Emergency department presentations by <scp>A</scp>boriginal children: Issues for consideration for appropriate health services

Duncan, Catriona; Williams, Katrina; Nathanson, Dania; Thomas, Susan; Cottier, Carolyn; O’Meara, Matthew; Zwi, Karen

doi:10.1111/jpc.12225

Cited by 8 publications

(6 citation statements)

References 6 publications

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“…These included skin, subcutaneous and breast conditions, followed by injury, poisoning and toxic drug effects (regardless of triage category) [18]. Our findings are also consistent with previous studies that examined reasons for Aboriginal child presentations to remote primary health care services in the Northern Territory (NT) [19,20] and Sydney [21]. The 2004 Western Australian Aboriginal Child Health Survey (WAACHS) report of ATSI children aged 0-17 living in WA, also provides congruent data demonstrating that recurring infections were the dominant illnesses experienced by Aboriginal children [18].…”

Section: Resultssupporting

confidence: 90%

Emergency department presentations by children in remote Australia: a population-based study

Dossetor

Fitzpatrick

Glass

et al. 2020

Preprint

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Background Aboriginal leaders invited us to examine the frequency and reasons for children presenting to Fitzroy Crossing Hospital emergency department (ED), Western Australia.Methods ED presentations (2007-11 inclusive) were examined for children born in the Fitzroy Valley in 2002-03.Results ED data were examined for 127/134 (94.7%) eligible children, with 1058 presentations for 1743 conditions in children aged 3-9 over 5 years. Most (81%) had at least one ED presentation (median 9.0, range 1-50). There were no differences by sex or season but numbers of presentations increased over time. Common presentations included: injury (15.1%), diseases of the ear (14.9%), skin (13.8%), respiratory tract (13.4%), infectious and parasitic diseases (9.8%), screening, follow up, and social reasons (16.0%). Household over-crowding, financial and food insecurity were common socio-economic factors recorded at ED presentation. Prenatal alcohol exposure (PAE) was significantly associated with high-frequency (>10) ED presentations.Conclusion Children in very remote Fitzroy Crossing communities have high rates of preventable ED presentations, with higher rates in those with than without PAE. Support for culturally appropriate preventative programs and improved access to health services need to be provided in remote Australia.

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Section: Resultssupporting

confidence: 90%

Emergency department presentations by children in remote Australia: a population-based study

Dossetor

Fitzpatrick

Glass

et al. 2020

Preprint

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“…In 2002 the Northern Territory Department of Health reported all-cause post neonatal hospital admission rates (72%) that were much higher than the rates reported in our study (40%). [ 12 ] From 2008–2013 studies from eastern Australia (Victoria[ 22 ] and New South Wales[ 20 ]) and WA[ 23 ] reported high risks of all cause emergency department presentation in Indigenous children aged 0–4 years. There are limited data on ‘all-cause’ hospital utilisation in children under five years from Indigenous populations in Australia or other countries.…”

Section: Discussionmentioning

confidence: 99%

“…No data on the diagnosis at the time of the emergency department presentation were available. Preventable causes were defined according to AIHW[ 19 ], and adapted for use with infants[ 20 ]. Diseases of the respiratory system, digestive system, skin and subcutaneous tissue, ear and mastoid process, infectious and parasitic diseases, nutritional diseases, and injury and poisoning were classified as “preventable”.…”

Section: Methodsmentioning

confidence: 99%

Hospital Utilisation in Indigenous and Non-Indigenous Infants under 12 Months of Age in Western Australia, Prospective Population Based Data Linkage Study

et al. 2016

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BackgroundIndigenous infants (infants aged under 12 months) have the highest hospital admission and emergency department presentation risks in Australia. However, there have been no recent reports comparing hospital utilisation between Indigenous and non-Indigenous infants.MethodsOur primary objective was to use a large prospective population-based linked dataset to assess the risk of all-cause hospital admission and emergency department presentation in Indigenous compared to non-Indigenous infants in Western Australia (WA). Secondary objectives were to assess the effect of socio-economic status (Index of Relative Socio-Economic Disadvantage [IRSD]) on hospital utilisation and to understand the causes of hospital utilisation.FindingsThere were 3,382 (5.4%) Indigenous and 59,583 (94.6%) non-Indigenous live births in WA from 1 January 2010 to 31 December 2011. Indigenous infants had a greater risk of hospital admission (adjusted odds ratio [aOR] 1.90, 95% confidence interval [95% CI] 1.77–2.04, p = <0.001) and emergency department presentation (aOR 2.15, 95% CI 1.98–2.33, p = <0.001) compared to non-Indigenous infants. Fifty nine percent (59.0%) of admissions in Indigenous children were classified as preventable compared to 31.2% of admissions in non-Indigenous infants (aOR 2.12, 95% CI 1.88–2.39). The risk of hospital admission in the most disadvantaged (IRSD 1) infants in the total cohort (35.7%) was similar to the risk in the least disadvantaged (IRSD 5) infants (30.6%) (aOR 1.04, 95% CI 0.96–1.13, p = 0.356).InterpretationWA Indigenous infants have much higher hospital utilisation than non Indigenous infants. WA health services should prioritise Indigenous infants regardless of their socio economic status or where they live.

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“…No data on cause of emergency department presentation were available. Causes of hospitalisation were defined according to the AIHW,16 and adapted for use with infants 17. Diseases were categorised as the respiratory system, digestive system, skin and subcutaneous tissue, ear and mastoid process, infectious and parasitic diseases, nutritional diseases, injury and poisoning, perinatal conditions (eg, prematurity, hypoxic-ischaemic encephalopathy), congenital malformations, chromosomal abnormalities and all other conditions.…”

Section: Methodsmentioning

confidence: 99%

Effect of socioeconomic disadvantage, remoteness and Indigenous status on hospital usage for Western Australian preterm infants under 12 months of age: a population-based data linkage study

et al. 2017

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ObjectivesOur primary objective was to determine the incidence of hospital admission and emergency department presentation in Indigenous and non-Indigenous preterm infants aged postdischarge from birth admission to 11 months in Western Australia. Secondary objectives were to assess incidence in the poorest infants from remote areas and to determine the primary causes of hospital usage in preterm infants.DesignProspective population-based linked data set.Setting and participantsAll preterm babies born in Western Australia during 2010 and 2011.Main outcome measuresAll-cause hospitalisations and emergency department presentations.ResultsThere were 6.9% (4211/61 254) preterm infants, 13.1% (433/3311) Indigenous preterm infants and 6.5% (3778/57 943) non-Indigenous preterm infants born in Western Australia. Indigenous preterm infants had a higher incidence of hospital admission (adjusted incident rate ratio (aIRR) 1.24, 95% CI 1.08 to 1.42) and emergency department presentation (aIRR 1.71, 95% CI 1.44 to 2.02) compared with non-Indigenous preterm infants. The most disadvantaged preterm infants (7.8/1000 person days) had a greater incidence of emergency presentation compared with the most advantaged infants (3.1/1000 person days) (aIRR 1.61, 95% CI 1.30 to 2.00). The most remote preterm infants (7.8/1000 person days) had a greater incidence of emergency presentation compared with the least remote preterm infants (3.0/1000 person days; aIRR 1.82, 95% CI 1.49 to 2.22).ConclusionsIn Western Australia, preterm infants have high hospital usage in their first year of life. Infants living in disadvantaged areas, remote area infants and Indigenous infants are at increased risk. Our data highlight the need for improved postdischarge care for preterm infants.

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Emergency department presentations by Aboriginal children: Issues for consideration for appropriate health services

Cited by 8 publications

References 6 publications

Emergency department presentations by children in remote Australia: a population-based study

Emergency department presentations by children in remote Australia: a population-based study

Hospital Utilisation in Indigenous and Non-Indigenous Infants under 12 Months of Age in Western Australia, Prospective Population Based Data Linkage Study

Effect of socioeconomic disadvantage, remoteness and Indigenous status on hospital usage for Western Australian preterm infants under 12 months of age: a population-based data linkage study

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