title: Does health assessment improve health outcomes in indigenous people? An RCT with 13 years of follow-up.
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.
  
  
  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.
authors.affiliation: School of Population Health, The University of Western Australia, Crawley, Australia.
authors.forename: Janine
authors.initials: J
authors.lastname: Calver
authors.forename: Amy
authors.initials: A
authors.lastname: Wiltshire
authors.forename: C D'Arcy J
authors.initials: CD
authors.lastname: Holman
authors.forename: Ernest
authors.initials: E
authors.lastname: Hunter
authors.forename: Carol
authors.initials: C
authors.lastname: Garfield
authors.forename: Diana L
authors.initials: DL
authors.lastname: Rosman
mesh_terms: 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*