The Getting Better at Chronic Care Project (GBACC) was designed to improve the care of Indigenous adults with poorly controlled type 2 diabetes (HbA1c ≥69 mmol/mol) and ≥1 comorbidity living in 12 rural and remote north Queensland communities. Eighty-seven such people in 6 intervention communities received, in addition to standard primary care, intensive chronic condition management for 18 months, delivered by Indigenous health workers (IHWs) who had a Certificate III or IV in Aboriginal and/or Torres Strait Islander Primary Health Care. The IHWs received additional training in diabetes management and intensive support from the clinical support team. The Indigenous health worker-supported (IHW-S) model was family-centred and based on community outreach. A total of 106 patients in 6 usual care (UC) communities received input from a centre-based primary care team (nurses, general practitioners, IHWs, etc.), with less intensive IHW support. This paper reports the outcomes of a cost–consequence analysis for implementation of this intensive management, covering the period from 1 March 2012 to 5 September 2013. The mean cost of the 18-month intervention trial was $AU10,060 per person ($AU6,706/year). The intervention was associated with a nonsignificantly greater reduction in mean HbA1c levels (–10.1 mmol/mol in the IHW-S group vs –5.4 mmol/mol in the UC group; p=0.17), a significant reduction in the proportion with extremely poor diabetes control (HbA1c ≥102 mmol/mol; p=0.002), and a sub-significant differential reduction in hospitalisation rates for type 2 diabetes as primary diagnosis (–0.09 admissions/person/year; p=0.06), with a net reduction in mean annual hospital costs of $646/person (p=0.07). Quality of life utility scores declined in both groups (between-group difference, p=0.62) and both had high rates of disease progression (between-group difference, p=0.73).
