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The cost-effectiveness of primary care for Indigenous Australians with diabetes living in remote Northern Territory communities

Thomas, S, Zhao, Yuejen, Guthridge, Steven and Wakerman, John (2014). The cost-effectiveness of primary care for Indigenous Australians with diabetes living in remote Northern Territory communities. Medical Journal of Australia,200(11):658-662.

Document type: Journal Article
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IRMA ID 75039815xPUB334
Title The cost-effectiveness of primary care for Indigenous Australians with diabetes living in remote Northern Territory communities
Author Thomas, S
Zhao, Yuejen
Guthridge, Steven
Wakerman, John
Journal Name Medical Journal of Australia
Publication Date 2014
Volume Number 200
Issue Number 11
ISSN 0025-729X   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84904498076
Start Page 658
End Page 662
Total Pages 5
Place of Publication Australia
Publisher Australasian Medical Publishing Company Pty. Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Objective: To evaluate the costs and health outcomes associated with primary care use by Indigenous people with diabetes in remote communities in the Northern Territory.

Design, setting and participants:
A population-based retrospective cohort study from 1 January 2002 to 31 December 2011 among Indigenous NT residents ≥ 15 years of age with diabetes who attended one of five hospitals or 54 remote clinics in the NT.

Main outcome measures:
Hospitalisations, potentially avoidable hospitalisations (PAH), mortality and years of life lost (YLL). Variables included disease stage (new, established or complicated cases) and primary care use (low, medium or high).

Results: 14 184 patients were eligible for inclusion in the study. Compared with the low primary care use group, the medium-use group (patients who used primary care 2–11 times annually) had lower rates of hospitalisation, lower PAH, lower death rates and fewer YLL. Among complicated cases, this group showed a significantly lower mean annual hospitalisation rate (1.2 v 6.7 per person [P < 0.001]) and PAH rate (0.72 v 3.64 per person [P < 0.001]). Death rate and YLL were also significantly lower (1.25 v 3.77 per 100 population [P < 0.001] and 0.29 v 1.14 per person-year [P < 0.001], respectively). The cost of preventing one hospitalisation for diabetes was $248 for those in the medium-use group and $739 for those in the high-use group. This compares to $2915, the average cost of one hospitalisation.

Conclusion: Improving access to primary care in remote communities for the management of diabetes results in net health benefits to patients and cost savings to government.

DOI http://dx.doi.org/10.5694/mja13.11316   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)


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