Work

Uncovering missed opportunities to provide holistic care for a cross‐sectional cohort of Aboriginal and/or Torres Strait Islander Peoples in a metropolitan hospital

Year: 2025

Type: article

Abstract: BACKGROUND: Chronic disease disproportionately affects Aboriginal and/or Torres Strait Islander Peoples. More is needed to enhance prevention, detection and chronic disease care. AIMS: To describe and quantify chronic disease markers and reasons for hospital admission in a cross-sectional cohort of Aboriginal and/or Torres Strait Islander Peoples. METHODS: Retrospective medical record review (paper-based and electronic) in a metropolitan tertiary referral, Level 1 trauma hospital in Sydney, New South Wales, Australia. A cohort discharged from the study hospital (January-December 2017) was identified using admission and discharge data. Records were selected for inclusion sequentially based on discharge. Main outcome measures were primary outcomes demographics, reasons for admission, presence of chronic disease and chronic disease markers. RESULTS: The patient cohort (n = 300) was young (mean age: 45 years (range: 16-79 years)), and primarily male (n = 191/300, 64%), with high levels of multiple chronic diseases and related complications. Nearly four in 10 had no general practitioner (n = 116/300, 39%). Nearly one in five (n = 54/300, 18%) had no fixed address. The cohort was often admitted more than once, and admissions were most often for substance use or mental health. CONCLUSIONS: Findings quantify previously unpublished levels of chronic disease markers and reasons for hospital admission of Aboriginal and/or Torres Strait Islander Peoples. Findings highlight missed care opportunities, within hospital for all chronic diseases and on transitions of care to the community. More is needed to make hospital system changes that encourage clinicians to provide holistic care. Further research using continuous quality improvement methods could help rethink these systems.

Source: Internal Medicine Journal

DOI: 10.1111/imj.70256