Hospital use in Aboriginal and non‐Aboriginal patients with chronic disease

Whyatt, David; Yap, Matthew; Tenneti, Raji; Pearson, Glenn; Vickery, Alistair

doi:10.1111/1742-6723.12779

Cited by 6 publications

(17 citation statements)

References 17 publications

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“…This is consistent with other research in the area of frequent admissions which reiterates the fact that a small proportion of patients account for a disproportionate share of avoidable admissions. [9,15] Research in the area of frequent avoidable admissions commonly aims to develop risk pro les or risk prediction tools to help identity those patients most at risk. [7,9,15] Our study showed that Aboriginal people experiencing avoidable admissions were more likely to be female, younger, single, have diabetes complications, asthma and COPD, live in moderately accessible to very remote locations, and to be more disadvantaged compared with non-Aboriginal people.…”

Section: Discussionmentioning

confidence: 99%

“…[9,15] Research in the area of frequent avoidable admissions commonly aims to develop risk pro les or risk prediction tools to help identity those patients most at risk. [7,9,15] Our study showed that Aboriginal people experiencing avoidable admissions were more likely to be female, younger, single, have diabetes complications, asthma and COPD, live in moderately accessible to very remote locations, and to be more disadvantaged compared with non-Aboriginal people. Further research in identifying a risk pro le for this vulnerable group of people would be helpful in creating appropriate community medical and prevention care.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14] The very few research studies that have examined frequent admissions show that Aboriginal people are signi cantly more likely to experience frequent emergency department presentations and frequent admissions to hospital compared with non-Aboriginal people. [8,15,16] A South Australian prevalence study from 2005 to 2011 examining avoidable admissions using linked administrative public hospital record data found that Aboriginal people hospitalised with a chronic condition went on to experience on average 2.6 avoidable admissions in the next 12 months compared to 1.9 avoidable admissions among non-Aboriginal people. [17] Another study examined all inpatient episodes, rather than just avoidable chronic condition admissions, in Northern Territory public hospitals between 2005 and 2013.…”

Section: Introductionmentioning

confidence: 99%

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Frequent avoidable admissions amongst Aboriginal and non-Aboriginal people with chronic disease in New South Wales, Australia: a retrospective cohort study

Jayakody¹,

Oldmeadow²,

Carey³

et al. 2020

Preprint

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Background: Aboriginal and Torres Strait Islander people have high rates of avoidable hospital admissions for chronic diseases, however little is known about the frequency of avoidable admissions for this population. This study aimed to examine trends in avoidable admissions among Aboriginal and non-Aboriginal people with ambulatory care sensitive chronic conditions in New South Wales (NSW), Australia. Methods: A retrospective cohort analysis using de-identified linked administrative data of Aboriginal and non-Aboriginal patients between 2005/06 to 2013/14. Eligible patients were admitted to a NSW public hospital and who had one or more of the following ambulatory care sensitive chronic conditions as a principal diagnosis: diabetic complications, asthma, angina, hypertension, congestive heart failure and/or chronic obstructive pulmonary disease. The primary outcomes were the number of avoidable admissions for an individual in each financial year, and whether an individual had three or more admissions compared with one to two avoidable admissions in each financial year. Poisson and logistic regression models and a test for differences in yearly trends were used to assess the frequency of avoidable admissions over time, adjusting for sociodemographic variables and restricted to those aged ≤75 years.Results: There were a total of 27,467 avoidable admissions corresponding to 19,025 patients over the nine-year period (71.2% Aboriginal; 28.8% non-Aboriginal). Aboriginal patients were 15% more likely than non-Aboriginal patients to have a higher number of avoidable admissions per financial year (IRR=1.15; CI: 1.11, 1.20). Aboriginal patients were almost twice as likely as non-Aboriginal patients to experience three or more avoidable admissions per financial year (OR=1.90; CI=1.60, 2.26). There were no significant differences between Aboriginal and non-Aboriginal people in yearly trends for either the number of avoidable admissions, or whether or not an individual experienced three or more avoidable admissions per financial year (p=0.8599; 0.8608 respectively). Conclusion: Aboriginal people were significantly more likely to experience frequent avoidable admissions over a nine-year period compared to non-Aboriginal people. These high rates reflect the need for further research into which interventions are able to successfully reduce avoidable admissions among Aboriginal people with chronic diseases, and the importance of culturally appropriate early prevention and community health care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Frequent avoidable admissions amongst Aboriginal and non-Aboriginal people with chronic disease in New South Wales, Australia: a retrospective cohort study

Jayakody¹,

Oldmeadow²,

Carey³

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…This finding is comparable to other studies differentiating health care utilization in Indigenous and non-Indigenous Australians. Whyatt et al conducted a longitudinal cohort study from 2002 to 2014 comparing rates of hospital utilization in Indigenous and non-Indigenous Australians with chronic diseases [ 15 ]. Whyatt et al found that while inpatient length of stay in Indigenous Australian patients were similar to non-Indigenous patients (as we found in our study), Indigenous Australians had much higher rates of Emergency Department presentations, were more likely to be admitted as an inpatient, and were also younger than non-Indigenous Australians [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Whyatt et al conducted a longitudinal cohort study from 2002 to 2014 comparing rates of hospital utilization in Indigenous and non-Indigenous Australians with chronic diseases [ 15 ]. Whyatt et al found that while inpatient length of stay in Indigenous Australian patients were similar to non-Indigenous patients (as we found in our study), Indigenous Australians had much higher rates of Emergency Department presentations, were more likely to be admitted as an inpatient, and were also younger than non-Indigenous Australians [ 15 ]. Common factors found in our study and other studies predicting increased healthcare utilization for Indigenous and non-Indigenous Australian patients include the presence of chronic disease and more telling, severity of disease.…”

Section: Discussionmentioning

confidence: 99%

Differential Impact of Malnutrition on Health Outcomes Among Indigenous and Non-Indigenous Adults Admitted to Hospital in Regional Australia—A Prospective Cohort Study

et al. 2018

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The burden of malnutrition in Indigenous people is a major health priority and this study’s aims are to understand health outcomes among Indigenous and non-Indigenous patients. This cohort study includes 608 medical inpatients in three regional hospitals. Participants were screened for malnutrition using the Subjective Global Assessment tool. Hospital length of stay, discharge destination, 30-day and six-month hospital readmission and survival were measured. Although no significant difference was observed between Indigenous participants who were malnourished or nourished (p = 0.120), malnourished Indigenous participants were more likely to be readmitted back into hospital within 30 days (Relative Risk (RR) 1.53, 95% CI 1.19–1.97, p = 0.002) and six months (RR 1.40, 95% Confidence Interval (CI) 1.05–1.88, p = 0.018), and less likely to be alive at six months (RR 1.63, 95% CI 1.20–2.21, p = 0.015) than non-Indigenous participants. Malnutrition was associated with higher mortality (Hazards Ratio (HR) 3.32, 95% CI 1.87–5.89, p < 0.001) for all participants, and independent predictors for six-month mortality included being malnourished (HR 2.10, 95% CI 1.16–3.79, p = 0.014), advanced age (HR 1.04, 95% CI 1.02–1.06, p = 0.001), increased acute disease severity (Acute Physiology and Chronic Health Evaluation score, HR 1.03, 95% CI 1.01–1.05, p = 0.002) and higher chronic disease index (Charlson Comorbidity Index, HR 1.36, 95% CI 1.16–3.79, p = 0.014). Malnutrition in regional Australia is associated with increased healthcare utilization and decreased survival. New approaches to malnutrition-risk screening, increased dietetic resourcing and nutrition programs to proactively identify and address malnutrition in this context are urgently required.

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Hospital pharmacy services supporting Aboriginal or Torres Strait Islander peoples in Australia: a systematic review

Welch

McMillan

Moles

2020

Pharmacy Practice and Res

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AimTo systematically review the literature to investigate the role of the hospital pharmacist and the services provided for Aboriginal and/or Torres Strait Islander people.MethodsA systematic literature review was performed following a search from inception to present of MEDLINE, International Pharmaceutical Abstracts (IPA), EMBASE, Scopus and Pubmed, in accordance with PRISMA guidelines. All forms of published literature were included. Aboriginal and/or Torres Strait Islander people and hospital pharmacists/pharmacy department services in Australia were the populations included.Results1592 studies were identified. After removal of duplicates and application of inclusion and exclusion criteria, 16 papers underwent full text review, with 7 papers included in the final review. No high‐level evidence articles were found. Joanna Briggs Institute Levels of Evidence for meaningfulness were low. Settings were varied and included rural, remote and urban sites. Five articles were allocated a Donabedian Model level where the structure was described. Two papers described structure and process. None described outcomes. Hospital pharmacy services included development of models for patient care, partnerships and resource sharing in rural and remote areas and ensuring continuity of care. ConclusionSystematic review of the literature to determine the role of hospital pharmacy services for Aboriginal and/or Torres Strait Islander people produced limited publications for review. From these, roles identified included: development of models for patient care, partnerships and resource sharing in rural and remote areas and ensuring continuity of care. Future research and publication of work by hospital pharmacists nurturing and developing relationships in partnership with Aboriginal and Torres Strait Islander communities is encouraged.

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Hospital use in Aboriginal and non‐Aboriginal patients with chronic disease

Cited by 6 publications

References 17 publications

Frequent avoidable admissions amongst Aboriginal and non-Aboriginal people with chronic disease in New South Wales, Australia: a retrospective cohort study

Frequent avoidable admissions amongst Aboriginal and non-Aboriginal people with chronic disease in New South Wales, Australia: a retrospective cohort study

Differential Impact of Malnutrition on Health Outcomes Among Indigenous and Non-Indigenous Adults Admitted to Hospital in Regional Australia—A Prospective Cohort Study

Hospital pharmacy services supporting Aboriginal or Torres Strait Islander peoples in Australia: a systematic review

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