title: Use of health services by remote dwelling Aboriginal infants in tropical northern Australia: a retrospective cohort study.
abstract: BACKGROUND
  Australia is a wealthy developed country. However, there are significant disparities in health outcomes for Aboriginal infants compared with other Australian infants. Health outcomes tend to be worse for those living in remote areas. Little is known about the health service utilisation patterns of remote dwelling Aboriginal infants. This study describes health service utilisation patterns at the primary and referral level by remote dwelling Aboriginal infants from northern Australia.
  
  
  RESULTS
  Data on 413 infants were analysed. Following birth, one third of infants were admitted to the regional hospital neonatal nursery, primarily for preterm birth. Once home, most (98%) health service utilisation occurred at the remote primary health centre, infants presented to the centre about once a fortnight (mean 28 presentations per year, 95%CI 26.4-30.0). Half of the presentations were for new problems, most commonly for respiratory, skin and gastrointestinal symptoms. Remaining presentations were for reviews or routine health service provision. By one year of age 59% of infants were admitted to hospital at least once, the rate of hospitalisation per infant year was 1.1 (95%CI 0.9-1.2).
  
  
  CONCLUSIONS
  The hospitalisation rate is high and admissions commence early in life, visits to the remote primary health centre are frequent. Half of all presentations are for new problems. These findings have important implications for health service planning and delivery to remote dwelling Aboriginal families.
authors.affiliation: Centre for Rural Health, Northern Rivers, School of Public Health, Sydney Medical School, University of Sydney, New South Wales, Australia. sbarzeev@usyd.edu.au
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Bar-Zeev
authors.forename: Sue G
authors.initials: SG
authors.lastname: Kruske
authors.forename: Lesley M
authors.initials: LM
authors.lastname: Barclay
authors.forename: Naor H
authors.initials: NH
authors.lastname: Bar-Zeev
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Carapetis
authors.forename: Sue V
authors.initials: SV
authors.lastname: Kildea
mesh_terms: D002662:Child Health Services / Q000706:statistics & numerical data*; D015331:Cohort Studies; D054624:Health Status Disparities; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020380:Needs Assessment; D015876:Northern Territory; D009725:Nurseries, Hospital / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012423:Rural Health / Q000208:ethnology* / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000706:statistics & numerical data*