Hospital Utilisation in Indigenous and Non-Indigenous Infants under 12 Months of Age in Western Australia, Prospective Population Based Data Linkage Study.
Indigenous infants (infants aged under 12 months) have the highest hospital admission and emergency department presentation risks in Australia. However, there have been no recent reports comparing hospital utilisation between Indigenous and non-Indigenous infants.



Our primary objective was to use a large prospective population-based linked dataset to assess the risk of all-cause hospital admission and emergency department presentation in Indigenous compared to non-Indigenous infants in Western Australia (WA). Secondary objectives were to assess the effect of socio-economic status (Index of Relative Socio-Economic Disadvantage [IRSD]) on hospital utilisation and to understand the causes of hospital utilisation.



There were 3,382 (5.4%) Indigenous and 59,583 (94.6%) non-Indigenous live births in WA from 1 January 2010 to 31 December 2011. Indigenous infants had a greater risk of hospital admission (adjusted odds ratio [aOR] 1.90, 95% confidence interval [95% CI] 1.77-2.04, p = <0.001) and emergency department presentation (aOR 2.15, 95% CI 1.98-2.33, p = <0.001) compared to non-Indigenous infants. Fifty nine percent (59.0%) of admissions in Indigenous children were classified as preventable compared to 31.2% of admissions in non-Indigenous infants (aOR 2.12, 95% CI 1.88-2.39). The risk of hospital admission in the most disadvantaged (IRSD 1) infants in the total cohort (35.7%) was similar to the risk in the least disadvantaged (IRSD 5) infants (30.6%) (aOR 1.04, 95% CI 0.96-1.13, p = 0.356).



WA Indigenous infants have much higher hospital utilisation than non Indigenous infants. WA health services should prioritise Indigenous infants regardless of their socio economic status or where they live.
School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.
Kimberley
K
McAuley
School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.|Kurongkurl Katitjin, Centre for Indigenous Australian Education and Research, Edith Cowan University, Perth, Western Australia, Australia.
Daniel
D
McAullay
School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.
Natalie A
NA
Strobel
School of Psychology and Exercise Science, Murdoch University, Perth, Western Australia, Australia.
Rhonda
R
Marriott
The Rural Clinical School of Western Australia, The University of Western Australia, Broome, Western Australia, Australia.
David N
DN
Atkinson
The Rural Clinical School of Western Australia, The University of Western Australia, Broome, Western Australia, Australia.
Julia V
JV
Marley
Telethon Kids Institute, Perth, Western Australia, Australia.
Fiona J
FJ
Stanley
School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.
Karen M
KM
Edmond
D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D006296:Health Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016247:Information Storage and Retrieval; D036801:Parturition; D011446:Prospective Studies; D012306:Risk; D012923:Social Class; D035862:Vulnerable Populations / Q000706:statistics & numerical data; D014904:Western Australia