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Economic evaluation of Indigenous health worker management of poorly controlled type 2 diabetes in north Queensland

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Diabetes and its complications produce significant burdens for the health system in Australia. Between 2000–01 and 2008–09, total annual health expenditure for diabetes increased by 86% to $1507 million (2.3% of total health expenditure in 2008–09), an increase greater than that for all disease during the same period (60%).1

Indigenous Australians experience a disproportionally high burden of diabetes, which is responsible for 12% of the large gap in disability-adjusted life-years between Indigenous and non-Indigenous people.2 Indigenous Australians also have higher rates of hospitalisation for diabetes (3.4–5.0 times higher) and higher mortality rates from diabetes (7.0 times higher) than non-Indigenous Australians.3 They are also more likely to develop type 2 diabetes at an earlier age.4 Persistently high blood glucose levels cause organ damage, resulting in renal, circulatory and ophthalmic disorders. Indigenous Australians experience exceptionally high rates of these complications, including 11.2 times the rate of hospitalisation for renal failure4 and less effective care partnerships with their clinicians.5 It is therefore important to develop clinical programs that better manage diabetes and its complications in Indigenous…