospital show how Australia’s health system is consistently failing some communities.

Perils of place: identifying hotspots of health inequality

Download report here : NACCHO download Perils-of-Place

Places such as Frankston and Broadmeadows in Victoria and Mount Isa and Palm Island in Queensland have had potentially preventable hospitalisation rates at least fifty percent above the state average in every year for a decade.

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The problem can be addressed, but only if governments come up with targeted solutions for individual places. Australia is not a uniform country and a one-size-fits-all approach will not work. Local, tailored policy responses are required.

Reducing potentially preventable hospitalisations in hot spots in Victoria and Queensland — the two states the report studied – would save a total of at least $15 million a year. Indirect savings should be significantly larger.

The report introduces a method of identifying small areas where health inequalities are entrenched and, without intervention, are likely to endure.

To build up the limited evidence of what works in reducing place-based health problems, the report recommends that government combine with Primary Health Networks and local communities to run three- to five-year trials of tailored programs in selected places.

Rigorous evaluation is critical, so that the lessons from successful trials can be applied across the country.

Because persistent hotspots are rare, targeting them alone will not substantially reduce the growing burden of potentially preventable hospitalisations, but it’s an important first step.

Government and Primary Health Networks must ensure that all communities get a fair go. The government will save money and, more importantly, some of the most disadvantaged Australians will get the chance to lead healthier, more productive lives.

 

 

NACCHO #Aboriginal Health : #AIHW releases specific Measures tool Item 715 MBS Health checks

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All Aboriginal and Torres Strait Islander people are eligible for an annual Indigenous-specific health check: item 715 on the Medicare Benefits Schedule (MBS).

AIHW Press Release 21 July 2016

Medicare Health Assessment for Aboriginal and Torres Strait Islander People (MBS Item 715) – PDF 322 KB

See update 22 July For Aboriginal Health Workers
The aim of this MBS health assessment item is to help ensure that Aboriginal and Torres Strait Islander people receive primary health care matched to their needs, by encouraging early detection, diagnosis and intervention for common and treatable conditions that cause morbidity and early mortality.

For the purpose of this item, a person is an Aboriginal or Torres Strait Islander person if they, or their parent or carer, identify them as being of Aboriginal or Torres Strait Islander descent.

The MBS health assessment for Aboriginal and Torres Strait Islander people covers the full age spectrum, and should be used for health assessments for the following age groups:

  • Aboriginal and Torres Strait Islander children who are less than 15 years old
  • Aboriginal and Torres Strait Islander adults who are aged fifteen years and over but under the age of 55 years
  • Aboriginal and Torres Strait Islander older people who are aged 55 years and over

Indigenous specific measures tool 5th release (dynamic data display)

This tool shows numbers and usage rates of the checks at various geographic areas. Charts and tables in the tool can be customised to show different time periods and, where possible, disaggregations by age and sex.

The Australian Institute of Health and Welfare has released a new web product on 21 July, 2016:

Indigenous specific measures tool 5th release (dynamic data display)

1.The Indigenous health check (MBS 715) data tool provides information on use of MBS-rebated health checks for Aboriginal and Torres Strait Islander people displayed using SAS Visual Analytics.

2 The tool shows; numbers and rates of health check uptake at national, jurisdiction, Medicare Local and peer group, and Primary Health Network levels.

3 .This update adds national and jurisdiction data up to December 2015, updated from 30 June 2014.

The page can be viewed at this link: http://www.aihw.gov.au/indigenous-australians/indigenous-health-check-data-tool/

Source data: Excel download (1.5MB XLS)

Helpline: 1800 223 919 or nidisc@aihw.gov.au.

Components of the Health Assessment

The health assessment includes an assessment of the patient’s health, including their physical, psychological and social wellbeing. It also assesses what preventive health care, education and other assistance should be offered to the patient to improve their health and wellbeing. It complements existing services already undertaken by a range of health care providers. This health assessment must include:

  • information collection, including taking a patient history and undertaking examinations and investigations as required;
  • making an overall assessment of the patient;
  • recommending appropriate interventions;
  • providing advice and information to the patient;
  • keeping a record of the health assessment, and offering the patient a written report about the health assessment, with recommendations about matters covered by the health assessment; and
  • offering the patient’s carer (if any, and if the medical practitioner considers it appropriate and the patient agrees) a copy of the report or extracts of the report relevant to the carer.

As part of a health assessment, a medical practitioner may develop a simple strategy for the good health of the patient. The strategy should identify any services the patient needs and the actions the patient, or parent or carer, should take. It should be developed in collaboration with the patient, or parent or carer, and documented in the written report on the assessment that is offered to the patient, and/or patient’s carer.

NACCHO’s new Baseline Profiles to demonstrate extent, experience and value of the ACCHO Sector to policy makers

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“NACCHO will use the Baseline Profile to demonstrate the extent, experience and value of the ACCHO Sector to policy makers in government and those developing new programmes and budgets.

NACCHO is developing Baseline Profiles for its Member Services in 300 locations coordinated by 140 NACCHO Member Services as a first step in getting health and related data back in the hands of the Member Service ACCHOs and their communities.”

ACCHOs are a critical component of Australia’s primary health care system; the Baseline Profiles and Member Service’s localised profiles will re-enforce this fact “

Matthew Cooke Chair NACCHO

NACCHO delivers Map-Based Decision Support Services – Our Data in Our Hands for more info

NACCHO Baseline Profiles – putting data to work is from NACCHO Aboriginal Health Newspaper Page 10 April edition : Download 24 pages here

In these times of changing Federal policies, cut backs in areas of funding and overall fiscal constraints, ACCHOs are faced with providing broad ranging evidence of their performance to justify existing budgets and staffing levels, as well as justifying applications for new funding for the expansion of services into identified areas of need.

Challenges are also arising as an increasing number of programmes are being funnelled through the newly formed Primary Health Networks.

A new approach for determining funding allocations being used by the government and PHNs is referred to as “market testing”. This approach will potentially require ACCHOs to compete with state and territory health departments, other NGOs and for-profit practices and corporations for the provision of basic services and for the delivery of new programmes.

Mapping the service delivery footprint of ACCHOs service areas is important to demonstrate their role and significance as unique providers of comprehensive primary health care in over 300 locations coordinated by 140 NACCHO Member Services. ACCHOs are working with many of the new PHNs to build an understanding of the actual range of services provided to the population in their communities and the geographic extent of their service delivery. PHNs are required by the Department of Health to develop Health Needs Assessments and associated planning.

The ACCHO Sector has over 320,000 clients with over 3.7million client contacts delivered in 2013-2014. In comparison, the number of Emergency Department presentations in public hospital emergency departments in all states and territories was 7,195,903 (2013-2014) and RFDS undertook 292,523 client (patient) contacts in the same period.

NACCHOs Baseline Profiles, based on publicly available data, are being created for each Member Service. The profiles form a template to enable Member Services to add data from their own information systems. These localised templates will then be available for use in reports for Service planning and to provide evidence of performance, as well as for communications with community, funding bodies and policy makers.  A critical aspect of planning is “access to services”, for both existing services and for identifying areas where there is no access i.e. gaps.

The Baseline Profiles are using drive times (the time it takes to drive to an ACCHO) as a way of determining accessibility to health services, building on the work of the Australian Institute of Health and Welfare (AIHW) and the Queensland Aboriginal and Islander Health Council (QAIHC).

SEE Koori Mail for 2 and 3 below :The graphic shows example panels from the Baseline Profile for the Geraldton Regional Aboriginal Medical Service in the electorate of Durack and Country WA PHN.

Map 1

1.Maps showing the 60 minute drive time area from Geraldton, age-gender pyramid of the population and service delivery area for the Geraldton Regional Aboriginal Medical Service (GRAMS)
2.Heat map showing areas with a high density of Aboriginal people and the area included in a 60 minute drive time. Aboriginal population within the 60 minute drive-time of Geraldton is 3,382 with 4,727 in the larger service delivery area (ABS Census 2011) 3.Age-gender pyramid of the Aboriginal population in the 60minute drive time area.

Service delivery area with GRAMS fixed and mobile clinic serviced locations.