Investigating the feasibility, acceptability and appropriateness of outreach case management in an urban Aboriginal and Torres Strait Islander primary health care service: a mixed methods exploratory study

Making Education Easy

Authors:

Askew DA et al.

June 8, 2016

Summary:

The Home-based, Outreach case Management of chronic disease Exploratory (HOME) study provided holistic, patient-centred multidisciplinary care for Aboriginal and Torres Strait Islander people with chronic disease. This paper describes outcomes of an initial evaluation of this model of care. Nine patients and one patient’s spouse, as well as 15 health service staff participated in in-depth, semi-structured interviews. Patients and health service staff were very positive about the model of care. Over the 6 months of care, the patients became more involved in their health care, rates of depression declined significantly from baseline (p=0.03), and there were significant improvements in both systolic blood pressure (p<0.001) and diabetes control (p=0.05).

Comment:

With regard to the first paper, although some may consider the results as ‘proof’ that intensive case management is not cost-effective, the authors have provided useful advice here. Many of the recommendations made (more integration with other services, higher case load) align with a Whānau Ora approach. I’d be keen to see an ‘equity’ and ‘Indigenous’ lens applied to any health economic analysis undertaken here. The second paper confirms that case management can have significant impact on health outcomes for Indigenous people living with long-term conditions. There are differences between the populations of these two studies – including urban versus rural locations and health conditions. However, I think both provide useful information for health providers in Aotearoa.

Reference: BMC Health Services Research. 2016;16:178

Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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