Australian health review : a publication of the Australian Hospital Association
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This study explores the association between selected socioeconomic characteristics of emergency patients with waiting times in emergency departments and walk-outs (those who did not wait for treatment) in South Western Sydney Area Health Service hospital emergency departments. Bivariate and multivariate analyses indicated that waiting times to see a doctor and walk-out rates varied by age, sex, country of birth, insurance status, socioeconomic status, severity of patient illness and day of arrival. Patients who were female, from a non-English-speaking background, self-referred, uninsured and those from lower socioeconomic status showed significantly longer waiting times than others. ⋯ This applied across socioeconomic categories. These findings indicate that prolonged waiting times for triage, which occur at the busiest periods, may be one of the main indicators for patients leaving emergency departments without treatment. The study also demonstrates variability in waiting times, which could possibly be partly addressed by more standardised triage policies, but may be influenced by other non-clinical factors, which require further investigation.
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While many studies investigated the higher morbidity and mortality levels of indigenous Australians in the high-density indigenous areas in the Northern Territory, Western Australia and South Australia, few examined the situation in New South Wales, where more than 28% of the indigenous population lives. Admissions to acute public and private hospitals in New South Wales for 1989-1995 are used in the study reported here to examine indigenous health and its differential patterns by disease categories. ⋯ Age-standardised estimates for the indigenous population are provided. Age composition of admissions for each disease category and admissions by residential area are also estimated.
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The optimal way of delivering specialist services to rural and remote Australia, and particularly to remote Aboriginal and Torres Strait Islander communities, is a matter of keen debate at present, and is being considered by the Australian Medical Workforce Advisory Committee. This paper contributes to that debate by considering one specialist medical group, namely adult physicians, and discusses both their role and optimal number in the Top End of the Northern Territory, in light of the general workforce literature and recent changes to the organisation of physician services in the Northern Territory. Models of specialist service delivery need to be explicit, and organisational methods transparent, if the service is to be equitable, flexible and accountable to primary care practitioners.