Diabetes In Indigenous Communities In Queensland: Essay On The Need For Entrepreneurial Venture.

Prevalence of Diabetes in Indigenous Communities of Queensland

Discuss about the Melbourne Collaborative Cohort Study.

Diabetes is considered to be the most growing disease in the world and especially in Australia it has created a huge challenge for the public health system. It is found that the indigenous communities in Australia are three times more likely to experience to Diabetes than the non-indigenous population (Burrow & Ride, 2016). It was reported that indigenous women are two times more likely to acquire gestational diabetes as compared to their non-indigenous counterparts. Once again there is a stratification witnessed among children as they are eight times likely to be affected by Type 2 disease (NCD Risk Factor Collaboration, 2016). On the front of mortality rates, the indigenous people are more likely to be die from diabetes compared to the non-indigenous Australians. There have been robust efforts from the Australian government to make changes in the healthcare system and alleviate the lives of people. National Health and Hospitals Reform Commission was established in 2009 that made important recommendations (Chamberlain et al., 2015). The improved federal structures of the government aims to intervene on the issues of workforce planning, preventive health, registration of the practitioner and the issues of pricing and funding of the service related to healthcare. It is felt that there is a need to address the health care issues through the customer value proposition related to private health insurance.

A review of literature and pilot study on the diabetes management in Queensland it was found the healthcare services for the indigenous population is in a deplorable state. The public sector initiatives alone are not enough to address the rise of diabetes in Queensland. Community-based healthcare units have come up to look after the needs of the indigenous Queenslanders and create awareness for them (McDermott et al., 2015). Since, a community health-worker model has found to be more effective, I purport to set up an entrepreneurial venture that work in collaboration with social workers specializing in diabetic doctors or diabeticians, dietician and diabetic educators.

Since diabetes has been recognized as the 12^th largest disease in Australia, there is an urgent need to look into the problem. The Australian government has been relentlessly committed towards the prevention and seeking of pertinent solution for diabetes. According to Thomas et al., (2014), 5 per cent of the adults residing in Queensland are reported to have diabetes according to th2 1011-2012 report. According to Kelaher (2014), 7 per cent of the adults residing in Queensland are found to have diabetes based on GTT (blood measurement). This kind of a situation makes it compelling to initiate a business venture that can tap the key issues of diabetes. The prevalence of Type 1 diabetes among adults in Queensland is 21, 870. The number of registered case of Type 2 diabetes among adults in Queensland is 1, 40, 276.

According to Grantham et al., (2013), the NDDS (National Diabetes Scheme) has recognized that there is a growing trend of diabetes among the 20 to 30 year olds (Type II diabetes strikes younger, 2018). Regarding the cause of the development of Type 1 diabetes not much data is available. However, in case of Type 2 diabetes the identified reasons obesity, sedentary lifestyle, consumption of fast food, genetic reasons-situations when there is a family history of the person diagnosed with diabetes (Chamberlain et al., 2013). Highland blood can also lead to diabetes. According to Hodge et al., (2013), persons who have PCOS (Polycystic Ovary Syndrome) also have the tendency to develop diabetes.

The symptoms of diabetes are an increased thirst, a feeling of exhaustion or fatigue, blurred vision and the continuous urge to urinate. Diabetes has the potential to pose long-term damage to the diabetes patients, this is known as diabetic complications. It affects the nerves and blood vessels of the body and leads to more damage of certain parts of the body than the other parts. Another malaise brought by diabetes is the effect on the heart. It can propel coronary heart disease and is connected with cholesterol. It is cholesterol that intensifies the possibility of cardiovascular disease and heart attacks. Another problem concomitant with diabetes is diabetic retinopathy which is an outcome of diabetes in uncontrolled and controlled conditions (HealthInfoNet, 2014). Diabetes can also damage the kidney and the nerves. The condition of nerve damage can be witnessed in the form of numbness of nerves, abnormal sweating and the issue of delay in the emptying of stomach (Garcia-Garcia & Jha, 2015). Diabetic nephropathy is n outcome of damage in the kidney. This occurs over a protracted period of time.

Government Healthcare Initiatives for Diabetes Management

There is a correlation between the complications of diabetes, educational level, age group, status associated with the occupation, relation with the family members. More number of indigenous Queenslanders are getting checked for diabetes. It is predicted the problem that a large number of youth are in serious danger. The indigenous patients had to bear an obnoxious amount of $306 billion that is more than 1 of 5 dollars spent for medical care in Australia. The occurrence of diabetes is not limited to the individual biography but the broader social and historical context.

• Demand forecasts with assumptions- The biomedical and behavioral risk factors associated with diabetes can heighten the risk of acquiring diabetes. Indigenous Queenslanders have the greater tendency to develop diabetes than the non-indigenous population in Australia (Bartlett, Haines & Butler, 2018). They are reported to have multiple risk factors and associated health issues.
• Report or published paper- Reeve et al (2014), in their study of diabetes among the indigenous population, In Australia, Diabetes mellitus is known for being a National Health Priority Area for Australia. There has been a paucity of research of diabetes among the indigenous population. The high occurrence of diabetes among the indigenous population is due to the difference in education and in BMI that is widening the gap between the incidence of diabetes between the indigenous and the non-indigenous population.
• key performance indicators (KPIs) on current performance levels- My desired outcome with my entrepreneurial venture is that I want subsidized healthcare benefits to reach the indigenous Queenslanders through consultation of the experts in the fields. The stakeholders of the organization (diabeticians, medical sociologists, health social workers and nutritionists) will play an equal role in the success of the organization. I will conduct a survey among the persons affected with diabetes to assess whether they have received the healthcare service. I will continuously seek their feedback to keep a tab on their health outcome. These feedback will enable me to improve the service of the organization. I will create awareness programs among the indigenous Queenslanders through door-to-door campaigns, street play and stage shows.
• Examples of the problem- It is found that the change in the nutrition and transformation in the physical activity has played a key role in the development of diabetes. In 2010, a study in Australia found that women who have not breastfeed their children are more likely to develop diabetes compared to women who did not have a child.

Financial- The pilot study that would be conducted will provide an insight into the incidence, number and problems among indigenous Queenslanders because of diabetes (since a large-scale pilot survey requires money).

• Financial- Diabetes awareness programs can be conducted and purchase of insulin that is to be distributed at a low cost.
• Non-financial- simHealth believes that the involvement of the different stakeholders will alleviate the magnitude and burden of diabetes

Summarize how you will measure the outcomes using the table below. Include around 4 or 5 key outcome measures.

Measurement Description	Baseline Measure What is the current state?	Target Measure (Include interim targets. Consider $, FTE, rates, target budget, etc.)	When will measurement occur?
What is the measure?			Start Date	Frequency	End Date
·       Purchase of insulin ·       Awareness programs among the community through street play ·       Awareness program though stage show and street play	Currently we are in the stage of sourcing the materials. Currently we are in the stage of planning the themes and scripting. Currently we are looking for the appropriate venue and scripting the play	FTE 30 $ 20 $ 35 $	10th April 15th April 15th April	6 5 4	10th June 10th June 3rd June4        Solution/s

Option 1 -       Current situation – Currently we are trying to collect data about the indigenous population in Queenslanders and working with the different stakeholders to help with the problem.

Option 2 -       The preferred option - The organization is interested to involve the indigenous community in raising the awareness.

Criteria	Option 1		Option 2
Benefits Community or patients Staff Organisation	This will be helpful as the different stakeholders are involved.		The engagement of the indigenous community in the diagnosis, prevention and identification of the problem will have long-term effects.
Risk Community or patients Staff Organisation	No possible risks as the experts will look into the incidence of diabetes.		There would not be risks as the community members will be involved in driving change for their won awareness and prevention.
Costs: Project Recurrent Savings/Revenue	47 Australian AUD (According to the patronage offered by the Australian government) 35 AUD 20 AUD	47 AUD 30 AUD 25 AUD
Time to implement	2 month	2 month

State your recommendation/s and briefly explain your reasoning. Your reasons might include

Involving the community and different stakeholders will prove beneficial for alleviating diabetes. The people who are affected by diabetes should be made active participants in driving change of their condition. It will create a sustainable community that will involved in be creating awareness among the indigenous community and alleviate their problem.

• Benefits to patients, staff and organization- The collaborative effort will create a strong network of informed experts as well the parties who are affected by diabetes.
• Risks to patients, staff and organization - In context to the present business case, there are no identifiable risks.
• Costs
• Estimate of the set up costs (if any) – non recurrent costs- Right now there are no possible costs
• Estimate of the ongoing costs – recurrent costs- It would be of 30 USD
• Time it would take to implement the option- Since the project involves doing a pilot study, survey, evaluation of the situation followed by implementation, a two months period will be required.

	Non-recurrent (set up costs)	Recurrent (ongoing running costs)
Estimated expenditure ·        Labour Costs ·        Non-labour Costs ·        Capital Acquisitions	26 AUD 20 AUD 25 AUD	35 AUD 32 AUD 28 AUD
Estimated revenue / cost savings (if any)	32 AUD	30 AUD
Estimated net cost to simHealth	47 AUD	47 AUD

Reference and bibliography

Bartlett, C., Haines, L., & Butler, S. (2018). Reimagining health reform in Australia: Taking a systems approach to health and wellness. Strategyand.pwc.com. Retrieved 5 April 2018, from https://www.strategyand.pwc.com/reports/health-reform-australia

Burrow, S., & Ride, K. (2016). Review of diabetes among Aboriginal and Torres Strait Islander people.

Chamberlain, C., McNamara, B., Williams, E. D., Yore, D., Oldenburg, B., Oats, J., & Eades, S. (2013). Diabetes in pregnancy among indigenous women in Australia, Canada, New Zealand and the United States: a systematic review of the evidence for screening in early pregnancy. Diabetes/metabolism research and reviews, 29(4), 241-256.

Chamberlain, C., McLean, A., Oats, J., Oldenburg, B., Eades, S., Sinha, A., & Wolfe, R. (2015). Low rates of postpartum glucose screening among Indigenous and non-Indigenous women in Australia with gestational diabetes. Maternal and child health journal, 19(3), 651-663.

Garcia-Garcia, G., & Jha, V. (2015). CKD in disadvantaged populations.

Grantham, N. M., Magliano, D. J., Hodge, A., Jowett, J., Meikle, P., & Shaw, J. E. (2013). The association between dairy food intake and the incidence of diabetes in Australia: the Australian Diabetes Obesity and Lifestyle Study (AusDiab). Public health nutrition, 16(2), 339-345.

HealthInfoNet, A. I. (2014). Overview of Australian Indigenous health status. Perth: Edith Cowan University.

Hodge, A. M., Flicker, L., O’Dea, K., English, D. R., & Giles, G. G. (2013). Diabetes and ageing in the Melbourne collaborative cohort study (MCCS). Diabetes research and clinical practice, 100(3), 398-403.

Kelaher, M. A. (2014). Experiencing racism in health care: the mental health impacts for Victorian Aboriginal communities. Education, 55(56), 8-3.

McDermott, R. A., Schmidt, B., Preece, C., Owens, V., Taylor, S., Li, M., & Esterman, A. (2015). Community health workers improve diabetes care in remote Australian Indigenous communities: results of a pragmatic cluster randomized controlled trial. BMC health services research, 15(1), 68.micro and mac.

NCD Risk Factor Collaboration. (2016). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4· 4 million participants. The Lancet, 387(10027), 1513-1530.

Reeve, R., Church, J., Haas, M., Bradford, W., & Viney, R. (2014). Factors that drive the gap in diabetes rates between Aboriginal and non?Aboriginal people in non?remote NSW. Australian and New Zealand journal of public health, 38(5), 459-465.

Thomas, S. L., Zhao, Y., Guthridge, S. L., & Wakerman, J. (2014). The cost-effectiveness of primary care for Indigenous Australians with diabetes living in remote Northern Territory communities. The Medical Journal of Australia, 200(11), 658-662.

Type II diabetes strikes younger. (2018). Couriermail.com.au. Retrieved 5 April 2018, from https://www.couriermail.com.au/news/queensland/more-queenslanders-under-40-being-diagnosed-with-type-ii-diabetes/news-story/12d50ddf8adcc1788f3613e791d945e0