Otitis media in Aboriginal children: The discordance between burden of illness and access to services in rural/remote and urban Australia

Gunasekera, Hasantha; Morris, Peter S.; Daniels, John; Couzos, Sophie; Craig, Jonathan C.

doi:10.1111/j.1440-1754.2009.01532.x

Cited by 46 publications

(52 citation statements)

References 11 publications

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“…Despite the high burden of otitis media in Aboriginal children living in remote Australian communities2 8 48–50 and children attending remote Aboriginal Medical Services nationally,42 we found lower VTI rates among Aboriginal compared with non-Aboriginal children in remote areas in NSW. Furthermore, our analyses indicate that remoteness was a significant mediating factor in the relationship between Aboriginality and the insertion of ventilation tubes.…”

Section: Discussioncontrasting

confidence: 64%

“…Our data support this, as do the findings from a North American study 34. Better access to specialist ear health services is also influenced by the availability of audiologists and ear, nose and throat (ENT) surgeons in the area where a child lives, with affluent families more commonly living in areas with a greater supply of hospital-based and private specialist services 42. Parental education might also play a role in the parent's ability to effectively navigate our complex health system to gain access to specialist services on their child's behalf.…”

Section: Discussionmentioning

confidence: 99%

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Inequalities in ventilation tube insertion procedures between Aboriginal and non-Aboriginal children in New South Wales, Australia: a data linkage study

et al. 2013

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ObjectivesAustralian Aboriginal children experience earlier, more frequent and more severe otitis media, particularly in remote communities, than non-Aboriginal children. Insertion of ventilation tubes is the main surgical procedure for otitis media. Our aim was to quantify inequalities in ventilation tube insertion (VTI) procedures between Australian Aboriginal and non-Aboriginal children, and to explore the influence of birth characteristics, socioeconomic background and geographical remoteness on this inequality.DesignRetrospective cohort study using linked hospital and mortality data from July 2000 to December 2008.Setting and participantsA whole-of-population cohort of 653 550 children (16 831 Aboriginal and 636 719 non-Aboriginal) born in a New South Wales hospital between 1 July 2000 and 31 December 2007 was included in the analysis.Outcome measureFirst VTI procedure.ResultsVTI rates were lower in Aboriginal compared with non-Aboriginal children (incidence rate (IR), 4.3/1000 person-years; 95% CI 3.8 to 4.8 vs IR 5.8/1000 person-years; 95% CI 5.7 to 5.8). Overall, Aboriginal children were 28% less likely than non-Aboriginal children to have ventilation tubes inserted (age-adjusted and sex-adjusted rate ratios (RRs) 0.72; 95% CI 0.64 to 0.80). After adjusting additionally for geographical remoteness, Aboriginal children were 19% less likely to have ventilation tubes inserted (age-adjusted and sex-adjusted RR 0.81; 95% CI 0.73 to 0.91). After adjusting separately for private patient/health insurance status and area socioeconomic status, there was no significant difference (age-adjusted and sex-adjusted RR 0.96; 95% CI 0.86 to 1.08 and RR 0.93; 95% CI 0.83 to 1.04, respectively). In the fully adjusted model, there were no significant differences in VTI rates between Aboriginal and non-Aboriginal children (RR 1.06; 95% CI 0.94 to 1.19).ConclusionsDespite a much higher prevalence of otitis media, Aboriginal children were less likely to receive VTI procedures than their non-Aboriginal counterparts; this inequality was largely explained by differences in socioeconomic status and geographical remoteness.

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Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Inequalities in ventilation tube insertion procedures between Aboriginal and non-Aboriginal children in New South Wales, Australia: a data linkage study

et al. 2013

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“…Prevalence Exceptionally high levels of ear disease and hearing loss have been reported for many years in many Indigenous communities, particularly in remote areas [158,[160][161][162]. The levels described among children living in some remote communities in northern and central Australia are such that they would be classified by the WHO as being 'a massive public health problem' requiring 'urgent attention' [163, p.2].…”

Section: Extent Of Ear Disease Among Indigenous Peoplementioning

confidence: 99%

Reports indicate that changes are needed to close the gap for Indigenous health

Russell

2014

Medical Journal of Australia

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The Australian Indigenous HealthInfoNet's mission is to contribute to improvements in Indigenous health by making relevant, high quality knowledge and information easily accessible to policy makers, health service providers, program managers, clinicians, researchers and the general community.The HealthInfoNet addresses this mission by undertaking research into various aspects of Indigenous health and disseminating the results (and other relevant knowledge and information) mainly via its Internet site (www.healthinfonet.ecu.edu.au). The HealthInfoNet's research mainly involves analysis and synthesis of data and other information obtained from academic, professional, government and other sources.The HealthInfoNet's work in translational research aims at transferring the results of pure and applied research into policy and practice. In this research, the HealthInfoNet addresses the knowledge needs of a wide range of potential users. These include policy makers, health service providers, program managers, clinicians and other health professionals (including Indigenous health workers), and researchers. The HealthInfoNet also provides easy-to-read and summarised material for students and the general community. Director:Professor Neil Thomson Address:Australian Indigenous HealthInfoNet PrefaceThis Overview has been prepared by the Australian Indigenous HealthInfoNet as a part of our contributions to 'closing the gap' in health between Indigenous people and other Australians by making relevant, high quality knowledge and information easily accessible to policy makers, health service providers, program managers, clinicians, researchers, students and the general community. 1The main purpose of the Overview is to provide a comprehensive summary of the most recent indicators of the health of Indigenous people. It is beyond the scope of the Overview to analyse trends in the various indicators, so it tends to draw attention to the current health status of Australia's Indigenous peoples. The Overview doesn't attempt to review other aspects, such as the availability and use of services (including barriers to their use) and strategies and policies related to specific health topics. Readers interested in these aspects should refer to the topic-specific reviews that are available on the HealthInfoNet's website.Research for the Overview involves the collection, collation, and analysis of a wide range of relevant information, including both published and unpublished material. Sources include government reports, particularly those produced by the Australian Bureau of Statistics (ABS), the Australian Institute of Health and Welfare (AIHW), the Australian Health Ministers Advisory Council (AHMAC) and the Steering Committee for the Review of Government Service Provision (SCRGSP).Very important additions to the regular ABS and AIHW publications are four series of special reports that bring together key information about Indigenous disadvantages in health and related areas: This Overview draws heavily on information from the main adminis...

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“…Such expertise may be limited in the primary health care setting, where most diagnoses of OM are made, particularly in the rural and remote settings in which the OM burden is greatest. 3,4 Despite OM being one of the most common childhood illnesses and having important, long term health consequences, 3 diagnostic inaccuracy is common, [5][6][7] leading to delayed treatment, under-or overtreatment, and an increased risk of complications, including hearing loss 8,9 and antibiotic resistance. 3 In many countries, general practitioners manage children with OM, some of whom are referred to audiologists.…”

mentioning

confidence: 99%

“…Otolaryngologists are specialists in the diagnosis and treatment of OM, but access to their services is limited, especially outside major urban centres. 4 Audiologists are usually more readily available, and could provide an initial assessment before the child is referred to an otolaryngologist. Whether audiologists can reliably triage at risk children for specialist otolaryngology management, however, is unclear.…”

mentioning

confidence: 99%

Agreement between diagnoses of otitis media by audiologists and otolaryngologists in Aboriginal Australian children

Gunasekera

Miller

Burgess

et al. 2018

Medical Journal of Australia

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Otitis media in Aboriginal children: The discordance between burden of illness and access to services in rural/remote and urban Australia

Cited by 46 publications

References 11 publications

Inequalities in ventilation tube insertion procedures between Aboriginal and non-Aboriginal children in New South Wales, Australia: a data linkage study

Inequalities in ventilation tube insertion procedures between Aboriginal and non-Aboriginal children in New South Wales, Australia: a data linkage study

Reports indicate that changes are needed to close the gap for Indigenous health

Agreement between diagnoses of otitis media by audiologists and otolaryngologists in Aboriginal Australian children

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