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首页> 外文期刊>Journal of Health Services Research & Policy >Specialist clinics in remote Australian Aboriginal communities: where rock art meets rocket science
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Specialist clinics in remote Australian Aboriginal communities: where rock art meets rocket science

机译：澳大利亚偏远原住民社区的专科诊所：岩石艺术与火箭科学的交汇处

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People in remote Aboriginal communities in the Northern Territory have greater morbidity and mortality than otherrnAustralians, but face considerable barriers when accessing hospital-based specialist services. The Specialist OutreachrnService, which began in 1997, was a novel policy initiative to improve access by providing a regular multidisciplinaryrnvisiting specialist services to remote communities. It led to two interesting juxtapositions: that of ‘state of the art’rnspecialist services alongside under-resourced primary care in remote and relatively traditional Aboriginalrncommunities; and that of attempts to develop an evidence base for the effectiveness of outreach, while meetingrnthe short-term evaluative requirements of policy-makers.rnIn this essay, first we describe the development of the service in the Northern Territory and its initial processrnevaluation. Through a Cochrane systematic review we then summarise the published research on the effectivenessrnof specialist outreach in improving access to tertiary and hospital-based care. Finally we describe the findings of anrnobservational population-based study of the use of specialist services and the impact of outreach to three remoterncommunities over 11 years.rnSpecialist outreach improves access to specialist care and may lessen the demand for both outpatient andrninpatient hospital care. Specialist outreach is, however, dependent on well-functioning primary care. According tornthe way in which outreach is conducted and the service is organised, it can either support primary care or it canrnhinder primary care and, as a result, reduce its own effectiveness.
机译：与其他澳大利亚人相比，北领地偏远原住民社区的人们发病率和死亡率更高，但是在获得医院专科服务时面临着相当大的障碍。专家外联服务始于1997年，是一项新颖的政策倡议，旨在通过向偏远社区定期提供多学科的专家服务来改善交通状况。它导致了两种有趣的并置：在偏远和相对传统的原住民社区中，“最先进的”专业服务与资源不足的初级保健相结合；在满足决策者的短期评估要求的同时，还试图建立一个有效的证据基础。在本文中，我们首先描述了北领地服务的发展及其最初的流程评估。然后，通过Cochrane系统评价，我们总结了有关有效性专家服务范围以改善获得三级和医院护理的机会的已发表研究。最后，我们描述了基于肛门保护的基于人群的专科服务使用研究的结果，以及在11年内对三个偏远社区进行外联的影响。但是，专科服务的范围取决于运作良好的初级保健。根据进行外展和组织服务的方式，它可以支持初级保健或阻碍初级保健，结果降低了其自身的效力。

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