Use of health services by remote dwelling Aboriginal infants in tropical northern Australia: a retrospective cohort study
1 Centre for Rural Health, Northern Rivers; School of Public Health, Sydney Medical School, University of Sydney, New South Wales 2480, Australia
2 School of Health, Charles Darwin University, Darwin 0909, Australia
3 Centre for Rural Health; Northern Rivers, University of Sydney, New South Wales 2480, Australia
4 Menzies School of Health Research, Charles Darwin University, Darwin 0909, Australia
5 Midwifery Research Unit, Australian Catholic University and the Mater Medical Research Institute, Queensland 4010, Australia
BMC Pediatrics 2012, 12:19 doi:10.1186/1471-2431-12-19Published: 28 February 2012
Australia is a wealthy developed country. However, there are significant disparities in health outcomes for Aboriginal infants compared with other Australian infants. Health outcomes tend to be worse for those living in remote areas. Little is known about the health service utilisation patterns of remote dwelling Aboriginal infants. This study describes health service utilisation patterns at the primary and referral level by remote dwelling Aboriginal infants from northern Australia.
Data on 413 infants were analysed. Following birth, one third of infants were admitted to the regional hospital neonatal nursery, primarily for preterm birth. Once home, most (98%) health service utilisation occurred at the remote primary health centre, infants presented to the centre about once a fortnight (mean 28 presentations per year, 95%CI 26.4-30.0). Half of the presentations were for new problems, most commonly for respiratory, skin and gastrointestinal symptoms. Remaining presentations were for reviews or routine health service provision. By one year of age 59% of infants were admitted to hospital at least once, the rate of hospitalisation per infant year was 1.1 (95%CI 0.9-1.2).
The hospitalisation rate is high and admissions commence early in life, visits to the remote primary health centre are frequent. Half of all presentations are for new problems. These findings have important implications for health service planning and delivery to remote dwelling Aboriginal families.