Closing the health gap in Central Australia: reduction in Indigenous Australian inpatient self-discharge rates following routine collaboration with Aboriginal Health Workers
Abstract Background Indigenous Australians experience significant socioeconomic disadvantage and healthcare disparity compared to non-Indigenous Australians. A retrospective cohort study to describe the association between rates of self-discharge in Indigenous orthopaedic patients and the introducti...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-08-01
|
| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-09921-7 |
| _version_ | 1797453407175311360 |
|---|---|
| author | Tim Cheok Morgan Berman Richard Delaney-Bindahneem Matthew Phillip Jennings Linda Bray Ruurd Jaarsma Pradeep Mathew Poonnoose Kanishka Williams Narlaka Jayasekera |
| author_facet | Tim Cheok Morgan Berman Richard Delaney-Bindahneem Matthew Phillip Jennings Linda Bray Ruurd Jaarsma Pradeep Mathew Poonnoose Kanishka Williams Narlaka Jayasekera |
| author_sort | Tim Cheok |
| collection | DOAJ |
| description | Abstract Background Indigenous Australians experience significant socioeconomic disadvantage and healthcare disparity compared to non-Indigenous Australians. A retrospective cohort study to describe the association between rates of self-discharge in Indigenous orthopaedic patients and the introduction of routine Aboriginal Liaison Officers (ALO) within the Orthopaedic multi-disciplinary team (MDT) was performed. Methods ALO were introduced within our routine Orthopaedic MDT on the 22nd of February 2021. Two patient cohorts were analysed, Group 1; patients admitted in the 9-months prior to inclusion of ALO, and Group 2; patients admitted within 9-months thereafter. The primary outcome of interest was the rate of self-discharge among Indigenous patients. Secondary outcomes of interest were the stage of treatment when patients self-discharged, recurrent self-discharge, risk factors for self-discharge and association between self-discharge and length of hospital stay. Results Introduction of ALO within routine Orthopaedic MDT was associated with a significant 37% reduced risk of self-discharge among Indigenous patients (p = 0·009), and significantly fewer self-discharges before their definitive surgical and medical treatment (p = 0·0024), or before completion of postoperative intravenous antibiotic treatment (p = 0·030). There was no significant change in the risk of recurrent self-discharge (p = 0·557). Risk factors for self-discharge were younger age; pensioners or unemployed; residents of Alice Springs Town-Camps or of communities within 51 to 100 km of Alice Springs; and those diagnosed with lacerations of the upper limb, but without tendon injury, wound and soft tissue infections or osteomyelitis. In Group 2, the odds of self-discharge decreased with increased length of hospital stay (p = 0·040). Conclusions Routine inclusion of ALO within the Orthopaedic MDT reduced the risk of self-discharge in Indigenous patients. Those who self-discharged did so only after critical aspects of their care were met. |
| first_indexed | 2024-03-09T15:22:22Z |
| format | Article |
| id | doaj.art-5976fadf42c84e91be21c3df5183f108 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-09T15:22:22Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-5976fadf42c84e91be21c3df5183f1082023-11-26T12:43:18ZengBMCBMC Health Services Research1472-69632023-08-0123111010.1186/s12913-023-09921-7Closing the health gap in Central Australia: reduction in Indigenous Australian inpatient self-discharge rates following routine collaboration with Aboriginal Health WorkersTim Cheok0Morgan Berman1Richard Delaney-Bindahneem2Matthew Phillip Jennings3Linda Bray4Ruurd Jaarsma5Pradeep Mathew Poonnoose6Kanishka Williams7Narlaka Jayasekera8Department of Trauma and Orthopaedics, Alice Springs HospitalDepartment of Trauma and Orthopaedics, Alice Springs HospitalDepartment of Trauma and Orthopaedics, Alice Springs HospitalDepartment of Trauma and Orthopaedics, Alice Springs HospitalDepartment of Trauma and Orthopaedics, Alice Springs HospitalDepartment of Trauma and Orthopaedics, Alice Springs HospitalDepartment of Trauma and Orthopaedics, Alice Springs HospitalDepartment of Trauma and Orthopaedics, Alice Springs HospitalDepartment of Trauma and Orthopaedics, Alice Springs HospitalAbstract Background Indigenous Australians experience significant socioeconomic disadvantage and healthcare disparity compared to non-Indigenous Australians. A retrospective cohort study to describe the association between rates of self-discharge in Indigenous orthopaedic patients and the introduction of routine Aboriginal Liaison Officers (ALO) within the Orthopaedic multi-disciplinary team (MDT) was performed. Methods ALO were introduced within our routine Orthopaedic MDT on the 22nd of February 2021. Two patient cohorts were analysed, Group 1; patients admitted in the 9-months prior to inclusion of ALO, and Group 2; patients admitted within 9-months thereafter. The primary outcome of interest was the rate of self-discharge among Indigenous patients. Secondary outcomes of interest were the stage of treatment when patients self-discharged, recurrent self-discharge, risk factors for self-discharge and association between self-discharge and length of hospital stay. Results Introduction of ALO within routine Orthopaedic MDT was associated with a significant 37% reduced risk of self-discharge among Indigenous patients (p = 0·009), and significantly fewer self-discharges before their definitive surgical and medical treatment (p = 0·0024), or before completion of postoperative intravenous antibiotic treatment (p = 0·030). There was no significant change in the risk of recurrent self-discharge (p = 0·557). Risk factors for self-discharge were younger age; pensioners or unemployed; residents of Alice Springs Town-Camps or of communities within 51 to 100 km of Alice Springs; and those diagnosed with lacerations of the upper limb, but without tendon injury, wound and soft tissue infections or osteomyelitis. In Group 2, the odds of self-discharge decreased with increased length of hospital stay (p = 0·040). Conclusions Routine inclusion of ALO within the Orthopaedic MDT reduced the risk of self-discharge in Indigenous patients. Those who self-discharged did so only after critical aspects of their care were met.https://doi.org/10.1186/s12913-023-09921-7Indigenous healthSelf-dischargeSurgeryOrthopaedics |
| spellingShingle | Tim Cheok Morgan Berman Richard Delaney-Bindahneem Matthew Phillip Jennings Linda Bray Ruurd Jaarsma Pradeep Mathew Poonnoose Kanishka Williams Narlaka Jayasekera Closing the health gap in Central Australia: reduction in Indigenous Australian inpatient self-discharge rates following routine collaboration with Aboriginal Health Workers BMC Health Services Research Indigenous health Self-discharge Surgery Orthopaedics |
| title | Closing the health gap in Central Australia: reduction in Indigenous Australian inpatient self-discharge rates following routine collaboration with Aboriginal Health Workers |
| title_full | Closing the health gap in Central Australia: reduction in Indigenous Australian inpatient self-discharge rates following routine collaboration with Aboriginal Health Workers |
| title_fullStr | Closing the health gap in Central Australia: reduction in Indigenous Australian inpatient self-discharge rates following routine collaboration with Aboriginal Health Workers |
| title_full_unstemmed | Closing the health gap in Central Australia: reduction in Indigenous Australian inpatient self-discharge rates following routine collaboration with Aboriginal Health Workers |
| title_short | Closing the health gap in Central Australia: reduction in Indigenous Australian inpatient self-discharge rates following routine collaboration with Aboriginal Health Workers |
| title_sort | closing the health gap in central australia reduction in indigenous australian inpatient self discharge rates following routine collaboration with aboriginal health workers |
| topic | Indigenous health Self-discharge Surgery Orthopaedics |
| url | https://doi.org/10.1186/s12913-023-09921-7 |
| work_keys_str_mv | AT timcheok closingthehealthgapincentralaustraliareductioninindigenousaustralianinpatientselfdischargeratesfollowingroutinecollaborationwithaboriginalhealthworkers AT morganberman closingthehealthgapincentralaustraliareductioninindigenousaustralianinpatientselfdischargeratesfollowingroutinecollaborationwithaboriginalhealthworkers AT richarddelaneybindahneem closingthehealthgapincentralaustraliareductioninindigenousaustralianinpatientselfdischargeratesfollowingroutinecollaborationwithaboriginalhealthworkers AT matthewphillipjennings closingthehealthgapincentralaustraliareductioninindigenousaustralianinpatientselfdischargeratesfollowingroutinecollaborationwithaboriginalhealthworkers AT lindabray closingthehealthgapincentralaustraliareductioninindigenousaustralianinpatientselfdischargeratesfollowingroutinecollaborationwithaboriginalhealthworkers AT ruurdjaarsma closingthehealthgapincentralaustraliareductioninindigenousaustralianinpatientselfdischargeratesfollowingroutinecollaborationwithaboriginalhealthworkers AT pradeepmathewpoonnoose closingthehealthgapincentralaustraliareductioninindigenousaustralianinpatientselfdischargeratesfollowingroutinecollaborationwithaboriginalhealthworkers AT kanishkawilliams closingthehealthgapincentralaustraliareductioninindigenousaustralianinpatientselfdischargeratesfollowingroutinecollaborationwithaboriginalhealthworkers AT narlakajayasekera closingthehealthgapincentralaustraliareductioninindigenousaustralianinpatientselfdischargeratesfollowingroutinecollaborationwithaboriginalhealthworkers |