The George Institute for Global Health, Level 5/1 King Street, Newtown, NSW, 2042, Australia.
Department of Paediatric Surgery, The Children's Hospital at Westmead, Corner Hawkesbury Road and, Hainsworth St, Westmead, NSW, 2145, Australia.
BMC Health Serv Res. 2023 Jun 9;23(1):604. doi: 10.1186/s12913-023-09567-5.
Aboriginal and Torres Strait Islander peoples have a unique place in Australia as the original inhabitants of the land. Similar to other First Nations people globally, they experience a disproportionate burden of injury and chronic health conditions. Discharge planning ensures ongoing care to avoid complications and achieve better health outcomes. Analysing discharge interventions that have been implemented and evaluated globally for First Nations people with an injury or chronic conditions can inform the implementation of strategies to ensure optimal ongoing care for Aboriginal and Torres Strait Islander people.
A systematic review was conducted to analyse discharge interventions conducted globally among First Nations people who sustained an injury or suffered from a chronic condition. We included documents published in English between January 2010 and July 2022. We followed the reporting guidelines and criteria set in Preferred Reporting Items for Systematic Review (PRISMA). Two independent reviewers screened the articles and extracted data from eligible papers. A quality appraisal of the studies was conducted using the Mixed Methods Appraisal Tool and the CONSIDER statement.
Four quantitative and one qualitative study out of 4504 records met inclusion criteria. Three studies used interventions involving trained health professionals coordinating follow-up appointments, linkage with community care services and patient training. One study used 48-hour post discharge telephone follow-up and the other text messages with prompts to attend check-ups. The studies that included health professional coordination of follow-up, linkage with community care and patient education resulted in decreased readmissions, emergency presentations, hospital length of stay and unattended appointments.
Further research on the field is needed to inform the design and delivery of effective programs to ensure quality health aftercare for First Nations people. We observed that discharge interventions in line with the principal domains of First Nations models of care including First Nations health workforce, accessible health services, holistic care, and self-determination were associated with better health outcomes.
This study was prospectively registered in PROSPERO (ID CRD42021254718).
澳大利亚原住民和托雷斯海峡岛民作为这片土地的原住居民，在澳大利亚有着独特的地位。与全球其他原住民一样，他们遭受了不成比例的伤害和慢性健康问题的困扰。出院计划确保了持续的护理，以避免并发症并实现更好的健康结果。分析全球范围内针对因受伤或患有慢性疾病的原住民实施和评估的出院干预措施，可以为实施确保原住民获得最佳持续护理的策略提供信息。
我们进行了一项系统评价，以分析全球范围内针对因受伤或患有慢性疾病的原住民实施的出院干预措施。我们纳入了 2010 年 1 月至 2022 年 7 月期间以英文发表的文献。我们遵循了系统评价报告的首选条目（PRISMA）中规定的报告准则和标准。两名独立评审员筛选了文章并从合格论文中提取了数据。使用混合方法评估工具和 CONSIDER 声明对研究进行了质量评估。
在 4504 条记录中，有 4 项定量研究和 1 项定性研究符合纳入标准。其中 3 项研究使用了涉及受过培训的卫生专业人员协调随访预约、与社区护理服务的联系以及患者培训的干预措施。其中 1 项研究使用了出院后 48 小时的电话随访，另一项研究则使用了带有提示信息的短信，以促使患者参加检查。包括卫生专业人员协调随访、与社区护理联系和患者教育的研究结果表明，再入院率、急诊就诊率、住院时间和未就诊预约减少。
需要进一步研究该领域，为设计和提供有效的方案提供信息，以确保原住民获得高质量的康复护理。我们观察到，符合原住民护理模式主要领域的出院干预措施，包括原住民卫生工作者、可及的卫生服务、整体护理和自决，与更好的健康结果相关。
本研究已在 PROSPERO（注册号：CRD42021254718）上进行了前瞻性注册。
