Does health assessment improve health outcomes in Indigenous people? An RCT with 13 years of follow‐up
Objective: To examine the impact of a multi‐component health assessment on mortality and morbidity in Kimberley Aboriginal residents during a 13‐year follow‐up. Method: A population‐based randomised controlled trial using linked hospital, cancer and death records to evaluate outcomes in 620 interven...
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| Veröffentlicht in: | Australian and New Zealand journal of public health 2005-04, Vol.29 (2), p.107-111 |
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| container_title | Australian and New Zealand journal of public health |
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| creator | Calver, Janine Wiltshire, Amy Holman, C. D'Arcy J. Hunter, Ernest Garfield, Carol Rosman, Diana L. |
| description | Objective: To examine the impact of a multi‐component health assessment on mortality and morbidity in Kimberley Aboriginal residents during a 13‐year follow‐up.
Method: A population‐based randomised controlled trial using linked hospital, cancer and death records to evaluate outcomes in 620 intervention and 6,736 control subjects.
Results: The intervention group had a higher rate of first‐time hospitalisation for any reason (IRR=1.37; 95% Cl 1.25‐1.50), a higher rate of injury‐related hospital episodes (IRR=1.31; 95% Cl 1.15‐1.48) and a higher notification rate of alcoholrelated cancers There was a smaller difference in the rates of multiple hospitalisations (IRR=1.14; 95% Cl 0.75‐1.74) and no improvement in overall mortality compared with controls (IRR=1.08; 95% Cl 0.91‐1.29).
Conclusions: There was no overall mortality benefit despite increased health service contact associated with the intervention.
Implications: Although not influencing mortality rates, multi‐component health assessment may result in a period of increased health service use in Aboriginal and Torres Strait Islander populations, thus constituting an ‘intervention’. However, this should not be confused with systematic and sustained interventions and investment in community development to achieve better health outcomes. |
| doi_str_mv | 10.1111/j.1467-842X.2005.tb00058.x |
| format | Article |
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Method: A population‐based randomised controlled trial using linked hospital, cancer and death records to evaluate outcomes in 620 intervention and 6,736 control subjects.
Results: The intervention group had a higher rate of first‐time hospitalisation for any reason (IRR=1.37; 95% Cl 1.25‐1.50), a higher rate of injury‐related hospital episodes (IRR=1.31; 95% Cl 1.15‐1.48) and a higher notification rate of alcoholrelated cancers There was a smaller difference in the rates of multiple hospitalisations (IRR=1.14; 95% Cl 0.75‐1.74) and no improvement in overall mortality compared with controls (IRR=1.08; 95% Cl 0.91‐1.29).
Conclusions: There was no overall mortality benefit despite increased health service contact associated with the intervention.
Implications: Although not influencing mortality rates, multi‐component health assessment may result in a period of increased health service use in Aboriginal and Torres Strait Islander populations, thus constituting an ‘intervention’. However, this should not be confused with systematic and sustained interventions and investment in community development to achieve better health outcomes.</description><identifier>ISSN: 1326-0200</identifier><identifier>EISSN: 1753-6405</identifier><identifier>DOI: 10.1111/j.1467-842X.2005.tb00058.x</identifier><identifier>PMID: 15915612</identifier><language>eng</language><publisher>Oxford, UK: Elsevier B.V</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking - adverse effects ; Alcohol Drinking - ethnology ; Cancer ; Classification ; Community development ; Feedback ; Female ; Follow-Up Studies ; Health services ; Health Status Indicators ; Hospitalization - statistics & numerical data ; Hospitals ; Humans ; Indigenous peoples ; Intervention ; Male ; Medical Record Linkage ; Medical research ; Middle Aged ; Morbidity ; Mortality ; Mortality rates ; Native peoples ; Neoplasms - chemically induced ; Neoplasms - epidemiology ; Neoplasms - ethnology ; Nutrition research ; Proportional Hazards Models ; Public health ; Registries ; Research subjects ; Treatment Outcome ; Western Australia - epidemiology ; Wounds and Injuries - epidemiology ; Wounds and Injuries - ethnology</subject><ispartof>Australian and New Zealand journal of public health, 2005-04, Vol.29 (2), p.107-111</ispartof><rights>2005 Copyright 2005 THE AUTHORS.</rights><rights>2005. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5867-ac0bcfa58dc983f3b8d7b3e65eca2faa1a783b411f5a4175cf2237098bc2d15a3</citedby><cites>FETCH-LOGICAL-c5867-ac0bcfa58dc983f3b8d7b3e65eca2faa1a783b411f5a4175cf2237098bc2d15a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1467-842X.2005.tb00058.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1467-842X.2005.tb00058.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27843,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15915612$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Calver, Janine</creatorcontrib><creatorcontrib>Wiltshire, Amy</creatorcontrib><creatorcontrib>Holman, C. D'Arcy J.</creatorcontrib><creatorcontrib>Hunter, Ernest</creatorcontrib><creatorcontrib>Garfield, Carol</creatorcontrib><creatorcontrib>Rosman, Diana L.</creatorcontrib><title>Does health assessment improve health outcomes in Indigenous people? An RCT with 13 years of follow‐up</title><title>Australian and New Zealand journal of public health</title><addtitle>Aust N Z J Public Health</addtitle><description>Objective: To examine the impact of a multi‐component health assessment on mortality and morbidity in Kimberley Aboriginal residents during a 13‐year follow‐up.
Method: A population‐based randomised controlled trial using linked hospital, cancer and death records to evaluate outcomes in 620 intervention and 6,736 control subjects.
Results: The intervention group had a higher rate of first‐time hospitalisation for any reason (IRR=1.37; 95% Cl 1.25‐1.50), a higher rate of injury‐related hospital episodes (IRR=1.31; 95% Cl 1.15‐1.48) and a higher notification rate of alcoholrelated cancers There was a smaller difference in the rates of multiple hospitalisations (IRR=1.14; 95% Cl 0.75‐1.74) and no improvement in overall mortality compared with controls (IRR=1.08; 95% Cl 0.91‐1.29).
Conclusions: There was no overall mortality benefit despite increased health service contact associated with the intervention.
Implications: Although not influencing mortality rates, multi‐component health assessment may result in a period of increased health service use in Aboriginal and Torres Strait Islander populations, thus constituting an ‘intervention’. However, this should not be confused with systematic and sustained interventions and investment in community development to achieve better health outcomes.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Alcohol Drinking - adverse effects</subject><subject>Alcohol Drinking - ethnology</subject><subject>Cancer</subject><subject>Classification</subject><subject>Community development</subject><subject>Feedback</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health services</subject><subject>Health Status Indicators</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Indigenous peoples</subject><subject>Intervention</subject><subject>Male</subject><subject>Medical Record Linkage</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Mortality rates</subject><subject>Native peoples</subject><subject>Neoplasms - chemically induced</subject><subject>Neoplasms - epidemiology</subject><subject>Neoplasms - ethnology</subject><subject>Nutrition research</subject><subject>Proportional Hazards Models</subject><subject>Public health</subject><subject>Registries</subject><subject>Research subjects</subject><subject>Treatment Outcome</subject><subject>Western Australia - epidemiology</subject><subject>Wounds and Injuries - epidemiology</subject><subject>Wounds and Injuries - ethnology</subject><issn>1326-0200</issn><issn>1753-6405</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7TQ</sourceid><recordid>eNqVkc2O0zAUhSMEYn7gFZAFEmKTYsex47IZVZ3pzEjlRzCIio3lODfUJYlLnEzbHY_AM_Ik3KgFJBYIvLmW_d3je3yi6DGjI4br-WrEUpnFKk0Wo4RSMepyikWNtneiY5YJHsuUiru454mMKSJH0UkIK4QYHt2PjpgYMyFZchwtzz0EsgRTdUtiQoAQamg64up162_h543vO-trJF1DrpvCfYLG94Gswa8rOCOThryd3pCNQ5RxsgPTBuJLUvqq8pvvX7_16wfRvdJUAR4e6mn0fnZxM72K568vr6eTeWyFQlPG0tyWRqjCjhUvea6KLOcgBViTlMYwkymep4yVwqTo1ZZJwjM6VrlNCiYMP42e7nVx_i89hE7XLlioKtMAjqxlpqSSfIzgs7-CTI2ZUomkA_rkD3Tl-7ZBG5pTKSmjSSaRerGnbOtDaKHU69bVpt1pRvUQnF7pITg9BKeH4PQhOL3F5keHJ_q8huJ36yEpBM72wMZVsPsPaT35-OaK0QwV4r2CCx1sfymY9jN-Cs-E_vDqUr-bz-YvF9lCz5A_3_OAcd06aHWwDhoLhWvBdrrw7l-c_QAMWs7w</recordid><startdate>200504</startdate><enddate>200504</enddate><creator>Calver, Janine</creator><creator>Wiltshire, Amy</creator><creator>Holman, C. D'Arcy J.</creator><creator>Hunter, Ernest</creator><creator>Garfield, Carol</creator><creator>Rosman, Diana L.</creator><general>Elsevier B.V</general><general>Blackwell Publishing Ltd</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T2</scope><scope>7TQ</scope><scope>C1K</scope><scope>DHY</scope><scope>DON</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7U2</scope><scope>7X8</scope></search><sort><creationdate>200504</creationdate><title>Does health assessment improve health outcomes in Indigenous people? An RCT with 13 years of follow‐up</title><author>Calver, Janine ; Wiltshire, Amy ; Holman, C. D'Arcy J. ; Hunter, Ernest ; Garfield, Carol ; Rosman, Diana L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5867-ac0bcfa58dc983f3b8d7b3e65eca2faa1a783b411f5a4175cf2237098bc2d15a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Alcohol Drinking - adverse effects</topic><topic>Alcohol Drinking - ethnology</topic><topic>Cancer</topic><topic>Classification</topic><topic>Community development</topic><topic>Feedback</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Health services</topic><topic>Health Status Indicators</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Indigenous peoples</topic><topic>Intervention</topic><topic>Male</topic><topic>Medical Record Linkage</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Mortality rates</topic><topic>Native peoples</topic><topic>Neoplasms - chemically induced</topic><topic>Neoplasms - epidemiology</topic><topic>Neoplasms - ethnology</topic><topic>Nutrition research</topic><topic>Proportional Hazards Models</topic><topic>Public health</topic><topic>Registries</topic><topic>Research subjects</topic><topic>Treatment Outcome</topic><topic>Western Australia - epidemiology</topic><topic>Wounds and Injuries - epidemiology</topic><topic>Wounds and Injuries - ethnology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Calver, Janine</creatorcontrib><creatorcontrib>Wiltshire, Amy</creatorcontrib><creatorcontrib>Holman, C. D'Arcy J.</creatorcontrib><creatorcontrib>Hunter, Ernest</creatorcontrib><creatorcontrib>Garfield, Carol</creatorcontrib><creatorcontrib>Rosman, Diana L.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>PAIS Index</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Safety Science and Risk</collection><collection>MEDLINE - Academic</collection><jtitle>Australian and New Zealand journal of public health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Calver, Janine</au><au>Wiltshire, Amy</au><au>Holman, C. D'Arcy J.</au><au>Hunter, Ernest</au><au>Garfield, Carol</au><au>Rosman, Diana L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does health assessment improve health outcomes in Indigenous people? An RCT with 13 years of follow‐up</atitle><jtitle>Australian and New Zealand journal of public health</jtitle><addtitle>Aust N Z J Public Health</addtitle><date>2005-04</date><risdate>2005</risdate><volume>29</volume><issue>2</issue><spage>107</spage><epage>111</epage><pages>107-111</pages><issn>1326-0200</issn><eissn>1753-6405</eissn><abstract>Objective: To examine the impact of a multi‐component health assessment on mortality and morbidity in Kimberley Aboriginal residents during a 13‐year follow‐up.
Method: A population‐based randomised controlled trial using linked hospital, cancer and death records to evaluate outcomes in 620 intervention and 6,736 control subjects.
Results: The intervention group had a higher rate of first‐time hospitalisation for any reason (IRR=1.37; 95% Cl 1.25‐1.50), a higher rate of injury‐related hospital episodes (IRR=1.31; 95% Cl 1.15‐1.48) and a higher notification rate of alcoholrelated cancers There was a smaller difference in the rates of multiple hospitalisations (IRR=1.14; 95% Cl 0.75‐1.74) and no improvement in overall mortality compared with controls (IRR=1.08; 95% Cl 0.91‐1.29).
Conclusions: There was no overall mortality benefit despite increased health service contact associated with the intervention.
Implications: Although not influencing mortality rates, multi‐component health assessment may result in a period of increased health service use in Aboriginal and Torres Strait Islander populations, thus constituting an ‘intervention’. However, this should not be confused with systematic and sustained interventions and investment in community development to achieve better health outcomes.</abstract><cop>Oxford, UK</cop><pub>Elsevier B.V</pub><pmid>15915612</pmid><doi>10.1111/j.1467-842X.2005.tb00058.x</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; PAIS Index; Alma/SFX Local Collection |
| subjects | Adolescent Adult Aged Aged, 80 and over Alcohol Drinking - adverse effects Alcohol Drinking - ethnology Cancer Classification Community development Feedback Female Follow-Up Studies Health services Health Status Indicators Hospitalization - statistics & numerical data Hospitals Humans Indigenous peoples Intervention Male Medical Record Linkage Medical research Middle Aged Morbidity Mortality Mortality rates Native peoples Neoplasms - chemically induced Neoplasms - epidemiology Neoplasms - ethnology Nutrition research Proportional Hazards Models Public health Registries Research subjects Treatment Outcome Western Australia - epidemiology Wounds and Injuries - epidemiology Wounds and Injuries - ethnology |
| title | Does health assessment improve health outcomes in Indigenous people? An RCT with 13 years of follow‐up |
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