Closing the Gap: Examining how the problem of Aboriginal and Torres Strait Islander disadvantage is represented in policy

Objectives Review the evidence for the effectiveness of chronic condition self-management programs applied to Aboriginal and Torres Strait Islander Peoples. Methods A rapid review methodology was followed to develop an evidence summary from peer-reviewed and grey literature. Results Only seven peer-reviewed studies were identified. The evidence indicated that group programs, particularly the Stanford Program, and structured individual chronic condition self-management programs were of good quality for Aboriginal and Torres Strait Islander Peoples, although these need to be integrated into practice in order to see the greatest benefits. The Flinders Program showed promise as a standardised program with content designed specifically with and for these populations. Numerous grey literature sources were identified, many using strong participatory approaches developed locally within Aboriginal and Torres Strait Islander Peoples. However, few of these programs have been subject to rigorous evaluation. Discussion Despite the significant focus on chronic condition self-management programs to help address the burden of disease for Aboriginal and Torres Strait Islander Peoples, few studies exist that have been properly evaluated. The Closing the Gap Principles developed by the Australian Institute of Health and Welfare offer important guidance for how to proceed to maximise engagement, cultural appropriateness and ownership of program initiatives.

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Culturally safe and sustainable solution for Closing the Gap-registered patients discharging from a tertiary public hospital

Australian Health Review ◽

10.1071/ah18160 ◽

2020 ◽

Vol 44 (2) ◽

pp. 200

Author(s):

Scott Mitchell ◽

Hayley Michael ◽

Stephanie Highden-Smith ◽

Vivian Bryce ◽

Sean Grugan ◽

...

Keyword(s):

Continuity Of Care ◽

Public Hospital ◽

Torres Strait Islander ◽

Culturally Sensitive ◽

Public Hospitals ◽

Smooth Transition ◽

Cardiac Care ◽

Funding Model ◽

Closing The Gap ◽

Torres Strait

This case study describes the development, implementation and review of a sustainable and culturally sensitive procedure for a hospital-funded discharge medicine subsidy for Aboriginal and Torres Strait Islander patients registered with the Closing the Gap (CTG) program discharging from a public hospital. A 7-day fully subsidised medication supply was approved to be offered to Aboriginal and Torres Strait Islander patients admitted under cardiac care teams, including cardiology and cardiothoracic surgery patients. Patients were offered the option of a 7-day supply free of cost to them or a full Pharmaceutical Benefits Scheme (PBS) supply if preferred. A general practitioner (GP) appointment was organised within 7 days of discharge to ensure patients received ongoing supply of their medications as well as timely clinical review after discharge. Over a 34-month period from September 2015 to June 2018, 535 Aboriginal and Torres Strait Islander patients were admitted to the hospital under cardiac care teams. Of these patients, 296 received a subsidised discharge medication supply with a total cost of A$6314.56 to the hospital over the trial period, with a mean cost of A$21.26 per discharge. The provision of subsidised medications through the CTG program has improved the continuity of care for Aboriginal and Torres Strait Islander patients. The culturally sensitive approach is well received and has allowed smooth transition back to the community. This site-specific and state-based funding model was found to be financially sustainable at a public hospital. What is known about the topic?The CTG PBS program is not applicable to discharge prescriptions from public hospitals. As such, patients are required to either leave the hospital with no medicines or leave the hospital with medicines for which they have to pay full PBS price. This creates a huge financial barrier to the care for CTG-registered patients in the acute care setting. What does this paper add?A sustainable solution to the problem was found via a state-funded model while providing a supportive team to ensure GP follow-up and continuity of care after discharge. What are the implications for practitioners?If similar approvals are granted and supported at other public hospital sites, practitioners will be afforded one less barrier to provide patient-centred care for Aboriginal and Torres Strait Islander patients.

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Aboriginal and Torres Strait Islander Education

International Journal of Critical Indigenous Studies ◽

10.5204/ijcis.v5i2.90 ◽

2012 ◽

Vol 5 (2) ◽

pp. 50-52

Author(s):

David Singh

Keyword(s):

Student Outcomes ◽

Torres Strait Islander ◽

Indigenous Australians ◽

Australian Government ◽

Education Systems ◽

Indigenous Children ◽

Australian Education ◽

Closing The Gap ◽

Torres Strait

Australian education systems have long been challenged by the gap between Indigenous and nonIndigenous student outcomes. All levels of Australian government, as well as Indigenous leaders and educators, however, continue to meet the challenge through exhortation, strategies and targets. The most prominent of such strategies is ‘Closing the Gap’, which gives practical expression to the Australian Government’s commitment to measurably improving the lives of Indigenous Australians, especially Indigenous children.

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