• David Whyatt, Matthew Yap, Raji Tenneti, Glenn Pearson, and Alistair Vickery.
• School of Primary, Aboriginal and Rural Health Care, The University of Western Australia, Perth, Western Australia, Australia.
• Emerg Med Australas. 2017 Oct 1; 29 (5): 516-523.

ObjectiveThe objective of this study was to compare rates of hospital utilisation in Aboriginal and non-Aboriginal peoples before and after hospital admission for chronic obstructive pulmonary disease, heart failure and/or type 2 diabetes mellitus.MethodsThis was a longitudinal cohort study from 2002 to 2014, which was conducted in all hospitals in Western Australia. The participants of this study were Aboriginal and non-Aboriginal patients with a principal diagnosis of heart failure, type 2 diabetes or chronic obstructive pulmonary disease, on admission to hospital, where such an event had not occurred in the previous 3 years. Inpatient days and ED presentations were the main outcome measures.ResultsAmong the patients with chronic disease, Aboriginal people have similar inpatient days for all causes compared to non-Aboriginal people. However, they have much higher ED presentations in comparison. Age of onset of cardinal events occurs 15-20 years earlier in Aboriginal patients with chronic disease. Although age has little influence on ED presentations in non-Aboriginal chronic disease patients, younger Aboriginal people with chronic disease present far more often to ED than older Aboriginal people.ConclusionsAboriginal people use health services in a different manner when compared to non-Aboriginal people. In a subset of patients with chronic disease, high use may be reduced with better access to primary healthcare. Policy-makers and healthcare providers should examine healthcare use from primary to tertiary care among the Aboriginal population, with a particular focus on ED presentations; investigate the underlying causes driving specific patterns of health service utilisation among Aboriginal people; and develop interventions to reduce potential deleterious impacts, and enhance the potential benefits, of specific patterns of healthcare use.© 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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