Hospital Utilisation in Indigenous and Non-Indigenous Infants under 12 Months of Age in Western Australia, Prospective Population Based Data Linkage Study.

Kimberley Mcauley,Natalie A Strobel,Rhonda Marriott,David N Atkinson,Julia V Marley,Fiona J Stanley,Daniel Mcaullay,Karen M Edmond,Linda Anne Selvey

doi:10.1371/journal.pone.0154171

Kimberley Mcauley, Natalie A Strobel + Show 7 more

Open Access

https://doi.org/10.1371/journal.pone.0154171

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Abstract

BackgroundIndigenous infants (infants aged under 12 months) have the highest hospital admission and emergency department presentation risks in Australia. However, there have been no recent reports comparing hospital utilisation between Indigenous and non-Indigenous infants.MethodsOur primary objective was to use a large prospective population-based linked dataset to assess the risk of all-cause hospital admission and emergency department presentation in Indigenous compared to non-Indigenous infants in Western Australia (WA). Secondary objectives were to assess the effect of socio-economic status (Index of Relative Socio-Economic Disadvantage [IRSD]) on hospital utilisation and to understand the causes of hospital utilisation.FindingsThere were 3,382 (5.4%) Indigenous and 59,583 (94.6%) non-Indigenous live births in WA from 1 January 2010 to 31 December 2011. Indigenous infants had a greater risk of hospital admission (adjusted odds ratio [aOR] 1.90, 95% confidence interval [95% CI] 1.77–2.04, p = <0.001) and emergency department presentation (aOR 2.15, 95% CI 1.98–2.33, p = <0.001) compared to non-Indigenous infants. Fifty nine percent (59.0%) of admissions in Indigenous children were classified as preventable compared to 31.2% of admissions in non-Indigenous infants (aOR 2.12, 95% CI 1.88–2.39). The risk of hospital admission in the most disadvantaged (IRSD 1) infants in the total cohort (35.7%) was similar to the risk in the least disadvantaged (IRSD 5) infants (30.6%) (aOR 1.04, 95% CI 0.96–1.13, p = 0.356).InterpretationWA Indigenous infants have much higher hospital utilisation than non Indigenous infants. WA health services should prioritise Indigenous infants regardless of their socio economic status or where they live.

Highlights

Over the last ten years a key element of the Australian Federal Government strategy to ‘Close the gap’[1, 2] in health outcomes between Australian Aboriginal and Torres Strait Islander and non-Indigenous infants has been to improve access to urban and remote area health services for Indigenous mothers and children
Indigenous infants were 1.7 times more likely to be admitted to hospital at least once (44.0%) compared to non-Indigenous infants (29.2%) (Table 2)
Ten percent (10.4%, 352) of Indigenous infants had three or more admissions to hospital in their first year of life compared to three percent (3.1%, 1834) of non-Indigenous infants (Table 2)