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.


METHODS
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% CI 1.25-1.50), a higher rate of injury-related hospital episodes (IRR=1.31; 95% CI 1.15-1.48) and a higher notification rate of alcohol-related cancers. There was a smaller difference in the rates of multiple hospitalisations (IRR=1.14; 95% CI 0.75-1.74) and no improvement in overall mortality compared with controls (IRR=1.08; 95% CI 0.91-1.29).


CONCLUSIONS
There was no overall mortality benefit despite increased health service contact associated with the intervention.


CONCLUSIONS
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.
Calver
Janine
J
School of Population Health, The University of Western Australia, Crawley, Australia.
Wiltshire
Amy
A
Holman
C D'Arcy J
CD
Hunter
Ernest
E
Garfield
Carol
C
Rosman
Diana L
DL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D009369:Neoplasms / Q000139:chemically induced / Q000453:epidemiology / Q000208:ethnology*; D016016:Proportional Hazards Models; D012042:Registries; D016896:Treatment Outcome; D014904:Western Australia / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000208:ethnology*