Comparison and outcomes of emergency department presentations with respiratory disorders among Australian indigenous and non-indigenous patients

Abstract

Background There is sparse evidence in the literature assessing emergency department presentation with respiratory disorders among Indigenous patients. The objective of this study was to evaluate the clinical characteristics and outcomes for Indigenous Australians in comparison to non-Indigenous patients presenting to Emergency Department (ED) with respiratory disorders. Methods In this study, two non-contiguous one-month study periods during wet (January) and dry (August) season were reported on, and differences in demographics, respiratory diagnosis, hospital admission, length of hospital stay, re-presentation to hospital after discharge and mortality between Australian Indigenous and non-Indigenous patients was assessed. Results There were a total of 528 respiratory ED presentations, 258 (49%) during wet and 270 (51%) in dry season, from 477 patients (52% female and 40% Indigenous). The majority of ED presentations (84%) were self-initiated, with a difference between Indigenous (80%) and non-Indigenous (88%) presentations. Indigenous presentations recorded a greater proportion of transfers from another healthcare facility compared to non-Indigenous presentations (11% vs. 1%). Less than half of presentations (42%) resulted in admission to the ward with no difference by Indigenous status. Lower respiratory tract infections were the most common cause of presentation (41%), followed by airway exacerbation (31%) which was more commonly seen among Indigenous (34%) than non-Indigenous (28%) presentations. Almost 20% of Indigenous patients reported multiple presentations to ED compared to 1% of non-Indigenous patients, though mortality on follow up did not differ (22% for both). Conclusions The results of this study may be an avenue to explore possibilities of implementing programs that may be helpful to reduce preventable ED presentation and recurrent hospitalisations among Indigenous population.

Sex differences in pulmonary function parameters among Indigenous Australians with and without chronic airway disease

“…Indigenous people have a higher burden of chronic health conditions, including cardiorespiratory disorders, giving rise to higher morbidity and mortality [33][34][35][36][37]. Understanding the different clinical manifestations [38][39][40] and appropriate interventions [41][42][43][44][45][46][47][48][49][50] will help in early diagnosis and management of chronic health conditions in the Indigenous population, for better health related outcomes. Varying manifestations of sex differences in PFTP's have been demonstrated in this study, both with and without underlying radiological evidence of CADs among an Indigenous Australian cohort.…”

COPD disease knowledge, self-awareness and reasons for hospital presentations among a predominately Indigenous Australian cohort: a study to explore preventable hospitalisation

“…As such, it is plausible that the current study captured anywhere from 40% to 60% of current Indigenous COPD patients in the TEHS region. More recently, several aspects of respiratory health issues among Indigenous Australians from the TEHS region of the NT has been reported in the literature 19–24 28 32 35–40 52–66. Hence, this study could be considered as an important further step forward67 in addressing COPD disease awareness and knowledge in an Indigenous population.…”

“…In this study, SOB was the predominant reason for hospital presentation. A recent study also demonstrated that SOB was the most common reason for hospital presentation 28. Additionally, a higher proportion of Indigenous patients were transferred to tertiary care hospital from other remote/regional health centres 28.…”

“…Indigenous people worldwide, including Indigenous Australians, are reported to have a higher respiratory disease burden alongside higher healthcare utilisation 5–9 19–24 26–29. Poor disease awareness and self-management strategies of COPD are not uncommon among various ethnic populations, including in high-income countries 16 18 27 30.…”

“…A recent study also demonstrated that SOB was the most common reason for hospital presentation. 28 Additionally, a higher proportion of Indigenous patients were transferred to tertiary care hospital from other remote/regional health centres. 28 In the current study, the majority of Indigenous patients resided in remote communities and preferred to seek help from local health centres when they become unwell and lacked COPD action plans.…”