An evaluation of the development, implementation, feasibility and impact of a tailored intervention to improve the quality of care for Aboriginal and Torres Strait Islander peoples attending urban general practice (NHMRC PhD scholarship)
Project Short Title
Cultural Respect in General Practice in Sydney
Mark Harris, Elizabeth Harris, Lisa Jackson Pulver, Muru Marri Indigenous Health Unit
Although $1.22 is spent on health for Aboriginal and Torres Strait Islander peoples for every $1.00 spent on other Australians, it does not reflect their greater need, and only approximately one-fifth of the health expenditures on Aboriginal and Torres Strait Islander peoples are from programs specifically designed for them. Aboriginal and Torres Strait Islander peoples highly utilise community health services and public hospitals (21% and 49% respectively compared to 3.9% and 28% for other Australians), and are comparatively low users of privately provided health services such as general practitioners (GPs), specialists, dental, pharmaceutical and other health services, which other Australians access about 40% more than Aboriginal and Torres Strait Islander peoples.
As at January 2009, less than half (41%) of the total Australian Aboriginal and Torres Strait Islander population had identified themselves as Indigenous under the Medicare Voluntary Indigenous Identification (MVII) program: about 47% of the Australian Aboriginal and Torres Strait Islander population are identified in rural areas, and 35% in urban areas. As part of the Australian Government’s 'Closing the Gap' initiative, the Indigenous Practice Incentive Payments (IPIP) were introduced in May 2010 to encourage GP’s to actively work towards chronic disease management of identified Indigenous patients in their practice. In order to determine the underlying reasons for the low rate of Indigenous status identification in general practice, or the perceived low usage of GP services by Aboriginal and Torres Strait Islander peoples, this study aims to explore the knowledge, attitudes and beliefs of GPs and their staff, and members of the local Aboriginal and Torres Strait Islander ciommunities in regards to identification of patients' Indigenous-status in general practice and the delivery of culturally appropriate healthcare. Informed by best practice and literature, the study will develop a tailored practice facilitation model that is sufficiently flexible and adaptable to general practice
This study aims to develop and evaluate strategies to improve the acceptability of health care provided to Aboriginal and Torres Strait Islander patients who attend mainstream general practice in urban Sydney by
• Increasing the number of Indigenous-identified patients by determining the barriers and enablers to Indigenous status identification in general practice
• Developing a practice facilitation model which has been developed in consultation with the local Aboriginal community and other stakeholders, and informed by best practice and literature.
Multiple site case study using a mixed-methods design