Improving access to specialist care for remote Aboriginal communities: evaluation of a specialist outreach service

Med J Aust. 2001 May 21;174(10):507-11. doi: 10.5694/j.1326-5377.2001.tb143400.x.


Objective: To identify barriers faced by Aboriginal people from remote communities in the Northern Territory (NT) when accessing hospital-based specialist medical services, and to evaluate the impact of the Specialist Outreach Service (SOS) on these barriers.

Design: Combined quantitative and qualitative study.

Setting: Remote Aboriginal communities in the "Top End" of the NT, 1993-1999 (spanning the introduction of the SOS in 1997).

Participants: 25 remote health practitioners, patients and SOS specialists.

Main outcome measures: Numbers of consultations with specialists; average cost per consultation; perceived barriers to accessing hospital-based outpatient care; and perceived impact of specialist outreach on these barriers.

Results: Perceived barriers included geographic remoteness, poor doctor-patient communication, poverty, cultural differences, and the structure of the health service. Between 1993 and 1999, there were 5,184 SOS and non-SOS outreach consultations in surgical specialties. Intensive outreach practice (as in gynaecology and ophthalmology) increased total consultations by up to 441% and significantly reduced the number of transfers to hospital outpatient clinics (P< 0.001). Average cost per consultation was $277 for SOS consultations, compared with $450 at Royal Darwin Hospital and $357 at the closest regional hospital. Outreach has reduced barriers relating to distance, communication and cultural differences, and potentially bolsters existing primary healthcare services.

Conclusions: When compared with hospital-based outpatient services alone, outreach is a more accessible, appropriate and efficient method of providing specialist medical services to remote Aboriginal communities in the NT.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel
  • Community-Institutional Relations*
  • Culture
  • Female
  • Health Services Accessibility*
  • Humans
  • Male
  • Medicine*
  • Native Hawaiian or Other Pacific Islander*
  • Northern Territory
  • Referral and Consultation
  • Rural Population
  • Specialization*