Judith M Katzenellenbogen1, Laura J Miller2, Peter Somerford2, Suzanne McEvoy3, Dawn Bessarab1. 1. Aboriginal Health Education and Research Unit, Curtin University, GPO Box U1987, Perth 6000, WA, Australia. 2. Epidemiology Branch, Public Health and Clinical Services Division, WA Department of Health, 189 Royal Street, East Perth, WA 6004, Australia. Email:. 3. South Metropolitan Population Health Unit, South Metropolitan Health Service, WA Department of Health, 7 Pakenham Street, Fremantle, WA 6160, Australia. Email.
Abstract
OBJECTIVES: The aim of the present study was to provide descriptive planning data for a hospital-based Aboriginal Health Liaison Officer (AHLO) program, specifically quantifying episodes of care and outcomes within 28 days after discharge. METHODS: A follow-up study of Aboriginal in-patient hospital episodes was undertaken using person-based linked administrative data from four South Metropolitan hospitals in Perth, Western Australia (2006-11). Outcomes included 28-day deaths, emergency department (ED) presentations and in-patient re-admissions. RESULTS: There were 8041 eligible index admissions among 5113 individuals, with episode volumes increasing by 31% over the study period. Among patients 25 years and older, the highest ranking comorbidities included injury (47%), drug and alcohol disorders (41%), heart disease (40%), infection (40%), mental illness (31%) and diabetes (31%). Most events (96%) ended in a regular discharge. Within 28 days, 24% of events resulted in ED presentations and 20% resulted in hospital readmissions. Emergency readmissions (13%) were twice as likely as booked re-admissions (7%). Stratified analyses showed poorer outcomes for older people, and for emergency and tertiary hospital admissions. CONCLUSIONS: Future planning must address the greater service volumes anticipated. The high prevalence of comorbidities requires intensive case management to address case complexity. These data will inform the refinement of the AHLO program to improve in-patient experiences and outcomes.
OBJECTIVES: The aim of the present study was to provide descriptive planning data for a hospital-based Aboriginal Health Liaison Officer (AHLO) program, specifically quantifying episodes of care and outcomes within 28 days after discharge. METHODS: A follow-up study of Aboriginal in-patient hospital episodes was undertaken using person-based linked administrative data from four South Metropolitan hospitals in Perth, Western Australia (2006-11). Outcomes included 28-day deaths, emergency department (ED) presentations and in-patient re-admissions. RESULTS: There were 8041 eligible index admissions among 5113 individuals, with episode volumes increasing by 31% over the study period. Among patients 25 years and older, the highest ranking comorbidities included injury (47%), drug and alcohol disorders (41%), heart disease (40%), infection (40%), mental illness (31%) and diabetes (31%). Most events (96%) ended in a regular discharge. Within 28 days, 24% of events resulted in ED presentations and 20% resulted in hospital readmissions. Emergency readmissions (13%) were twice as likely as booked re-admissions (7%). Stratified analyses showed poorer outcomes for older people, and for emergency and tertiary hospital admissions. CONCLUSIONS: Future planning must address the greater service volumes anticipated. The high prevalence of comorbidities requires intensive case management to address case complexity. These data will inform the refinement of the AHLO program to improve in-patient experiences and outcomes.
Authors: Amanda Jayakody; Christopher Oldmeadow; Mariko Carey; Jamie Bryant; Tiffany Evans; Stephen Ella; John Attia; Rob Sanson-Fisher Journal: BMC Health Serv Res Date: 2018-11-26 Impact factor: 2.655