Thomas D P, Heller R F, Hunt J M
Danila Dilba Biluru Butji Binnilutlum (Medical Service), Darwin.
Aust N Z J Public Health. 1998 Feb;22(1):86-91. doi: 10.1111/j.1467-842x.1998.tb01150.x.
Clinical consultation at Danila Dilba, an Aboriginal community-controlled health service in Darwin, were compared with consultations in Australian general practice. We described 583 consultations, using a questionnaire based on the International Classification of Primary Care. The methods were similar to those of the Australian Morbidity and Treatment Survey (AMTS) of consultations in Australian general practice undertaken by the University of Sydney Family Medicine Research Unit. Compared with Australian general practice consultations, consultations with Danila Dilba were more complex: more young patients, more new patients, more home visits, more problems managed, more new problems and more consultations leading to emergency hospital admission. Skin infections, diabetes mellitus, chronic alcohol abuse, rheumatic heart disease (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 in the AMTS. Nearly all patients saw an Aboriginal health worker first, and nearly half the consultations were with Aboriginal health workers alone. The results suggest possible limitations of fee-for-item Medicare funding of Aboriginal community-controlled health services compared with existing block grant funding.
在达尔文的一家原住民社区控制的健康服务机构——达尼拉·迪尔巴，对其临床诊疗情况与澳大利亚全科医疗的诊疗情况进行了比较。我们使用基于国际初级保健分类的问卷对583次诊疗进行了描述。这些方法与悉尼大学家庭医学研究单位开展的澳大利亚全科医疗诊疗情况的澳大利亚发病率与治疗调查（AMTS）的方法相似。与澳大利亚全科医疗诊疗相比，达尼拉·迪尔巴的诊疗更为复杂：年轻患者更多、新患者更多、家访更多、处理的问题更多、新问题更多以及导致急诊入院的诊疗更多。在达尼拉·迪尔巴的研究诊疗中，皮肤感染、糖尿病、慢性酒精滥用、风湿性心脏病（或风湿热）和慢性化脓性中耳炎的诊疗比澳大利亚发病率与治疗调查中与全科医生的诊疗更为常见。几乎所有患者首先见到的是原住民健康工作者，并且近一半的诊疗仅与原住民健康工作者进行。结果表明，与现有的整笔拨款资金相比，原住民社区控制的健康服务按项目收费的医疗保险资金可能存在局限性。
