With some exceptions, primary health care is failing to deliver adequate preventive health care to Indigenous Australians who experience higher levels of ill health than non-Indigenous people, new research reveals.
The findings add to a catalogue of similar research findings and stand in the face of major health and Medicare programs that have sought to improve health outcomes in Indigenous Australians through better access to preventive health assessments and follow-up care by primary healthcare providers.
The latest findings, published by in Globalization and Health by Australian researchers, are based on an audit of 17,108 of health records of well adults seen at 137 primary health care centres in five states/territories between 2005 and 2014.
The good news is we saw improvements in some areas of preventive healthcare
The audit examined whether best practice preventive health care assessments, such as blood pressure checks and heart health screening were recorded, and whether healthcare providers provided follow-up care based on health assessments findings.
Based on input from indigenous health stakeholders, the researchers made their conclusions by reviewing data in six priority areas: follow-up of abnormal blood pressure, heart health, urinalysis, blood lipids, enquiries about living conditions, and follow up of people at risk poor emotional well-being.
“The good news is we saw improvements in some areas of preventive healthcare,” said the paper’s lead author, Jodie Bailie of the University of Sydney.
“For example, we found more up to-date health summaries and immunisation records, increases in the measurement of weight and blood pressure, increased delivery of brief interventions for patients using high levels of alcohol, and better recording of Medicare numbers. Overall the delivery of preventive care in these areas has improved. However, we saw a concerning ten per cent decline in follow up healthcare plans for patients with high blood pressure and a 25 per cent decline in follow up healthcare plans for patients with poor emotional well-being
“Also, there was wide variation between health centres in nearly all aspects of preventive care. This is due to failures or weakness in the wider health system. Some of the areas that need improving are the follow up of healthcare plans for patients with high blood pressure and follow up healthcare plans for patients with poor emotional well-being.”
“Furthermore, research shows that while screening, or health assessments, may increase new diagnoses, there is no evidence that they prevent hospitalisations or premature death. While reasons for the lack of impact of health assessments are not well understood, it’s clear that health assessments have limited potential to improve health outcomes in the absence of appropriate follow-up care.”
The research also identified key drivers to improve care. These include: