title: Emergency department presentations by Aboriginal children: issues for consideration for appropriate health services.
abstract: OBJECTIVE
  This study describes the presentations made to the Sydney Children's Hospital (SCH) Emergency Department (ED) by local Aboriginal and Torres Strait Islander (Aboriginal) children with particular reference to children who present frequently or whose presentation was preventable.
  
  
  METHODS
  Data from the SCH ED Information System were extracted for all presentations made by children who identified as Aboriginal, aged between 0-15 years, who presented between 2005-2008. Presentations were coded according to the presenting problem, diagnosis, outcome, and whether the presentations were potentially preventable. Preventable presentations include those presentations considered to be avoidable and those that could have been managed by a local primary care or community service.
  
  
  RESULTS
  There were 1252 presentations to the SCH ED by 453 Aboriginal children aged 0-15 years. More than 50% of children presented more than once. Seventy-nine children presented more than five times. Nearly 45% of presentations were coded as potentially preventable.
  
  
  CONCLUSIONS
  A significant proportion of ED presentations were potentially preventable with the use of culturally appropriate and accessible local community and primary health care services and better referral pathways back to these services. Community engagement is required to raise awareness of common presentations and to look at strategies to prevent common problems both occurring and presenting to the ED. This will enhance the health of urban Aboriginal children.
authors.affiliation: Department of Community Child Health, Sydney Children's Hospital, Randwick, New South Wales, Australia.
authors.forename: Catriona
authors.initials: C
authors.lastname: Duncan
authors.forename: Katrina
authors.initials: K
authors.lastname: Williams
authors.forename: Dania
authors.initials: D
authors.lastname: Nathanson
authors.forename: Susan
authors.initials: S
authors.lastname: Thomas
authors.forename: Carolyn
authors.initials: C
authors.lastname: Cottier
authors.forename: Matthew
authors.initials: M
authors.lastname: O'Meara
authors.forename: Karen
authors.initials: K
authors.lastname: Zwi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D054521:Cultural Competency; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006302:Health Services Research; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D054525:Minority Health; D009517:New South Wales; D011320:Primary Health Care / Q000706:statistics & numerical data; D014504:Urban Health; D000095283:Australian Aboriginal and Torres Strait Islander Peoples
keywords: Aborigines; Australia; child; emergency service; health services research; paediatric/utilisation