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Variation in quality of preventive care for well adults in Indigenous community health centres in Australia

Bailie, Ross S., Si, Damin, Connors, Christine M., Kwedza, Ru, O'Donoghue, Lynette R., Kennedy, Catherine, Cox, Rhonda, Liddle, Helen E., Hains, Jenny, Dowden, Michelle C., Burke, Hugh P., Brown, Alex, Weeramanthri, Tarun S. and Thompson, Sandra (2011). Variation in quality of preventive care for well adults in Indigenous community health centres in Australia. BMC Health Services Research,11(1):139-150.

Document type: Journal Article
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Title Variation in quality of preventive care for well adults in Indigenous community health centres in Australia
Author Bailie, Ross S.
Si, Damin
Connors, Christine M.
Kwedza, Ru
O'Donoghue, Lynette R.
Kennedy, Catherine
Cox, Rhonda
Liddle, Helen E.
Hains, Jenny
Dowden, Michelle C.
Burke, Hugh P.
Brown, Alex
Weeramanthri, Tarun S.
Thompson, Sandra
Journal Name BMC Health Services Research
Publication Date 2011
Volume Number 11
Issue Number 1
ISSN 1472-6963   (check CDU catalogue open catalogue search in new window)
Start Page 139
End Page 150
Total Pages 12
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
Abstract Background: Early onset and high prevalence of chronic disease among Indigenous Australians call for action on prevention. However, there is deficiency of information on the extent to which preventive services are delivered in Indigenous communities. This study examined the variation in quality of preventive care for well adults attending Indigenous community health centres in Australia.

Methods: During 2005-2009, clinical audits were conducted on a random sample (stratified by age and sex) of records of adults with no known chronic disease in 62 Indigenous community health centres in four Australian States/Territories (sample size 1839). Main outcome measures: i) adherence to delivery of guideline-scheduled
services within the previous 24 months, including basic measurements, laboratory investigations, oral health checks, and brief intervention on lifestyle modification; and ii) follow-up of abnormal findings.

Results: Overall delivery of guideline-scheduled preventive services varied widely between health centres (range 5-74%). Documentation of abnormal blood pressure reading ([greater than or equal to]140/90 mmHg), proteinuria and abnormal blood glucose ([greater than or equal to]5.5 mmol/L) was found to range between 0 and > 90% at the health centre level. A similarly wide range was found between health centres for documented follow up check/test or management plan for people documented to have an abnormal clinical finding. Health centre level characteristics explained 13-47% of variation in documented preventive care, and the remaining variation was explained by client level characteristics.

Conclusions: There is substantial room to improve preventive care for well adults in Indigenous primary care settings. Understanding of health centre and client level factors affecting variation in the care should assist clinicians, managers and policy makers to develop strategies to improve quality of preventive care in Indigenous
Keywords high prevalence of chronic disease
Indigenous Australians
preventive care
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