title: Improving delivery of health care to Aboriginal and Torres Strait Islander children.
abstract: OBJECTIVE
  To identify opportunities to improve health-care delivery for urban Aboriginal and Torres Strait Islander children requiring hospital admission and to determine their characteristics.
  
  
  METHODS
  We analysed all documentation of admissions of Aboriginal and/or Torres Strait Islander children to a tertiary paediatric hospital in 2010. We reviewed the medical records to determine whether the Aboriginal status of patients was known, whether Aboriginal and/or Torres Strait Islander children and their families were reviewed by Aboriginal staff during admission and whether basic health-care quality indicators were met, including documentation of anthropometry, ear examination findings, immunisation status and catch-up immunisation delivery.
  
  
  RESULTS
  In 2010, 543 (2%) patients admitted to the institution were identified as Aboriginal and/or Torres Strait Islander: 140/538 (26.0%) were from the first decile (most disadvantaged) on Socio-Economic Indexes for Areas index. Of all admitted children, 148/543 (27.3%) were referred to Aboriginal health professionals during admission, more when length of stay was greater than 7 days (61% vs. 23%, P < 0.001). There was documentation of weight in 533/543 (98.2%), ear examinations in 64/543 (11.8%), immunisations being not up to date in 126/543 (23%), catch-up immunisation given in 7/126 (5.6%), Aboriginal and/or Torres Strait Islander status in 8/543 (1.5%) medical and 1/543 (0.2%) nursing discharge summaries.
  
  
  CONCLUSIONS
  We have identified several opportunities to improve culturally appropriate health-care delivery for Aboriginal and Torres Strait Islander children admitted to hospital, including improved recognition of Aboriginal and/or Torres Strait Islander status of patients, improved access to Aboriginal health professionals and increased performance and documentation of basic anthropometry, ear examination and immunisation catch-up.
authors.affiliation: Sydney Medical Program, Sydney Children's Hospitals Network (Westmead), Sydney, New South Wales, Australia.
authors.forename: Lucy
authors.identifier: http://orcid.org/0000-0003-0447-7917
authors.initials: L
authors.lastname: Attwood
authors.affiliation: Department of Paediatrics, University College London, London, United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Rodrigues
authors.affiliation: Sydney Children's Hospitals Network (Westmead), Sydney, New South Wales, Australia.
authors.forename: Josephine
authors.initials: J
authors.lastname: Winsor
authors.affiliation: Sydney Children's Hospitals Network (Westmead), Sydney, New South Wales, Australia.
authors.forename: Shirley
authors.initials: S
authors.lastname: Warren
authors.affiliation: Sydney Children's Hospitals Network (Westmead), Sydney, New South Wales, Australia.
authors.forename: Lyn
authors.initials: L
authors.lastname: Biviano
authors.affiliation: Sydney Medical Program, Sydney Children's Hospitals Network (Westmead), Sydney, New South Wales, Australia.|Sydney Children's Hospitals Network (Westmead), Sydney, New South Wales, Australia.
authors.forename: Hasantha
authors.initials: H
authors.lastname: Gunasekera
keywords: cultural competency; delivery of health care; immunisation; indigenous; paediatric