Quality indicators of diabetes care at DAHS: 1999-2009
International and Australian studies show that well structured approaches to diabetes care can improve short-term and intermediate patient outcomes. Derby Aboriginal Health Service (DAHS) is an Aboriginal community-controlled health service that was established in 1998. Key characteristics of DAHS include whole-of service involvement in internal CQI processes, use of electronic patient information and recall systems, and regional support and standardisation of care.
This study described the service characteristics of DAHS and documented diabetes management activities and intermediate clinical outcomes for Aboriginal patients with type 2 diabetes. Over the 10 years of the study (1999-2009):
- The proportion of clinical care activities undertaken according to regional protocols increased significantly, with very high levels recorded in the last 3 years (at least 70% of patients had each activity recorded).
- There were significant improvements in systolic BP, diastolic BP and cholesterol levels over the 10 years (P < 0.001 for all) and there were small improvements in HbA1c levels that approached statistical significance (P = 0.05).
This study shows that diabetes monitoring and outcomes can be improved and maintained over a 10-year period in a well supported remote Aboriginal community-controlled health service setting.
To our knowledge, the following publication it the first published Australian study looking at 10 years of diabetes management in primary care at an individual health service:
Julia V Marley,Carmel Nelson, Vicki O’Donnell and David Atkinson. Quality indicators of diabetes care: an example of remote-area Aboriginal primary health care over 10 years. Med J Aust 2012; 197 (7): 404-408.