More is more in remote Central Australia: more provision of primary healthcare services is associated with more acute medical evacuations and more remote telephone consultations.
BACKGROUND
This study investigated whether increased numbers of primary healthcare clinical consultations in Indigenous communities in some remote areas of Australia are associated with the reduced need for urgent medical evacuations and remote telephone consultations.


METHODS
A retrospective comparison study of routinely collected data utilising correlation analysis was conducted. Statistical associations have been measured using Pearson product-moment correlation coefficients. The setting was 20 primary healthcare centres in the Northern Territory servicing ≥5900 residents between July 2008 and June 2010; data were collected from Central Australia Remote Health and the Royal Flying Doctor Service-Central Operations, Alice Springs base. Main outcome measures included number of acute medical evacuations and number of remote telephone consultations relative to number of face-to-face consultations with Aboriginal health workers, remote area nurses and general practitioners.


RESULTS
Statistically significant positive correlations were found between numbers of acute medical evacuations and numbers of face-to-face consultations (r = 0.659; 95% confidence interval (CI): 0.305-0.855), remote area nurse consultations (r = 0.481; 95% CI: 0.055-0.765) and general practitioner consultations (r = 0.798; 95% CI: 0.555-0.920). Significant positive correlations were also found between numbers of remote telephone consultations and numbers of face-to-face consultations (r = 0.546; 95% CI: 0.135-0.795) and general practitioner consultations (r = 0.563; 95% CI: 0.163-0.805).


CONCLUSIONS
The provision of more frequent healthcare centre face-to-face consultations, including general practitioner consultations, is associated with an increased burden of acute medical evacuations and remote telephone consultation services in this remote setting.
Central Australia Remote Health, Alice Springs, Northern Territory, Australia. jhussain@alum.mit.edu.
Joy
J
Hussain
Department of Rural and Indigenous Health, School of Rural Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Moe, Victoria, Australia. Anske.Robinson@monash.edu.
Anske
A
Robinson
Department of Rural and Indigenous Health, School of Rural Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Moe, Victoria, Australia. Margaret.Stebbing@monash.edu.
Margaret
M
Stebbing
School of Rural Health (Churchill Campus), Monash University, Churchill, Victoria, Australia. Matthew.Mcgrail@monash.edu.
Matthew
M
McGrail
D017732:Air Ambulances / Q000706:statistics & numerical data*; D001315:Australia; D006801:Humans; D011320:Primary Health Care / Q000706:statistics & numerical data*; D019114:Remote Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D019035:Rural Health Services / Q000706:statistics & numerical data*
Australia/Pacific