Screening and Treatment of Diabetes in an Indigenous Primary Health Care setting: The Inala experience — ASN Events
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  3. Screening and Treatment of Diabetes in an Indigenous Primary Health Care setting: The Inala experience

Screening and Treatment of Diabetes in an Indigenous Primary Health Care setting: The Inala experience (#123)

Noel Hayman 1
  1. Queensland Health, Inala, QLD, Australia

Lack of appropriate health service provision for Aboriginal and Torres Strait people still remains an important social determinant of ill health. Historically, health services have been absent or inappropriate. Cultural factors, financial factors and distance from health services have been important barriers limiting indigenous access to mainstream health services.

The Inala Indigenous Health Service (IIHS), a mainstream health service has been in operation since 1995, and today has over 8,000 patients registered. The IIHS has been able to analyse 413 Adult Health Checks aged 15-54 years in 2009 (Published in MJA). The Adult Health Checks provide an opportunity to evaluate health status, identifying chronic disease risk factors and for implementing preventive care. For every 26 health checks completed and new diabetic is diagnosed. High prevalence rates of CVD risk factors were found.

Of significance are the high prevalence rates for alcohol use and smoking. 46% of patients drink at harmful levels and 67% were current smokers. Both risk factors significantly complicate diabetes management. From the health check data, 95% of smokers received brief intervention and 3% of problem drinkers were referred to ATODS for further assessment. All health check information is now entered into Eric (community data base) so that the prevalence of any risk factor over time can monitored and interventions implemented were needed.

To improve diabetes control the IIHS participates in CQI, have access to an Endocrinologist and an Ophthalmologist monthly. The average HbA1c has decreased from 9.6% to 7.8% over four years. Retinal photography is completed at the Annual Diabetes check and patients requiring laser are identified. Laser in carried out on site.

The high quality primary health care provided by the IIHS has been recognised by Queensland Health. Queensland Health is providing $7M to build a Centre of Excellence in Indigenous Primary Health Care and $2M to staff the new Centre. The Centre will focus strongly on research and teaching.