Objectives: To examine the accessibility and quality of care received in emergency departments by Aboriginal and Torres Strait Islander people compared with other Australians.
Methods:We examined 2004-05 data from the National Non-admitted Patient Emergency Department Care database from the Northern Territory and Western Australia, the only jurisdictions where Indigenous identification in the database was considered acceptable.
Results:In the NT, Indigenous people were 1.7 times as likely to present to an emergency department as non-Indigenous people. Indigenous patients in the NT and WA do not appear to use EDs for "primary care" problems more than nonIndigenous patients. More NT Indigenous patients walked out before being seen or before their treatment was completed. However, Indigenous patients generally waited a similar time, and often slightly shorter, to be seen as similar non-Indigenous patients in WA and the NT.
Conclusions:We recommend the regular monitoring of equity in the accessibility and quality of ED care for Indigenous people compared with other Australians. Indigenous identification in the database needs to improve so monitoring of ED However, most Aboriginal and Torres Strait Islander health care policy and research has concentrated on the primary care rather than the hospital sector.2 Most of the limited attention to hospital services has been on admitted patients rather than emergency departments (EDs), the focus of this paper.The Aboriginal and Torres Strait Islander Health Performance Framework 3 reported that Indigenous Australians were twice as likely to have visited an ED or outpatients clinic in the last week as other Australians. In contrast, the same national surveys showed that Indigenous Australians were only 1.1 times as likely as other Australians to have used any health care services. It is not apparent from these results whether Indigenous patients were accessing ED services at appropriately higher rates than other Australians because of their greater morbidity or What is known about the topic? Indigenous people attend emergency departments (EDs) more often than other Australians, wait a similar length of time before being seen, but are more likely to leave before receiving treatment.
What does this paper add?The study confirmed what was known, and found that Indigenous patients in the Northern Territory and Western Australia did not appear to use EDs for "primary care" problems more than non-Indigenous patients.
What are the implications for practitioners?The study suggests that EDs may be performing more equitably for Indigenous people than other elements of the health system, but Indigenous identification in the database needs to improve so that monitoring of ED performance can extend beyond WA and the NT.