A closer look at what ails us will help with fairer health funding in the NT
EMBARGOED UNTIL 12.00 NOON, SUNDAY 16 MAY 2004
A measure called the disability adjusted life-year (DALY), which takes into account years of life lost (YLL) due to premature mortality and years lost due to disability (YLD) would result in a fairer distribution of health funding than the current "per capita" system for Indigenous Australians living in the Northern Territory (NT), according to details of research published in the current issue of The Medical Journal of Australia.
Dr Yuejen Zhao, Epidemiologist from Health Gains Planning at the Northern Territory Department of Health and Community Services, says in order to more fairly distribute health dollars, a comprehensive assessment of fatal and non-fatal conditions is important in describing differentials in the health status of the NT population.
"Our study provides comparative data to identify health priorities and facilitate a more equitable distribution of health funding," said Dr Zhao.
At 198,000, the population of the NT represents about 1 per cent of the Australian population. Twenty nine per cent of the NT population is Indigenous compared to 2.4 per cent of the rest of Australia.
The study analysed NT data from 1 January 1994 to 30 December 1998 from many sources to determine disability-adjusted life-years (DALYs) by age, sex, cause and Aboriginality.
Cardiovascular disease was the leading contributor (14.9 per cent) to the total burden of disease and injury in the NT, followed by mental disorders (14.5 per cent) and malignant neoplasms (11.2 per cent).
There was also a substantial contribution from unintentional injury (10.4 per cent) and intentional injury (4.9 per cent).
Overall the NT Aboriginal population had a rate of burden of disease 2.5 times higher than the rate for Australia overall. In the 35-54 year age group their DALY rate was 4.1 times higher than the rate for non-Aboriginal NT residents.
"In 1996-97 Federal health funding for the Northern Territory was almost 20 per cent below the national average, before taking into account the higher cost because of remoteness and cultural complexity.
"By providing an alternative and more precise tool to assess and monitor needs for healthcare in the NT, our study is a step toward more effective and efficient resource allocation," Dr Zhao said.
Also in this issue of the Journal, Dr Zhiqiang Wang and colleagues look at the association between diabetes and coronary heart disease in Aboriginal people. They ask: are women disadvantaged? Professor Robyn McDermott and colleagues present a study on diabetes care in remote northern Australian Indigenous communities.
The Medical Journal of Australia is a publication of the Australian Medical Association.
CONTACT Dr Yuejen ZHAO, 08 8922 7247; Dr Steve Guthridge 08 8922 7232, 0401 116 338
Judith TOKLEY, AMA Public Affairs, 02 6270 5471, 0408 824 306