Just Accepted
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Value based health care for Aboriginal peoples with chronic conditions in the Northern Territory: A cohort study
Abstract
Objective(s): To investigate associations between patient activation, healthcare use and clinical outcomes for Aboriginal peoples living with a chronic condition in remote Northern Territory (NT) communities. Methods: A retrospective cohort study was undertaken between 2 April 2020-1 April 2022, to measure activation and its associations with chronic conditions secondary prevention treatment targets and healthcare usage: hospitalisations, potentially preventable hospitalisations and patient travel. All Aboriginal peoples enrolled at NT Government health services, who had one or more preventable chronic condition and were prescribed one or more oral chronic condition medication identified in the Primary Care Information System, were included in the study. Patient activation was defined as 90-day medicine possession ratio ≥80%. An activated patient has the belief, knowledge, skills and behaviours to manage their chronic conditions. Results: 5356 patients met the inclusion criteria; 9% of these patients were activated. Activated patients were older and sicker but were significantly more likely to achieve treatment targets for glycosylated haemoglobin, blood pressure, and total and low-density lipoprotein cholesterol. Activated patients used more primary health care and outpatient resources and had a non-significant trend for less acute care use. Conclusions: The remote NT Government primary health care system is providing low value chronic conditions care for patients. As identified by Aboriginal peoples, strengthening culturally appropriate self-management support could lead to more patients becoming activated, better health outcomes and decreased acute care demand.
AH24241 Accepted 28 November 2024
© CSIRO 2024
