McAuley Kimberley, McAullay Daniel, Strobel Natalie A, Marriott Rhonda, Atkinson David N, Marley Julia V, Stanley Fiona J, Edmond Karen M
School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.
Kurongkurl Katitjin, Centre for Indigenous Australian Education and Research, Edith Cowan University, Perth, Western Australia, Australia.
PLoS One. 2016 Apr 27;11(4):e0154171. doi: 10.1371/journal.pone.0154171. eCollection 2016.
Indigenous 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.
Our 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.
There 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).
WA 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.
在澳大利亚，原住民婴儿（12个月以下的婴儿）住院和前往急诊科就诊的风险最高。然而，最近没有关于比较原住民和非原住民婴儿住院率的报告。
我们的主要目标是使用一个基于人群的大型前瞻性关联数据集，评估西澳大利亚州（WA）原住民婴儿与非原住民婴儿全因住院和前往急诊科就诊的风险。次要目标是评估社会经济地位（相对社会经济劣势指数[IRSD]）对住院率的影响，并了解住院的原因。
2010年1月1日至2011年12月31日期间，西澳大利亚州有3382名（5.4%）原住民婴儿和59583名（94.6%）非原住民婴儿出生。与非原住民婴儿相比，原住民婴儿住院风险更高（调整优势比[aOR]为1.90，95%置信区间[95%CI]为1.77 - 2.04，p = <0.001），前往急诊科就诊的风险也更高（aOR为2.15，95%CI为1.98 - 2.33，p = <0.001）。原住民儿童中有59.0%的住院病例被归类为可预防的，而非原住民婴儿中这一比例为31.2%（aOR为2.12，95%CI为1.88 - 2.39）。在整个队列中，最弱势（IRSD为1）婴儿的住院风险（35.7%）与最不弱势（IRSD为5）婴儿的住院风险（30.6%）相似（aOR为1.04，95%CI为0.96 - 1.13，p = 0.356）。
西澳大利亚州的原住民婴儿住院率远高于非原住民婴儿。西澳大利亚州的医疗服务应优先考虑原住民婴儿，无论其社会经济地位或居住地点如何。
