To determine the degree to which the redesigned renal outreach program improves the efficiency and effectiveness (including cost-effectiveness) of the care and coordination delivered to chronic kidney disease patients across the continuum of care.
To find out what extent has the redesigned program improved:
- Communication across the primary/tertiary sectors and clinicians’ perceptions of the value of the information flow,
- Uptake of services and patient outcomes, and
- Costs of service delivery.
In 2017 the Northern Terrotiry Renal Services (NTRS) redesigned the renal outreach program in an attempt to address concerns about the low attendance rates at remote outreach clinics and the desire to provide a more holistic outpatient service that includes remote area outreach visits, outpatient clinics in urban areas and increased use of telemedicine.
Top End Health Service (TEHS) has strongly supported the development of the redesigned renal outreach program and is interested in its impact and value as compared to the previous program model. To this end TEHS has invited Menzies School of Health Research to undertake a process evaluation to ensure the program is being implemented as expected and/or identify issues with poor design to enable early and effective program changes.
Implications for policy and practice:
Outreach clinics aim to provide equitable and accessible services for the most dis-advantaged people. However, low attendance at outpatient clinics has a significant impact on resources across primary and tertiary services and contributes to poorer outcomes including inadequate preparation for end stage treatment and increase in avoidable admissions.
Our research has found:
Well-designed outreach programs to rural and remote communities have the potential to improve the engagement of primary health staff with specialist services, improve the uptake of health services by Indigenous people and decrease avoidable hospital admissions.
June 2017 to November 2017.