Exploring equity of care for Aboriginal and Torres Strait Islander peoples within the state-wide Musculoskeletal Physiotherapy Screening Clinic and Multi-disciplinary Service in Queensland Health.

Alistair McDougall, Maree Raymer, Peter Window, Michelle Cottrell, Curtley Nelson, Carl Francia, Eliza Watson, Shaun O'Leary
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Abstract

ObjectiveThis study aimed to explore equity of care for Aboriginal and Torres Strait Islander peoples compared to non-Indigenous Australians within a Queensland-wide musculoskeletal service.MethodThe service database was analysed between July 2018 and April 2022 across 18 Queensland Health facilities. Representation of Aboriginal and Torres Strait Islander peoples within the service's patient population was first explored. Second, service and patient-related characteristics and outcomes between Aboriginal and Torres Strait Islander patients and non-Indigenous patients undergoing an episode of care in the service were compared using analysis of variance and chi-squared tests.ResultsA greater proportion of Aboriginal and Torres Strait Islander peoples (4.34%) were represented within the service's patient population than in the general population (3.61%) state-wide. Aboriginal and Torres Strait Islander patients presented with a generally higher severity of clinical presentation across measures at initial consult. Very similar proportions of Aboriginal and Torres Strait Islander (63.2%) and non-Indigenous (64.3%) patients reported clinically meaningful treatment benefits. While a higher proportion of Aboriginal and Torres Strait Islander patients (69.7%) were discharged from the service without requiring specialist review compared to non-Indigenous patients (65.6%), Aboriginal and Torres Strait Islander patients had higher rates of discharge due to non-attendance (20.8%) when compared to non-Indigenous (10.6%) patients (P<0.01).ConclusionsDisparity in care retention for Aboriginal and Torres Strait Islander patients compared to non-Indigenous patients was observed within the musculoskeletal service. Consultation with Aboriginal and Torres Strait Islander communities is needed to address access barriers once in the service to guide service improvement.

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探索在昆士兰卫生部全州范围内的肌肉骨骼物理治疗筛查诊所和多学科服务中对土著居民和托雷斯海峡岛民的公平护理。
本研究旨在探讨在昆士兰州范围内的一项肌肉骨骼服务中,与非土著澳大利亚人相比,土著居民和托雷斯海峡岛民的护理是否公平。首先探讨了服务机构的患者人群中土著居民和托雷斯海峡岛民的代表性。其次,使用方差分析和卡方检验比较了土著居民和托雷斯海峡岛民患者与在该服务机构接受护理的非土著居民患者之间的服务和患者相关特征及结果。结果在该服务机构的患者人口中,土著居民和托雷斯海峡岛民的比例(4.34%)高于全州总人口(3.61%)。在初次就诊时,土著居民和托雷斯海峡岛民患者的临床表现严重程度普遍较高。原住民和托雷斯海峡岛民患者(63.2%)与非原住民患者(64.3%)报告的有临床意义的治疗获益比例非常接近。与非土著患者(65.6%)相比,土著居民和托雷斯海峡岛民患者(69.7%)无需专家复查即可出院,但与非土著患者(10.6%)相比,土著居民和托雷斯海峡岛民患者因未就诊而出院的比例更高(20.8%)(P<0.05)。
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