The Simpson Centre for Health Services Research, University of New South Wales.
Aust N Z J Public Health. 2010 Feb;34(1):50-6. doi: 10.1111/j.1753-6405.2010.00473.x.
To examine the differences in health services utilisation and the associated risk factors between Indigenous and non-Indigenous infants at a national level in Australia.
We analysed data from a national representative longitudinal study, the Longitudinal Study for Australian Children (LSAC) starting in 2004. We used survey logistic regression and survey multiple linear regression to examine the factors associated with health services utilisation.
Health status of Indigenous infants was poorer than that of non-Indigenous. In comparison to non-Indigenous infants, in the previous 12-month period, the Indigenous infants were significantly less likely to use the following health services: maternal and child health centre or help lines (OR=0.35, 95%CI: 0.24-0.49); maternal and child health nurse visits (OR=0.45, 95%CI: 0.32-0.63); general practitioners (GPs) (OR=0.45, 95%CI: 0.31-0.64); and paediatrician (OR=0.52, 95%CI: 0.35-0.77). In contrast, they were more likely to visit a hospital outpatient clinic (OR=1.82, 95%CI: 1.16-2.85). Mothers' age, education and marital status were associated with certain health services use. Financial status and residential location were the important predictors of the use of health services.
The rates of health services utilisation by Indigenous infants were lower and were associated with mothers' characteristics and socio-economic status.
The gaps in health services utilisation between Indigenous and non-Indigenous infant requires immediate policy initiatives. Further research is needed to explore the causal pathways between health status, health services utilisation and multiple risk factors at different levels.
在澳大利亚全国范围内,研究土著和非土著婴儿在卫生服务利用方面的差异及其相关的风险因素。
我们分析了一项全国代表性的纵向研究(2004 年开始的澳大利亚儿童纵向研究)的数据。我们使用调查逻辑回归和调查多元线性回归来研究与卫生服务利用相关的因素。
土著婴儿的健康状况比非土著婴儿差。与非土著婴儿相比,在过去 12 个月内,土著婴儿明显较少使用以下卫生服务:母婴健康中心或帮助热线(OR=0.35,95%CI:0.24-0.49);母婴健康护士访问(OR=0.45,95%CI:0.32-0.63);全科医生(GP)(OR=0.45,95%CI:0.31-0.64);以及儿科医生(OR=0.52,95%CI:0.35-0.77)。相比之下,他们更有可能去医院门诊就诊(OR=1.82,95%CI:1.16-2.85)。母亲的年龄、教育程度和婚姻状况与某些卫生服务的使用有关。经济状况和居住地点是卫生服务利用的重要预测因素。
土著婴儿的卫生服务利用率较低,与母亲的特征和社会经济地位有关。
土著和非土著婴儿在卫生服务利用方面的差距需要立即采取政策措施。需要进一步研究以探索不同层面健康状况、卫生服务利用和多种风险因素之间的因果关系。