title: The impact of supply reduction through alcohol management plans on serious injury in remote indigenous communities in remote Australia: a ten-year analysis using data from the Royal Flying Doctor Service.
abstract: OBJECTIVE
  To assess the impact of supply reduction through Alcohol Management Plans (AMP) on the rate of serious injuries in four indigenous communities in remote Australia.
  
  
  METHODS
  An ecological study used the database of the Royal Flying Doctor Service (RFDS) to calculate trauma retrieval rates for 8 years pre- and 2 years post-AMP in four remote communities covering a period from 1 January 1995 to 24 November 2005. All serious injuries in these communities required aero-medical retrieval. Results Serious injury resulted in a total of 798 retrievals during the observation period. One-sided analysis of variance for repeated measurements over the 10 years demonstrated a significant (P = 0.021) decrease of injury retrieval rates after the introduction of the AMP. Similarly, a comparison of linear trends of injury retrieval rates pre- and post-AMP also resulted in a significant decrease (P = 0.022; one-sided paired t-test). Comparisons of injury retrieval rates of just the 2 years pre- and post-AMP also revealed a significant reduction (P = 0.001; paired t-test), with an averaged 52% decline. Identical comparisons of retrieval rates for causes other than injury revealed no significant changes. Conclusion This impact evaluation provides evidence that AMP was effective in reducing serious injury in the assessed indigenous communities.
authors.affiliation: Royal Flying Doctor Service and School of Medicine, James Cook University, 1 Junction Street, Edgehill, Queensland, Australia. Stephen.margolis@jcu.edu.au
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Margolis
authors.forename: Valmae A
authors.initials: VA
authors.lastname: Ypinazar
authors.forename: Reinhold
authors.initials: R
authors.lastname: Muller
mesh_terms: D000056:Accident Prevention / Q000191:economics / Q000639:trends*; D000293:Adolescent; D000328:Adult; D017732:Air Ambulances; D000428:Alcohol Drinking / Q000191:economics / Q000453:epidemiology / Q000639:trends*; D000434:Alcoholic Beverages / Q000191:economics; D000437:Alcoholism / Q000191:economics / Q000453:epidemiology*; D001315:Australia / Q000453:epidemiology; D003695:Delivery of Health Care / Q000191:economics / Q000639:trends; D019468:Disease Management; D005260:Female; D006303:Health Services, Indigenous / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000191:economics / Q000639:trends*; D044382:Population Groups; D012111:Residence Characteristics