Emergency department presentations by Aboriginal children: Issues for consideration for appropriate health services

Authors

  • Catriona Duncan,

    1. Department of Community Child Health, Sydney Children's Hospital, Randwick, New South Wales, Australia
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  • Katrina Williams,

    1. Department of Community Child Health, Sydney Children's Hospital, Randwick, New South Wales, Australia
    Current affiliation:
    1. University of Melbourne and Royal Children's Hospital, Melbourne, Victoria, Australia
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  • Dania Nathanson,

    1. Department of Community Child Health, Sydney Children's Hospital, Randwick, New South Wales, Australia
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  • Susan Thomas,

    1. Department of Community Child Health, Sydney Children's Hospital, Randwick, New South Wales, Australia
    Current affiliation:
    1. NSW Ministry of Health (but now, Centre for Remote Health, Flinders University, Alice Springs, Northern Territory, Australia)
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  • Carolyn Cottier,

    1. Department of Community Child Health, Sydney Children's Hospital, Randwick, New South Wales, Australia
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  • Matthew O'Meara,

    1. Department of Community Child Health, Sydney Children's Hospital, Randwick, New South Wales, Australia
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  • Karen Zwi

    Corresponding author
    • Department of Community Child Health, Sydney Children's Hospital, Randwick, New South Wales, Australia
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  • Conflict of interest: None.

Correspondence: Associate Professor Karen Zwi, Head, Department of Community Child Health, Sydney Children's Hospital, High St, Randwick, NSW 2031, Australia. Fax: +61 2 93828188; email: Karen.zwi@sesiahs.health.nsw.gov.au

Abstract

Aim

This study describes the presentations made to the Sydney Children's Hospital (SCH) Emergency Department (ED) by local Aboriginal and Torres Strait Islander (Aboriginal) children with particular reference to children who present frequently or whose presentation was preventable.

Methods

Data from the SCH ED Information System were extracted for all presentations made by children who identified as Aboriginal, aged between 0–15 years, who presented between 2005–2008. Presentations were coded according to the presenting problem, diagnosis, outcome, and whether the presentations were potentially preventable. Preventable presentations include those presentations considered to be avoidable and those that could have been managed by a local primary care or community service.

Results

There were 1252 presentations to the SCH ED by 453 Aboriginal children aged 0–15 years. More than 50% of children presented more than once. Seventy-nine children presented more than five times. Nearly 45% of presentations were coded as potentially preventable.

Conclusions

A significant proportion of ED presentations were potentially preventable with the use of culturally appropriate and accessible local community and primary health care services and better referral pathways back to these services. Community engagement is required to raise awareness of common presentations and to look at strategies to prevent common problems both occurring and presenting to the ED. This will enhance the health of urban Aboriginal children.

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