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Specialist clinics in remote Australian Aboriginal communities: where rock art meets rocket science

Gruen, Russell and Bailie, Ross S. (2004). Specialist clinics in remote Australian Aboriginal communities: where rock art meets rocket science. Journal of Health Services Research & Policy,9(Suppl. 2):56-62.

Document type: Journal Article
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Title Specialist clinics in remote Australian Aboriginal communities: where rock art meets rocket science
Author Gruen, Russell
Bailie, Ross S.
Journal Name Journal of Health Services Research & Policy
Publication Date 2004
Volume Number 9
Issue Number Suppl. 2
ISSN 1355-8196   (check CDU catalogue open catalogue search in new window)
Start Page 56
End Page 62
Total Pages 7
Place of Publication UK
Publisher Royal Society of Medicine Press
Language English
Field of Research 320000 Medical and Health Sciences
Abstract People in remote Aboriginal communities in the Northern Territory have greater morbidity and mortality than other Australians, but face considerable barriers when accessing hospital-based specialist services. The Specialist Outreach Service, which began in 1997, was a novel policy initiative to improve access by providing a regular multidisciplinary visiting specialist services to remote communities. It led to two interesting juxtapositions: that of 'state of the art' specialist services alongside under-resourced primary care in remote and relatively traditional Aboriginal communities; and that of attempts to develop an evidence base for the effectiveness of outreach, while meeting the short-term evaluative requirements of policy-makers. In this essay, first we describe the development of the service in the Northern Territory and its initial process evaluation. Through a Cochrane systematic review we then summarise the published research on the effectiveness of specialist outreach in improving access to tertiary and hospital-based care. Finally we describe the findings of an observational population-based study of the use of specialist services and the impact of outreach to three remote communities over 11 years. Specialist outreach improves access to specialist care and may lessen the demand for both outpatient and inpatient hospital care. Specialist outreach is, however, dependent on well-functioning primary care. According to the way in which outreach is conducted and the service is organised, it can either support primary care or it can hinder primary care and, as a result, reduce its own effectiveness.
Keywords Aboriginal
Australian
Communities
DOI http://dx.doi.org/10.1258/1355819042349844   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes 2680 (Journal)
 
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Created: Mon, 17 Dec 2007, 09:02:11 CST