Incidence of Discharge Against Medical Advice in Queensland Hospital Emergency Departments Among Indigenous Patients from 2016 to 2021

How to Address Inequity for Indigenous Patients in the Australian Health System: Samuel’s Story

“…Samuel is a Lama Lama and Gugu Yimithirr man and Palm Island resident, a devout Christian who attends church every Sunday. He accidentally had a pocketknife lodged in his right eye when he was kindly helping a friend to cut some zip ties loose from a valve on the motor [2].…”

“…The complexity of the Australian health system make care transitions a challenging feature for many health service users, especially for those who hold different value systems and beliefs to that of Western models of care, have complex care needs, and/ or are in rural and remote locations. For instance, some of these challenges, that could be associated with the quality of care transition, can be observed in 1) the increase of Discharge Against Medical Advice [2] (DAMA, the rate at which Indigenous hospital patients leave hospital without completing treatment) over the last decade; [1] and 2) survival outcomes such as adjusted long term mortality and median number of potential life years lost were higher for Indigenous than non-Indigenous patients after intensive care in hospital [3,4]. System fragmentation and the documented evidence of care transitions of many patients test the adequacy and flexibility of health systems to provide access, and effective, efficient, and appropriate care.…”