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

Ross Stewart Bailie, Damin Si, Christine Connors, Ru Kwedza, Lynette Ruth O'donoghue, Catherine Kennedy, Rhonda Cox, Helen Liddle, Jennifer Anne Hains, Michelle Dowden, Hugh Burke, Alexander Brown, Tarun Weeramanthri, Sandra Thompson

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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 communities.
Original languageEnglish
Article number139
Pages (from-to)1-12
Number of pages12
JournalBMC Health Services Research
Volume11
Issue number1
DOIs
Publication statusPublished - 2011

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Community Health Centers
Preventive Medicine
Quality of Health Care
Health Status
Health
Chronic Disease
Guidelines
Clinical Audit
Oral Health
Administrative Personnel
Proteinuria
Documentation
Sample Size
Blood Glucose
Life Style
Reading
Primary Health Care
Outcome Assessment (Health Care)
Blood Pressure

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Bailie, R. S., Si, D., Connors, C., Kwedza, R., O'donoghue, L. R., Kennedy, C., ... Thompson, S. (2011). Variation in quality of preventive care for well adults in Indigenous community health centres in Australia. BMC Health Services Research, 11(1), 1-12. [139]. https://doi.org/10.1186/1472-6963-11-139
Bailie, Ross Stewart ; Si, Damin ; Connors, Christine ; Kwedza, Ru ; O'donoghue, Lynette Ruth ; Kennedy, Catherine ; Cox, Rhonda ; Liddle, Helen ; Hains, Jennifer Anne ; Dowden, Michelle ; Burke, Hugh ; Brown, Alexander ; Weeramanthri, Tarun ; Thompson, Sandra. / Variation in quality of preventive care for well adults in Indigenous community health centres in Australia. In: BMC Health Services Research. 2011 ; Vol. 11, No. 1. pp. 1-12.
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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-scheduledservices 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 communities.",
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Bailie, RS, Si, D, Connors, C, Kwedza, R, O'donoghue, LR, Kennedy, C, Cox, R, Liddle, H, Hains, JA, Dowden, M, Burke, H, Brown, A, Weeramanthri, T & Thompson, S 2011, 'Variation in quality of preventive care for well adults in Indigenous community health centres in Australia', BMC Health Services Research, vol. 11, no. 1, 139, pp. 1-12. https://doi.org/10.1186/1472-6963-11-139

Variation in quality of preventive care for well adults in Indigenous community health centres in Australia. / Bailie, Ross Stewart; Si, Damin; Connors, Christine; Kwedza, Ru; O'donoghue, Lynette Ruth; Kennedy, Catherine; Cox, Rhonda; Liddle, Helen; Hains, Jennifer Anne; Dowden, Michelle; Burke, Hugh; Brown, Alexander; Weeramanthri, Tarun; Thompson, Sandra.

In: BMC Health Services Research, Vol. 11, No. 1, 139, 2011, p. 1-12.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Variation in quality of preventive care for well adults in Indigenous community health centres in Australia

AU - Bailie, Ross Stewart

AU - Si, Damin

AU - Connors, Christine

AU - Kwedza, Ru

AU - O'donoghue, Lynette Ruth

AU - Kennedy, Catherine

AU - Cox, Rhonda

AU - Liddle, Helen

AU - Hains, Jennifer Anne

AU - Dowden, Michelle

AU - Burke, Hugh

AU - Brown, Alexander

AU - Weeramanthri, Tarun

AU - Thompson, Sandra

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N2 - 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-scheduledservices 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 communities.

AB - 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-scheduledservices 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 communities.

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KW - Oceanic Ancestry Group

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