Study protocol: national research partnership to improve primary health care performance and outcomes for Indigenous peoples

Ross Bailie,Andrew Stanley,James Semmens,Damin Si,Tricia Nagel,Kevin Rowley,Sandra Thompson,Karen Gardner,Haylene Grogan,Tarun Weeramanthri,Hugh Burke,Ian Anderson,Richard Weston,Cindy Shannon,Dallas Leon,David J Scrimgeour,Elizabeth Moore,Robyn Mcdermott,Christine Connors

doi:10.1186/1472-6963-10-129

Abstract

BackgroundStrengthening primary health care is critical to reducing health inequity between Indigenous and non-Indigenous Australians. The Audit and Best practice for Chronic Disease Extension (ABCDE) project has facilitated the implementation of modern Continuous Quality Improvement (CQI) approaches in Indigenous community health care centres across Australia. The project demonstrated improvements in health centre systems, delivery of primary care services and in patient intermediate outcomes. It has also highlighted substantial variation in quality of care. Through a partnership between academic researchers, service providers and policy makers, we are now implementing a study which aims to 1) explore the factors associated with variation in clinical performance; 2) examine specific strategies that have been effective in improving primary care clinical performance; and 3) work with health service staff, management and policy makers to enhance the effective implementation of successful strategies.Methods/DesignThe study will be conducted in Indigenous community health centres from at least six States/Territories (Northern Territory, Western Australia, New South Wales, South Australia, Queensland and Victoria) over a five year period. A research hub will be established in each region to support collection and reporting of quantitative and qualitative clinical and health centre system performance data, to investigate factors affecting variation in quality of care and to facilitate effective translation of research evidence into policy and practice. The project is supported by a web-based information system, providing automated analysis and reporting of clinical care performance to health centre staff and management.DiscussionBy linking researchers directly to users of research (service providers, managers and policy makers), the partnership is well placed to generate new knowledge on effective strategies for improving the quality of primary health care and fostering effective and efficient exchange and use of data and information among service providers and policy makers to achieve evidence-based resource allocation, service planning, system development, and improvements of service delivery and Indigenous health outcomes.

Highlights

Strengthening primary health care is critical to reducing health inequity between Indigenous and nonIndigenous Australians
Primary Health Care is defined as "socially appropriate, universally accessible, scientifically sound first level care provided by a suitably trained workforce supported by integrated referral systems and in a way that gives priority to those most in need, maximises community and indi
Our recent search of the websites of national level health departments of five countries (Australia, New Zealand, USA, Canada and the United Kingdom) for publicly released data on diabetes care reveals that Australia has poorly developed systems to report on quality of diabetes care at the primary care level, both for general and Indigenous populations [4]

Summary

Introduction

Strengthening primary health care is critical to reducing health inequity between Indigenous and nonIndigenous Australians. The project demonstrated improvements in health centre systems, delivery of primary care services and in patient intermediate outcomes It has highlighted substantial variation in quality of care. Vidual self-reliance and participation and involves collaboration with other sectors It includes health promotion, illness prevention, care of the sick, advocacy and community development [2]." International evidence has demonstrated that stronger primary care systems are associated with reduced premature mortality [3]. Our recent search of the websites of national level health departments of five countries (Australia, New Zealand, USA, Canada and the United Kingdom) for publicly released data on diabetes care reveals that Australia has poorly developed systems to report on quality of diabetes care at the primary care level, both for general and Indigenous populations [4]. New Zealand has designated systems to monitor diabetes care among its indigenous people

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