Hospital Care For Aboriginal People
Patient PerspectivesHospital care forAboriginal peoplePatient Perspectives – Hospital care for Aboriginal peoplebhi.nsw.gov.aui
BUREAU OF HEALTH INFORMATIONLevel 11, Sage Building, 67 Albert AvenueChatswood NSW 2067AustraliaTelephone: 61 2 9464 4444Email: BHI-enq@health.nsw.gov.aubhi.nsw.gov.au Copyright Bureau of Health Information 2016This work is copyrighted. It may be reproduced in whole or in part for study or trainingpurposes subject to the inclusion of an acknowledgement of the source. It may not bereproduced for commercial usage or sale. Reproduction for purposes other than thoseindicated above requires written permission from the Bureau of Health Information.State Health Publication Number: (BHI) 160151ISBN 978-1-76000-410-1 (print)ISBN 978-1-76000-411-8 (online)Suggested citation:Bureau of Health Information. Patient Perspectives – Hospital care for Aboriginal people.Sydney (NSW); BHI; 2016.Please note that there is the potential for minor revisions of data in this report.Please check the online version at bhi.nsw.gov.au for any amendments.Published August 2016The conclusions in this report are those of BHI and no official endorsement by theNSW Minister for Health, the NSW Ministry of Health or any other NSW public healthorganisation is intended or should be inferred.
Table of contentsForeword 2Key findings 3Summary 5At a glance Setting the scene 710Introduction 11About this report 13Data and methods 15Section 1 – Thematic analyses 20Overall experience of care 21Access and timeliness 23Assistance and responsiveness 25Comprehensive and whole-person care 27Coordination and continuity 29Engagement and participation 31Provision of information 33Respectfulness: Culture, dignity and privacy 35Respectfulness: Politeness and courtesy 37Responsive communication 39Trust and confidence 41Physical environment and comfort 43Safety and hygiene 45Patient-reported outcomes 47Section 2 – Synthesis of local health district results 50Local health district overview: Gap between Aboriginal and non-Aboriginal patients’ responses 51Local health district overview: Variation in Aboriginal patients’ responses 55Appendices 60References 79Acknowledgements 80Patient Perspectives – Hospital care for Aboriginal peoplebhi.nsw.gov.au
1Patient Perspectives – Hospital care for Aboriginal peoplebhi.nsw.gov.au
ForewordAboriginal people are the first peoples of Australia.There are more than 200,000 Aboriginal people whocall New South Wales (NSW) home. Aboriginalpeoples’ long and diverse history, profound connectionwith place, rich and varied culture and strong sense ofcommunity are integral to modern NSW.We know that Aboriginal people often experiencepoorer health, and many die at a relatively young agein comparison to non-Aboriginal people. Significantsocioeconomic disadvantage is associated withthese health and life expectancy gaps and has apervasive effect on Aboriginal individuals, familiesand communities.In March 2008, the Australian Government andOpposition signed the Close the Gap Statement ofIntent, pledging to close the health and life expectancygap between Aboriginal and Torres Strait Islanderpeople and non-Indigenous Australians by 2030.More recently, the NSW Government, in partnershipwith the Aboriginal Health and Medical ResearchCouncil of NSW (AH&MRC), developed the NSWAboriginal Health Plan 2013–2023. That documentoutlines the state’s commitment to closing the healthgap. The plan identifies a number of specific goalssuch as reducing smoking rates among pregnantAboriginal women and reducing rates of potentiallypreventable hospitalisations among Aboriginalpeople. More broadly, it emphasises the impact thatsystem-wide quality improvement efforts can haveon Aboriginal people’s health.Patient Perspectives: Hospital care for Aboriginalpeople does not consider the question of whetherthe gap is closing. It does however reflect onhealthcare system performance and inform efforts toimprove – for all patients and more specifically forAboriginal patients. Drawing on information frompatient surveys, this type of report can play animportant role in helping to achieve healthcare goals– from broad, system-wide objectives to morefocused and specific concerns that are particularlyimportant to Aboriginal people.Patient Perspectives – Hospital care for Aboriginal peopleAll patients and their carers can play a crucial rolein assessing performance and guiding efforts toimprove healthcare. Patients are the centralparticipants in care, and are often the soleconnection between different healthcareprofessionals, specialties and sectors. They canreflect on issues of accessibility, appropriatenessand effectiveness of care – providing informationthat is not, and often cannot be, captured byadministrative data or hospital records.This edition of Patient Perspectives provides animportant opportunity to listen to what Aboriginalpeople have to say about their experiences inhospital. It explores whether there are differences incare provided to Aboriginal patients compared tonon-Aboriginal patients. It also allows us to contrastperformance across local health districts, examiningwhether Aboriginal patients’ perspectives differaccording to location or geography; and identifyingwhere patients report good, or poor, experiencesof care.To produce this report, the Bureau of HealthInformation (BHI) worked with the Centre forAboriginal Health at the NSW Ministry of Health, theAH&MRC and the AH&MRC Ethics Committee,which provided advice and feedback. An advisorycommittee helped contextualise the results andacted as expert peer reviewers.Improving Aboriginal health is clearly a state andnational imperative, but its importance is not aconcern that should be limited to Aboriginal people.Disparities, when they remain unchallenged andunaddressed, pose fundamental questions thataffect all Australians – questions about our widervalues such as fairness and equal opportunity. Wehope this report makes a contribution to efforts toboth challenge and address such disparities in aconstructive way.Jean-Frédéric Lévesque MD, PhDChief Executive, Bureau of Health Informationbhi.nsw.gov.au2
Key findingsThis report provides, for the first time, system-wide anddetailed information about Aboriginal patients’ experiences ofhospital care in NSW. Altogether 2,682 adult Aboriginal patientstold us about their experiences – we heard from almost one inevery 10 adult Aboriginal patients hospitalised in 2014.3Patient Perspectives – Hospital care for Aboriginal peoplebhi.nsw.gov.au
10 key findings1Overall, hospital care was highly rated by Aboriginal patientsIn NSW, 64% of Aboriginal patients said the care they received was ‘very good’ and 25% said it was‘good’; 72% would ‘speak highly’ about their hospital experience.2However, when asked about specific aspects of care Aboriginal patients were lesspositive than non-Aboriginal patientsFor 26 of the 55 survey questions included in the report, Aboriginal patients answered significantly lesspositively than non-Aboriginal patients.3For some aspects of care these differences were largeThe widest gaps between Aboriginal patients’ and non-Aboriginal patients’ responses were seen inquestions about privacy and being given understandable answers to important questions.4Only one survey question was answered more positively by Aboriginal patients thannon-Aboriginal patientsThe question was about whether patients saw information about their rights (including how to complain)during their hospital stay.5Most Aboriginal patients said that the hospital care they received definitely helped themAlthough they were less likely than non-Aboriginal patients to say so.6Poor experiences of care were reported by a sizeable minority of Aboriginal patientsFor example, 23% of Aboriginal patients said health professionals did not discuss with them their worriesor fears; 22% said they experienced a complication of care; 20% said they were not given enoughinformation about their condition or treatment; and 16% said adequate arrangements were not made forservices after they were discharged from hospital.7Results differed across local health districtsFor example, in Hunter New England and Sydney there were very few questions for which Aboriginalpatients were markedly less positive than non-Aboriginal patients; while in Murrumbidgee and WesternNSW most questions were answered less positively by Aboriginal patients.8Gaps in experiences of care between Aboriginal and non-Aboriginal patients appearbigger in rural and remote areasThis is mostly related to the fact that non-Aboriginal patients admitted to rural hospitals report asignificantly better experience than non-Aboriginal patients who were hospitalised in urban areas.9When comparing Aboriginal patients’ experiences across the state, results variedAboriginal patients in Southern NSW and Sydney local health districts were more positive, and patients inNepean Blue Mountains were less positive, than all NSW Aboriginal patients for multiple questions.10Variation across question and local health district results suggests that gaps betweenAboriginal and non-Aboriginal patients’ experiences are not inevitablePatient Perspectives – Hospital care for Aboriginal peoplebhi.nsw.gov.au4
SummaryThis edition of Patient Perspectives describes theexperiences of 2,682 Aboriginal people who wereadmitted to a NSW public hospital during 2014.Within the 2014 Adult Admitted Patient Survey(AAPS), about 13,000 questionnaires were sent toAboriginal people in the three months following theirdischarge from one of 80 NSW public hospitals. Theresponse rate among Aboriginal patients was 21%.NSW level results – how did Aboriginalpatients rate their experiences of care?Most Aboriginal patients rated the care they receivedoverall in hospital as either ‘very good’ (64%) or‘good’ (25%). While a similar proportion of nonAboriginal patients (63%) rated hospital care overallas ‘very good’, for 26 of the 55 survey questionsanalysed in this report, Aboriginal patients were lesspositive than non-Aboriginal patients.In general, questions about directly observableelements of care such as physical environment andcomfort, safety and hygiene were answered similarlyby Aboriginal and non-Aboriginal patients.In contrast, for questions that focused oninterpersonal or relational aspects of care – such asrespectfulness of staff and delivery of comprehensiveand whole-person care – there were markeddifferences between Aboriginal and non-Aboriginalpatients’ responses.The widest gaps between the two groups were seenin questions about whether patients were ‘always’given enough privacy when discussing theircondition or treatment (Aboriginal patients 72% andnon-Aboriginal patients 81%) and whether doctors'always' answered important questions in anunderstandable way (66% and 74%).For one question only, Aboriginal patients were morepositive than non-Aboriginal patients. Aboriginalpatients were more likely to say they saw or receivedinformation about patient rights, including the right tocomplain (46% and 39%).5Patient Perspectives – Hospital care for Aboriginal peopleIn terms of self-reported outcomes, although mostAboriginal patients answered positively, they were lesslikely than non-Aboriginal patients to say the care andtreatment they received in hospital ‘definitely’ helpedthem (70% Aboriginal patients and 77% non-Aboriginalpatients). A similar difference was seen in theproportion of patients who said at the time ofquestionnaire completion (approximately three monthsafter hospital discharge), the problem for which theywere hospitalised was ‘much better' (66% and 73%).Across the state, 22% of Aboriginal patients saidthey experienced a complication during or shortlyafter their hospital stay – compared with 16% ofnon-Aboriginal patients. Among patients whoexperienced a complication, a higher proportion ofAboriginal patients rated their complication as 'veryserious' (29%) than non-Aboriginal patients (19%).Looking across the various aspects of careaddressed in the survey, Aboriginal patientsresponded most positively to questions aboutrespect, although in comparison, non-Aboriginalpatients responded even more positively.Among Aboriginal patients, 86% said their culturaland religious beliefs were ‘always’ respected;79% said they were ‘always’ treated with respectand dignity; and about eight in 10 said the variousstaff who treated them were ‘always’ politeand courteous.Negative reflections on performance included: 23% of Aboriginal patients said healthprofessionals did not discuss with them theirworries and fears (non-Aboriginal patients 18%) 16% of Aboriginal patients said adequatearrangements for services post-discharge were notmade by the hospital (non-Aboriginal patients 10%) 20% of Aboriginal patients said that during theirhospital stay, not enough information was givento them about their condition or treatment(non-Aboriginal patients 14%).bhi.nsw.gov.au
How did results vary byrurality of hospital?Aboriginal patients admitted to rural hospitals(located in regional and remote geographical areas)reported similar experiences of care to Aboriginalpatients admitted to urban hospitals (located inmajor cities).In contrast, among non-Aboriginal patients, thoseadmitted to rural hospitals were consistently morepositive than those admitted to urban hospitals.As a result, differences between the responses ofAboriginal and non-Aboriginal patients were morepronounced in rural hospitals.Within rural hospitals, the question with the largestdifference between Aboriginal and non-Aboriginalpatient responses focused on whether ‘completely’adequate arrangements were made for servicesneeded after discharge (Aboriginal patients 64% andnon-Aboriginal patients 76%).How did results vary acrosslocal health districts?At a local health district (LHD) and health networklevel, results are reported in terms of percentage pointdifferences, or gaps, in the proportion of Aboriginaland non-Aboriginal patients who selected the mostpositive response category. The proportion ofquestions with 10 percentage point gaps forwhich Aboriginal patients answered less positivelyranged from 0% in Hunter New England to 80%in Murrumbidgee.Comparing Aboriginal patients' responsesComparing the responses of Aboriginal patients fromeach LHD with all NSW Aboriginal patients, thosehospitalised in Sydney and Southern NSW weresignificantly more positive for seven and six of the 55survey questions respectively. Conversely, patientshospitalised in Nepean Blue Mountains weresignificantly less positive for six questions.Patient Perspectives – Hospital care for Aboriginal peopleAmong Aboriginal patients, LHD and health networkresults spanned 20 percentage points for mostquestions. Widest variations were in whether: Patients were ‘completely’ involved in decisionsabout medication (from 36% of Aboriginalpatients in Western Sydney to 82% of Aboriginalpatients in Mid North Coast; a 46 percentagepoint range) Patients ‘always’ saw nurses wash their hands,use hand gel, or use clean gloves before touchingthem (from 41% in St Vincent’s to 87% inSouthern NSW; a 46 percentage point range) Nurses ‘always’ knew enough about patients’care and treatment (from 37% in St Vincent’sto 80% in Southern NSW and Sydney; a 43percentage point range).There were eight questions for which results werefairly consistent across LHDs. Questions with theleast variation addressed whether: staff seen uponarrival were ‘always’ polite and courteous (a 14percentage point range); patients felt well enough toleave hospital at discharge (a 15 percentage pointrange); and nurses ‘always’ checked their patient’sname or ID band before giving them medications,treatments or tests (a 17 percentage point range).Variation in results suggests that gaps betweenAboriginal and non-Aboriginal patients’ experiencesare not inevitable.The results presented in this report are notadjusted for variation in sociodemographiccharacteristics. Adjusting for these variableshad a minimal impact on survey results and theeffect of Aboriginality was largely unchanged.LHD profiles provide detailed results for localcommunities, highlighting areas of goodand poor performance and summarisinggaps between Aboriginal and non-Aboriginalpatients in experiences of care.Available at bhi.nsw.gov.aubhi.nsw.gov.au6
Results at a glanceResponses to 55 survey questions were used tocompare the experiences of Aboriginal and nonAboriginal patients who were admitted to a NSWpublic hospital during 2014.Figure 1Differences were most pronounced for questionsabout respectfulness of care, and were small forquestions about acceptability of waiting times, physicalenvironment and safety and hygiene (Figure 1).NSW results for all questions, most positive response: Aboriginal and non-Aboriginal patientsAboriginal patients01020Non-Aboriginal patients30405060* Significant difference708090100Overall experience of care*Would ‘speak highly’ of the hospital to friends and familyOverall, nurses were rated as ‘very good’Overall, doctors were rated as ‘very good’Overall, care was rated as ‘very good’Access and timelinessTime spent in the emergency department was ‘about right’Time waited to be admitted to hospital was ‘about right’Time between booking appointment with specialist andadmission for procedure was ‘about right’Assistance and responsiveness*‘Always’ got the opportunity to talk to a nurse when needed‘Always’ got the opportunity to talk to a doctor when neededFamily or someone close ‘always’ got the opportunity totalk to a doctor when neededStaff assisted within a reasonable timeframe ‘all of the time’Health professional 'completely' discussed worries or fearsComprehensive and whole-person care*Nurses were ‘always’ kind and caring*Doctors were ‘always’ kind and caringFood ‘always’ suitable for dietary needsStaff ‘completely’ considered family and homesituation when planning discharge**At discharge, felt well enough to leave hospitalCoordination and continuityCare was ‘very well organised’*Nurses ‘always’ knew enough about patient's care and treatment*Doctors ‘always’ knew enough about patient's medical historyAt discharge, ‘completely’ adequate arrangementsmade for services needed*Told who to contact if worried about condition ortreatment after dischargeEngagement and participation‘Completely’ involved in decisions about use of medication‘Definitely’ involved in decisions about care and treatment‘Definitely’ involved in decisions about discharge*Given ‘completely’ enough information to manage care at home0102030405060708090100% of patients7Patient Perspectives – Hospital care for Aboriginal peoplebhi.nsw.gov.au
Aboriginal patients01020Non-Aboriginal patients30405060* Significant difference708090100Provision of informationGiven ‘right amount’ of information about hospital stay before arrivalGiven ‘right amount’ of information about condition or treatmentduring stay*Family or someone close given ‘right amount’ of information aboutcondition or treatment**While in hospital, received or saw information about patients’ rights‘Completely’ informed about medication side effects to watch forRespectfulness: Culture, dignity and privacy*Cultural or religious beliefs were ‘always’ respected*‘Always’ treated with respect and dignity*‘Always’ given enough privacy when being examined or treated*‘Always’ given enough privacy when discussing condition or treatmentRespectfulness: Politeness and courtesyStaff seen on arrival were ‘always’ polite and courteous*Emergency department staff were ‘always’ polite and courteous*Nurses were ‘always’ polite and courteous*Doctors were ‘always’ polite and courteousResponsive communicationHealth professional ‘completely’ explained what would be donein surgeryHealth professional ‘completely’ explained how surgery went*Nurses ‘always’ answered important questions in an understandable way*Doctors ‘always’ answered important questions in an understandable wayHealth professional ‘completely’ explained purpose of medicationTrust and confidence*‘Always’ had confidence and trust in nurses*‘Always’ had confidence and trust in doctorsPhysical environment and comfortWards or rooms were ‘very clean’Toilets and bathrooms were ‘very clean’Safety and hygieneNurses ‘always’ asked patient’s name or checked ID band beforegiving medications/treatments/testsCall button was ‘always’ placed within easy reach‘Always’ saw nurses wash their hands or use clean gloves‘Always’ saw doctors wash their hands or use clean glovesPatient-reported outcomes*Did not experience complication related to hospital care*Care and treatment received ‘definitely’ helped*The problem went to hospital for ‘much better’0102030405060708090100% of patientsPatient Perspectives – Hospital care for Aboriginal peoplebhi.nsw.gov.au8
9Patient Perspectives – Hospital care for Aboriginal peoplebhi.nsw.gov.au
Setting the scenePatient Perspectives – Hospital care for Aboriginal peoplebhi.nsw.gov.au10
IntroductionIn 2014, an estimated 220,900 Aboriginal people wereliving in NSW.1 Aboriginal people represent a relativelysmall proportion (3%) of the total NSW population.However, NSW is home to more Aboriginal people thanany other state or territory – 31% of the total AustralianAboriginal population live in NSW.2Compared with the non-Aboriginal population, theAboriginal population is known to: Be younger1 Be in poorer health3 Have a higher unemployment rate4 Have a lower rate of tertiary education3 Have lower levels on other socioeconomicindicators (e.g. literacy, income).3Nationally and statewide, there are extensive programsthat assess and report on Aboriginal health. However,much less is known about Aboriginal patients’experiences of healthcare.Defining health‘Aboriginal health’ refers not just to thephysical wellbeing of an individual. It relatesmore broadly to the social, emotional andcultural wellbeing of the whole communityin which each individual is able to achievetheir full potential as a human being.8,911Patient Perspectives – Hospital care for Aboriginal peopleEfforts to improve Aboriginal health– key documentsIn 2008, all governments in Australia committed towork towards ‘Closing the Gap’, agreeing to sixspecific targets and timelines addressing importantareas of disadvantage for Aboriginal people.Two of these targets relate directly to the health ofAboriginal people in Australia: to close the gap in lifeexpectancy within a generation (by 2031); and tohalve the gap in mortality rates for Indigenouschildren under five within a decade (by 2018).5The NSW Government, in partnership with theAboriginal Health and Medical Research Council ofNSW, has developed a number of documents tosupport this aim including the NSW Aboriginal HealthPlan 2013–2023 and the NSW Aboriginal HealthPartnership Agreement 2015–2025.4 The latteroutlines the state’s commitment to close the healthgap between Aboriginal and non-Aboriginal people inNSW and aims to complement and support the goalsoutlined in the national policy document, The NationalAboriginal and Torres Strait Islander Health Plan.Specific cultural competence interventions have alsobeen developed in Australia and internationally inresponse to the considerable research evidencepointing to the need for culturally responsive care.6In NSW, this includes the policy document Respectingthe Difference: An Aboriginal Cultural TrainingFramework for NSW Health, released in 2011.7bhi.nsw.gov.au
The health of Aboriginal peopleThe NSW Ministry of Health provides awide range of statistics on the health ofAboriginal people in NSW.1 For example: The estimated life expectancy forAboriginal babies born in 2010–12 was70.5 years for males and 74.6 for females(9.3 and 8.5 years less than fornon-Aboriginal babies, respectively) The mortality rate for Aboriginal peoplebetween 2009–13 was 1.5 times the ratefor non-Aboriginal people Infant mortality rates between 2011–13were 1.1 times higher for Aboriginalbabies than for non-Aboriginal babies In 2014, 74% of Aboriginal people aged16 years said their health was ‘excellent’,‘very good’, or ‘good’, compared with 81%of non-Aboriginal people Chronic diseases are major causes ofmorbidity and mortality among Aboriginalpeople nationally and in NSW Aboriginal people have higher rates ofheart disease, but lower rates of cardiacinterventions than non-Aboriginal peopleUsing patient experiencesto measure performancePatients’ experiences are important to measure fortwo main reasons:1. Patients are expert informants who can make animportant contribution to assessments ofperformance. Patients witness and can reflectupon many elements of healthcare quality andare often the only constant presence acrossdifferent treatments and various providers; theyare best placed to observe the extent to which careis integrated.2. Patient experiences are linked to importantintermediate outcomes such as adherence totreatment regimens and compliance with postdischarge advice. These in turn influence healthoutcomes and the ability to carry out the activitiesof daily living.10For Aboriginal patients, measuring experiences canhelp assess cultural sensitivity in healthcare delivery.Recognising and responding to culture has beenassociated with more effective communicationbetween patient and provider 11, adherence totreatment12, enhanced patient engagement in care,increased patient satisfaction and better patientoutcomes.6,11,13 Aboriginal people are hospitalised at arate of approximately 1.5 times that ofnon-Aboriginal people In 2012, approximately 40% of Aboriginalpeople visited an emergency departmentin the previous year, compared with 21%of non-Aboriginal people (for people aged16 years).healthstats.nsw.gov.auPatient Perspectives – Hospital care for Aboriginal peoplebhi.nsw.gov.au12
About this reportThis edition of Patient Perspectives draws on theexperiences of 2,682 Aboriginal people who wereadmitted to a NSW public hospital during 2014. Among Aboriginal patients only, variation insurvey responses across local health districts(LHDs) (most positive response).Report structureSection 2 provides a synthesis of results at a localhealth district (LHD) level.This report is based on responses to 55 surveyquestions, analysed in a range of ways.Section 1 is based on 14 thematic areas that coveroverall experience, aspects of care and patientreported health outcomes (Table 1 and Appendix 1).For each of these themes, the report presents: Results for NSW with responses from Aboriginalpatients compared with those from nonAboriginal patients Results by rurality of the hospital for Aboriginalpatients compared to non-Aboriginal patients(most positive response) (see Appendix 4)Table 1Unless otherwise specified, differences betweengroups are discussed only when a statisticallysignificant difference was detected. The numberof Aboriginal people living in LHDs varies (Table 2).For LHDs with relatively low numbers of Aboriginalresidents and patients – and as a consequence, lownumbers of survey respondents – the power todetect statistically significant differences is reduced(see Data and Methods section).Profile of respondentsOf respondents, 9% identified as Aboriginal in thesurvey. The sociodemographic profile and care needsThemes in this reportAspects of careSummary of question inclusionsOverall experience of careOverall ratings and how patients would describe their hospital stay to friends and family.Access and timelinessHow long patients wait for various stages of care and whether they consider these times tobe acceptable.Assistance and responsivenessHow staff respond to patients’ emotional and physical needs and provide assistance when needed.Comprehensive andwhole-person careWhether healthcare professionals consider all needs of a person, including their specificcircumstances and needs beyond the medical treatment of their condition.Coordination and continuityHow well organised care is between the various professionals and if care flows without disruption.Engagement and participationWhether the patient and where appropriate, their family/carer, are involved in decisions abouttheir treatment and care.Provision of informationWhether patients receive important information and if enough information was provided tothem, their families or carers.Physical environment and comfortCleanliness of wards and bathrooms.Respectfulness:Culture, dignity and privacyWhether patients’ values and beliefs are honoured and patient privacy is protected.Respectfulness:Politeness and courtesyWhether staff are courteous and polite.Responsive communicationWhether staff communicate in a clear and understandable way.Safety and hygieneHow well staff comply with clinical safety practices and hygiene guidelines.Trust and confidenceHow much trust and confidence patients have in the healthcare staff treating them.Patient-reported outcomesWhether the treatment received in hospital helped patients or made a difference to the healthproblem for which they were hospitalised.13Patient Perspectives – Hospital care for Aboriginal peoplebhi.nsw.gov.au
of Aboriginal respondents differed from nonAboriginal respondents. For example, Aboriginalpatients were younger (12% of Aborginal patientsaged 75 years; non-Aboriginal patients 27%); andfewer had completed university education (9% and17%). Aboriginal patients were more likely thannon-Aboriginal patients to: live in areas of greatestsocioeconomic disadvantage (Aboriginal patients 28%and non-Aboriginal patients 21%); describe theirhealth as poor (9% and 5%); and report having along-standing condition (65% and 48%) (Table 3).In terms of care needs, Aboriginal patients were morelikely than non-Aboriginal patients to say they haverelevant religious or cultural beliefs (Aboriginal patients62% and non-Aboriginal patients 42%); experiencedpain during their stay (59% and 54%); had familymembers who wanted to talk to a doctor (77% andTable 272%); needed their family and h
Aboriginal women and reducing rates of potentially preventable hospitalisations among Aboriginal people. More broadly, it emphasises the impact that system-wide quality improvement efforts can have on Aboriginal people's health. Patient Perspectives: Hospital care for Aboriginal people does not consider the question of whether the gap is closing.
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This Aboriginal Health Plan 2018–2022 builds on the successes of the former Sydney South West Area Health Service Aboriginal Health Plan 2010–2014, and aligns with the National Aboriginal and Torres Strait Islander Health Plan 2013–2023, NSW Aboriginal Health Plan 2013–2023, and the Sydney Local Health District Strategic Plan.
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