Improving delivery of health care to Aboriginal and Torres Strait Islander children

Lucy Attwood; Sarah Rodrigues; Josephine Winsor; Shirley Warren; Lyn Biviano; Hasantha Gunasekera

doi:10.1111/jpc.12756

Improving delivery of health care to Aboriginal and Torres Strait Islander children

J Paediatr Child Health. 2015 May;51(5):534-540. doi: 10.1111/jpc.12756. Epub 2014 Nov 2.

Authors

Lucy Attwood¹, Sarah Rodrigues², Josephine Winsor³, Shirley Warren³, Lyn Biviano³, Hasantha Gunasekera^{1

3}

Affiliations

¹ Sydney Medical Program, Sydney Children's Hospitals Network (Westmead), Sydney, New South Wales, Australia.
² Department of Paediatrics, University College London, London, United Kingdom.
³ Sydney Children's Hospitals Network (Westmead), Sydney, New South Wales, Australia.

PMID: 25363130
DOI: 10.1111/jpc.12756

Abstract

Aim: To identify opportunities to improve health-care delivery for urban Aboriginal and Torres Strait Islander children requiring hospital admission and to determine their characteristics.

Methods: We analysed all documentation of admissions of Aboriginal and/or Torres Strait Islander children to a tertiary paediatric hospital in 2010. We reviewed the medical records to determine whether the Aboriginal status of patients was known, whether Aboriginal and/or Torres Strait Islander children and their families were reviewed by Aboriginal staff during admission and whether basic health-care quality indicators were met, including documentation of anthropometry, ear examination findings, immunisation status and catch-up immunisation delivery.

Results: In 2010, 543 (2%) patients admitted to the institution were identified as Aboriginal and/or Torres Strait Islander: 140/538 (26.0%) were from the first decile (most disadvantaged) on Socio-Economic Indexes for Areas index. Of all admitted children, 148/543 (27.3%) were referred to Aboriginal health professionals during admission, more when length of stay was greater than 7 days (61% vs. 23%, P < 0.001). There was documentation of weight in 533/543 (98.2%), ear examinations in 64/543 (11.8%), immunisations being not up to date in 126/543 (23%), catch-up immunisation given in 7/126 (5.6%), Aboriginal and/or Torres Strait Islander status in 8/543 (1.5%) medical and 1/543 (0.2%) nursing discharge summaries.

Conclusions: We have identified several opportunities to improve culturally appropriate health-care delivery for Aboriginal and Torres Strait Islander children admitted to hospital, including improved recognition of Aboriginal and/or Torres Strait Islander status of patients, improved access to Aboriginal health professionals and increased performance and documentation of basic anthropometry, ear examination and immunisation catch-up.

Keywords: cultural competency; delivery of health care; immunisation; indigenous; paediatric.