Strengthening primary health care: achieving health gains in a remote region of Australia.

Abstract

To evaluate the impact of a comprehensive primary health care service model on key health performance indicators in a remote region of Australia. A cross-sectional 6-year retrospective evaluation of the results of a health service partnership between an Aboriginal community controlled health service, a hospital and a community health service in north-west Western Australia. Integration of health promotion, health assessments and chronic disease management with an acute primary health care service as a result of the formal partnership. Cross-sectional data on use and outcomes of health care from 1 July 2006 to 30 June 2012 are reported in accordance with national key performance indicators. There were increases in occasions of service (from 21218 to 33753), most notably in primary health care services provided to very remote outlying communities (from 863 to 11338). Health assessment uptake increased from 13% of the eligible population to 61%, leading to 73% of those identified with diabetes being placed on a care plan. Quality-of-care indicators (glycated haemoglobin checks and proportion of people with diabetics receiving antihypertensives) showed improvements over the 6-year study period, and there was also a downward trend in mortality. This study demonstrates that strengthening primary health care services by addressing key enablers and sustainability requirements can translate into population health gains consistent with the goals underpinning the National Health Care Reform and Closing the Gap policies, and may potentially reduce health inequity for remote-living Aboriginal Australians.