Indigenous Australians get less hospital care
Australian public hospitals may be systematically treating Indigenous patients differently, a Northern Territory-based epidemiologist reports.
Dr Joan Cunningham has found that in public hospitals during 1997 and 1998, people identified as Indigenous were less likely to have diagnostic tests or surgery than other comparable patients.
Her study, published in this week's Medical Journal of Australia, was based on data from the National Hospital Morbidity Database. This provided information on the age, sex, place of residence, diagnosis and care of admitted patients in almost all public and private hospitals in Australia.
Only 45 per cent of Indigenous patients received some kind of procedure in public hospitals, whereas 69 per cent of other patients were treated, reports Dr Cunningham, from the Menzies School of Health Research and the CRC for Aboriginal and Tropical Health.
She could not be absolutely sure she was comparing exactly like with like, because while she was able to adjust for certain factors like age, sex, condition, and the size of the hospital, the database lacked fine detail, Dr Cunningham said.
However, she added, any further adjustment was likely to be much smaller than the difference found.
According to Dr Cunningham, a growing body of research shows clear evidence that barriers exist for Indigenous Australians at many levels in the health care system including access to services, diagnosis, treatment, and outcomes.
"The results of this study are consistent with US research which shows fewer procedures among disadvantaged groups such as African-Americans."
She argues that since Indigenous Australians have an "alarming health profile", it is important to look in more detail as to why this discrepancy exists as the barriers may exist both outside and inside the hospital system.
"What happens in hospitals can't be seen in isolation there are barriers to access all along the way," she said.
"It's a whole-of-health-care issue."
As an example, Dr Cunningham cited a 1998 study by the CRC that found communication difficulties were a major barrier to effective service delivery for Indigenous Australians.
She also pointed to the draft National Aboriginal and Torres Strait Islander Health Strategy which refers to the need for culturally appropriate care.
Dr Cunningham found no difference in treatment in private hospitals, although these accounted for only 3 per cent of Indigenous admissions.