Abstract
BackgroundInterventions to improve delivery of preventive medical services have been shown to be effective in North America and the UK. However, there are few studies of the extent to which the impact of such interventions has been sustained, or of the impact of such interventions in disadvantaged populations or remote settings. This paper describes the trends in delivery of preventive medical services following a multifaceted intervention in remote community health centres in the Northern Territory of Australia.MethodsThe intervention comprised the development and dissemination of best practice guidelines supported by an electronic client register, recall and reminder systems and associated staff training, and audit and feedback. Clinical records in seven community health centres were audited at regular intervals against best practice guidelines over a period of three years, with feedback of audit findings to health centre staff and management.ResultsLevels of service delivery varied between services and between communities. There was an initial improvement in service levels for most services following the intervention, but improvements were in general not fully sustained over the three year period.ConclusionsImprovements in service delivery are consistent with the international experience, although baseline and follow-up levels are in many cases higher than reported for comparable studies in North America and the UK. Sustainability of improvements may be achieved by institutionalisation of relevant work practices and enhanced health centre capacity.
Highlights
Interventions to improve delivery of preventive medical services have been shown to be effective in North America and the UK
A variety of interventions to improve the delivery of preventive services in primary care have been shown to improve coverage and quality of care in North America and the UK
The aim of this paper is to examine the levels of, and trends in, delivery of preventive medical services prior to and following implementation of the guidelines
Summary
Interventions to improve delivery of preventive medical services have been shown to be effective in North America and the UK. There are few studies of the extent to which the impact of such interventions has been sustained, or of the impact of such interventions in disadvantaged populations or remote settings. This paper describes the trends in delivery of preventive medical services following a multifaceted intervention in remote community health centres in the Northern Territory of Australia. A variety of interventions to improve the delivery of preventive services in primary care have been shown to improve coverage and quality of care in North America and the UK. [1] there is little information on the sustainability of the impacts of such systems, or of the (page number not for citation purposes). BMC Health Services Research 2003, 3 http://www.biomedcentral.com/1472-6963/3/15. A variety of interventions to improve the delivery of preventive services in primary care have been shown to improve coverage and quality of care in North America and the UK. [1] there is little information on the sustainability of the impacts of such systems, or of the (page number not for citation purposes)
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