Background: Providing effective primary care for remote Indigenous communities in the Northern Territory (NT) is costly. There are few GPs working in the NT and therefore, less Medicare and PBS funds received. Indigenous Australians in the NT experience higher rates of chronic disease including diabetes and higher rates of hospitalisation, mortality and greater years of life lost (YLL). There is a lack of data confirming the cost-effectiveness and health outcomes associated with primary care utilisation for Indigenous people with diabetes in remote communities in the NT.

Method: A population based retrospective cohort study was conducted. Two variables of interest were disease stage (new, established or complicated cases) and primary care usage (low, medium or high). Outcome measures include hospitalisations, potentially avoidable hospitalisations (PAH), mortality and YLL.  

Results: Compared to the control group (low primary care utilisation), the intervention group (patients who utilised primary care between 2-11 times annually) experienced lower rates of annual hospitalisations, PAH, lower death rates and fewer YLL. For complicated cases, the intervention group experienced a reduction in annual hospitalisation rates from 6.7 to 1.2.  PAH rates were reduced from 3.64 to 0.72, death rates were reduced from 3.77 to 1.25 and YLL decreased from 1.14 to 0.29. The cost of preventing one hospitalisation for diabetes was $248 for those in the medium level intervention group and $739 for those in the high level utilisation group; much less than $2915, the average cost of one hospitalisation.

Conclusion: The benefits of primary care utilisation have been shown to provide net health benefits to patients and cost savings to government. Study results are of value to policy makers charged with allocation of scarce health dollars. Remaining with the status quo will mean high costs for hospital care with continued poor health outcomes.