Frequently asked questions

 

What do we know about the hospitalisation of Indigenous people?

For more detailed information about the hospitalisation of Indigenous Australians view the HealthInfoNet hospitalisation webpage

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Please reference this document as:
Australian Indigenous HealthInfoNet (2007) Frequently asked questions: what do we know about the hospitalisation of Indigenous people? Retrieved [access date] http://www.healthinfonet.ecu.edu.au/html/html_keyfacts/faq/faq_hospitalisation/faq_hospitalisation.htm

 

What do we know about the hospitalisation of Indigenous people?

How good is the identification of Indigenous people in hospital separation data? (November 2007)

As with other major health collections, the identification of Indigenous people in hospital records is incomplete [1, 2] . Statistics on hospitalisation provide some insights into ill-health in the population. They are, however, quite a poor reflection of the extent and patterns of treatable illness in the community, since they represent only illness that is serious enough to require hospitalisation.

Even then, the comparability of hospitalisation statistics is limited by many factors, including State/Territory and regional variations in admission policies, and differential geographic accessibility of hospitals. More importantly, the incompleteness of Indigenous identification in most jurisdictions means that most comparisons of Indigenous and non-Indigenous hospitalisation under-estimate the true difference. As a result of this, a degree of caution must be exercised in the interpretation of hospital statistics, including those summarised here.

Relatively recent studies have found that the overall levels of the identification of Indigenous people in the hospital data collections were:

  • 93% for the five NT public hospitals in 1997;
  • 85% for 11 public hospitals in Victoria , Queensland , SA, the ACT and the NT in 1998;
  • 86% in 26 public hospitals in WA in 2000; and
  • 74% in two metropolitan public hospitals in Queensland in 2000 [1].

Based on these studies, and on less formal assessments by the individual jurisdictions of the level of Indigenous identification in their hospital data collections, the data in recent years are considered ‘acceptable' only for Queensland, WA, SA and the NT [2]

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How do hospitalisation rates of Indigenous and non-Indigenous people compare? (November 2007)

Of the 2.86 million hospital separations recorded in Queensland, WA, SA and the NY during 2005-06, 184,232 (6.4%) were identified as Indigenous [2] The age-standardised separation rate of 1,039 separations per 1,000 for the Indigenous population was almost three times that of the non-Indigenous population (352 per 1,000).

Separation rates were higher for Indigenous people than for non-Indigenous people for virtually all age groups, with the highest differences in the middle adult years [2]. There was a higher proportion of separations for Indigenous females (57%) than Indigenous males, and this proportion was higher than the proportion of females overall (53%).

The highest age-standardised separation rate for Indigenous persons was in the Northern Territory (1,548 per 1,000), with a rate 6.5 times that of non-Indigenous people [2].

For patients identified as Indigenous, almost 40% of separations were for overnight stays compared with 45% for all patients [2].

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What are the main causes of hospitalisation for Indigenous people? (November 2007)

In 2005-06 the most common reason of hospitalisation for Indigenous people living in Qld, WA, SA and the NT was 'care involving dialysis' accounting for 46% of Indigenous separations (84,668 separations) [2]. Many of these separations involve repeat admissions for the same people, some on an almost daily basis.

Injury and other consequences of external causes (including motor vehicle accidents, assaults, and falls) was the next most common cause of hospitalisation for Indigenous people, being responsible for 14% of separations (13,819 separations) excluding those for dialysis, followed by pregnancy-related admissions, and respiratory and digestive diseases (Table 1) [2].

Table 1 Hospitalisation: leading causes of Indigenous separations (excluding dialysis): numbers, proportions of separations and Indigenous:non-Indigenous ratios, Queensland, WA, SA and the NT, 2004-05

Principal diagnosis Number of separations Proportion of Indigenous separations (excl dialysis)
 Ratio
Injury/poisoning 13,186 13.9 2.3
Pregnancy related 12,521 12.6 1.5
Respiratory diseases 11,216 11.3 3.3
Digestive diseases 8,608 8.6 0.8
Mental and behavioural disorders 5,674 5.9 1.8
Symptoms, signs not elsewhere classified 6,947 7.0 1.7
Circulatory diseases 5,676 5.7 1.8
Genitourinary diseases 4,305 4.3 1.3
Diseases of the skin & subcutaneous tissue 4,468 4.5 2.8
Infectious/parasitic diseases

3,921 3.9 3.0
Endocrine (incl diabetes) 3,740 3.8 4.1
Other 19,302 18.5 -
All causes, excluding dialysis 99,564 100 1.4

Source: Derived from AIHW, 2007 [2]

Notes:

  1. Excludes hospitalisation for dialysis
  2. Ratios are the standardised separation rates for Indigenous people divided by the standardised separation rates for non-Indigenous people
  3. Due to the incomplete identification of Indigenous status, these figures probably under-estimate the true difference between Indigenous and non-Indigenous rates by 20-25%

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References

1. Australian Institute of Health and Welfare (2005) Improving the quality of Indigenous identification in hospital separations data. (AIHW catalogue no. HSE 101) Canberra: Australian Institute of Health and Welfare
2. Australian Institute of Health and Welfare (2007) Australian hospital statistics 2005-06. (Health services series no. 30. Cat. No. HSE 50.) Canberra: Australian Institute of Health and Welfare

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Last updated: 8 November 2007