Sentinel Sites Evaluation, Final Report
Sentinel Sites Evaluation Final Report February 2013
Sentinel Sites Evaluation
Final Report
February 2013
Online ISBN: 978-1-74186-059-7
Publications Approval Number: 10490
Paper-based publications
Commonwealth of Australia 2013
This work is copyright. You may reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. Requests and inquiries concerning reproduction and rights are to be sent to the Online, Services and External Relations Branch, Department of Health, GPO Box 9848, Canberra ACT 2601, or via e-mail to [email protected].
Internet sites
Commonwealth of Australia 2013
This work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. Requests and inquiries concerning reproduction and rights are to be sent to the Online, Services and External Relations Branch, Department of Health, GPO Box 9848, Canberra ACT 2601, or via e-mail to [email protected].
This report has been independently prepared for the Australian Government Department of Health by Menzies School of Health Research and does not necessarily represent the views of the Australian Government
Contents
Definitions5
Guide to reading this report7
1.Executive summary9
1.1.Introduction9
1.2.Evaluation process and methods10
1.3.Overview of findings10
1.4.Effective implementation of the ICDP as a whole 16
1.5.Conclusion18
2.Introduction and methodology19
2.1.Introduction19
2.2.Overview of the Sentinel Sites21
2.3.Methodology23
2.4.Overview of Sentinel Sites31
3.National action to reduce Indigenous smoking rates (Measure A1) and helping Indigenous people reduce their risk of chronic disease (Measure A2)34
3.1.Description of measures34
3.2.State of implementation national context36
3.3.Findings from Sentinel Sites41
3.4.Summary and conclusions71
3.5.Policy considerations77
4.Local Indigenous community campaigns to promote better health (Measure A3)79
4.1.Description of measure79
4.2.State of implementation national context80
4.3.Findings from the Sentinel Sites84
4.4.Summary and conclusions96
4.5.Policy considerations99
5.Subsidising PBS medicine Co-payment (Measure B1)100
5.1.Description of measure100
5.2.State of implementation national context101
5.3.Findings from Sentinel Sites104
5.4.Summary and conclusions153
5.5.Policy considerations157
6.Higher Utilisation costs for MBS and PBS (Measure B2)158
6.1.Description of measure158
6.2.Data sources and analysis161
6.3.Findings from the Sentinel Sites162
6.4.Summary and conclusions213
6.5.Policy considerations216
7.Supporting primary care providers to coordinate chronic disease management (Measure B3 part A)218
7.1.Description of measure218
7.2.State of implementation national context219
7.3.Findings from the Sentinel Sites222
7.4.Summary and conclusions301
7.5.Policy considerations306
8.Supporting primary care providers to coordinate chronic disease management (Measure B3 part B)307
8.1.Description of measure307
8.2.State of implementation national context308
8.3.Findings from the Sentinel Sites310
8.4.Summary and conclusions339
8.5.Policy considerations344
9.Helping Indigenous people self-manage their risk of chronic disease (Measure B4)345
9.1.Description of measure345
9.2.State of implementation national context346
9.3.Findings from the Sentinel Sites348
9.4.Summary and conclusions361
9.5.Policy considerations364
10.Increasing access to specialists and multidisciplinary team care (Measure B5 part A)365
10.1.Description of measure365
10.2.State of implementation national context366
10.3.Findings from Sentinel Sites367
10.4.Summary and conclusions389
10.5.Policy considerations393
11.Increasing access to specialists and multidisciplinary team care (Measure B5 part B)394
11.1.Description of measure394
11.2.State of implementation national context395
11.3.Findings from Sentinel Sites396
11.4.Summary and conclusions423
11.5.Policy considerations427
12.Workforce support, education and training (Measure C1)429
12.1.Description of measure429
12.2.State of implementation national context430
12.3.Findings from Sentinel Sites orientation and Outreach Worker individualised training434
12.4.Findings from Sentinel Sites training opportunities in AHSs for GPs and nurses446
12.5.Summary and conclusions462
12.6.Policy considerations466
13.Expanding the outreach and service capacity of Indigenous Health Services (Measure C2)467
13.1.Description of measure467
13.2.State of implementation national context468
13.3.Findings from the Sentinel Sites469
13.4.Summary and conclusions494
13.5.Policy considerations498
14.Engaging Divisions of General Practice to improve Indigenous access to mainstream primary care (Measure C3)500
14.1.Description of measure500
14.2.State of implementation national context502
14.3.Findings from the Sentinel Sites504
14.4.Summary and conclusions538
14.5.Policy considerations542
15.Attracting more people to work in Indigenous Health (Measure C4)544
15.1.Description of measure544
15.2.State of Implementation national context544
16.Clinical practice and decision support guidelines (Measure C5)546
16.1.Description of measure546
16.2.State of implementation national context546
17.Whole of ICDP548
17.1.Introduction548
17.2.Effective implementation of the whole of ICDP550
17.3.Summary and conclusions581
17.4.Policy considerations592
Figures
Figure 2.1: Location of Sentinel Sites21
Figure 2.2: Sentinel Sites evaluation processes24
Figure 3.1: Number of prescriptions for nicotine replacement therapy per 1000 Aboriginal and Torres Strait Islander people aged 15 years for Sentinel Sites and the rest of Australia by quarter, September 2010 May 201258
Figure 3.2: Number of prescriptions for nicotine replacement therapy per 1000 Aboriginal and Torres Strait Islander people aged 15 years by remoteness of Sentinel Sites and the rest of Australia and quarter, September 2010 May 201258
Figure 3.3: Number of prescriptions for nicotine replacement therapy per 1000 Aboriginal and Torres Strait Islander people aged 15 years for Sentinel Sites and the rest of Australia by quarter and age, September 2010 May 201259
Figure 3.4: Enablers and constraints to effective implementation of the National Action to Reduce Aboriginal and Torres Strait Islander Smoking Rates and Helping Indigenous People Reduce their Risk of Chronic Disease measures65
Figure 3.5: Enablers and constraints to achievement of dedicated workforce with team structures and strategic focus66
Figure 3.6: Enablers and constraints to achievement of organisational environment with values and capacity to provide support68
Figure 3.7: Enablers and constraints to achievement of capability of the new health promotion workforce69
Figure 3.8: Enablers and constraints to achievement of health promotion capacity of the general primary health care workforce70
Figure 3.9: Enablers and constraints to achievement of complementary linkages with ICDP funded and other activities and services71
Figure 4.1: Enablers and constraints to effective implementation of the Local Indigenous Community Campaigns to Promote Better Health measure94
Figure 4.2: Enablers and constraints to achievement of an organisational environment with capacity to support evidence-based, locally generated initiatives95
Figure 4.3: Enablers and constraints to achievement of linkages with community, local service providers, and complementary linkages with other ICDP funded activities96
Figure 5.1: Number of Aboriginal and Torres Strait Islander people accessing the PBS Co-payment measure per 100 Aboriginal and Torres Strait Islander people aged 15 years for Sentinel Sites and the rest of Australia by quarter, September 2010 May 2012111
Figure 5.2: Clinic
