CLINICAL CONSULTATIONS IN AN ABORIGINAL COMMUNITY-CONTROLLED HEALTH-SERVICE - A COMPARISON WITH GENERAL-PRACTICE

Clinical consultations at Danila Dilba, an Aboriginal community-contro lled health service in Darwin, were compared with consultations in Aus tralian general practice. We described 583 consultations, using a ques tionnaire based on the International Classification of Primary: Care. The methods were similar to those of the Australian Morbidity and Trea tment Survey (AMTS) of consultations in Australian general practice un dertaken by the University of Sydney-Family Medicine Research Unit. Co mpared with Australian general practice consultations, consultations w ith Danila Dilba were more complex: more young patients, more ncrs pat ients, more home visits, more problems managed, more new problems and more consultations leading to emergency hospital admission. Skin infec tions, diabetes mellitus, chronic alcohol abuse, rheumatic heart disea se (or rheumatic fever) and chronic suppurative otitis media were much more commonly managed at study consultations at Danila Dilba than at consultations with general practitioners iii the AMTS, Nearly all pati ents saw an Aboriginal health worker first, and nearly half the consul tations were with Aboriginal health workers alone. The results suggest possible limitations of fee-for-item Medicare funding elf Aboriginal community-controlled health services compared with existing block gran t funding.