Characteristics of First Nations patients who take their own leave from an inner‐city emergency department, 2016–2020
OBJECTIVE: Using a strength‐based framework, we aimed to describe and compare First Nations patients who completed care in an ED to those who took their own leave. METHODS: Routinely collected adult patient data from a metropolitan ED collected over a 5‐year period were analysed. RESULTS: A total of...
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ftpubmed:oai:pubmedcentral.nih.gov:10087393 2023-06-06T11:53:39+02:00 Characteristics of First Nations patients who take their own leave from an inner‐city emergency department, 2016–2020 Hutton, Jennie Gunatillake, Tilini Barnes, Deborah Phillips, Georgina Maplesden, Jacqueline Chan, Andrew Shanahan, Prudence Zordan, Rachel Sundararajan, Vijaya Arabena, Kerry Quigley, Alyssa Pynor‐Greedy, T'ia Mason, Toni 2022-08-30 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10087393/ http://www.ncbi.nlm.nih.gov/pubmed/36041727 https://doi.org/10.1111/1742-6723.14057 en eng Wiley Publishing Asia Pty Ltd http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10087393/ http://www.ncbi.nlm.nih.gov/pubmed/36041727 http://dx.doi.org/10.1111/1742-6723.14057 © 2022 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Emerg Med Australas Original Research Text 2022 ftpubmed https://doi.org/10.1111/1742-6723.14057 2023-04-16T00:56:37Z OBJECTIVE: Using a strength‐based framework, we aimed to describe and compare First Nations patients who completed care in an ED to those who took their own leave. METHODS: Routinely collected adult patient data from a metropolitan ED collected over a 5‐year period were analysed. RESULTS: A total of 6446 presentations of First Nations patients occurred from 2016 to 2020, constituting 3% of ED presentations. Of these, 5589 (87%) patients waited to be seen and 857 (13%) took their own leave. Among patients who took their own leave, 624 (73%) left not seen and 233 (27%) left at own risk after starting treatment. Patients who were assigned a triage category of 4–5 were significantly more likely to take their own leave (adjusted odds ratio [OR] 3.17, 95% confidence interval [CI] 2.67–3.77, P < 0.001). Patients were significantly less likely to take their own leave if they were >60 years (adjusted OR 0.69, 95% CI 1.01–1.36, P = 0.014) and had private health insurance (adjusted OR 0.61, 95% CI 0.45–0.84, P < 0.001). Patients were more likely to leave if they were women (adjusted OR 1.17, 95% CI 1.01–1.36, P = 0.04), had an unknown housing status (adjusted OR 1.76, 95% CI 1.44–2.15, P < 0.001), were homeless (adjusted OR 1.50, 95% CI 1.22–1.93, P < 0.001) or had a safety alert (adjusted OR 1.60, 95% CI 1.35–1.90, P < 0.001). CONCLUSION: A lower triage category is a strong predictor of First Nations patients taking their own leave. It has been documented that First Nations patients are under‐triaged. One proposed intervention in the metropolitan setting is to introduce practices which expediate the care of First Nations patients. Further qualitative studies with First Nations patients should be undertaken to determine successful approaches to create equitable access to emergency healthcare for this population. Text First Nations PubMed Central (PMC) Emergency Medicine Australasia 35 1 74 81 |
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Original Research |
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Original Research Hutton, Jennie Gunatillake, Tilini Barnes, Deborah Phillips, Georgina Maplesden, Jacqueline Chan, Andrew Shanahan, Prudence Zordan, Rachel Sundararajan, Vijaya Arabena, Kerry Quigley, Alyssa Pynor‐Greedy, T'ia Mason, Toni Characteristics of First Nations patients who take their own leave from an inner‐city emergency department, 2016–2020 |
topic_facet |
Original Research |
description |
OBJECTIVE: Using a strength‐based framework, we aimed to describe and compare First Nations patients who completed care in an ED to those who took their own leave. METHODS: Routinely collected adult patient data from a metropolitan ED collected over a 5‐year period were analysed. RESULTS: A total of 6446 presentations of First Nations patients occurred from 2016 to 2020, constituting 3% of ED presentations. Of these, 5589 (87%) patients waited to be seen and 857 (13%) took their own leave. Among patients who took their own leave, 624 (73%) left not seen and 233 (27%) left at own risk after starting treatment. Patients who were assigned a triage category of 4–5 were significantly more likely to take their own leave (adjusted odds ratio [OR] 3.17, 95% confidence interval [CI] 2.67–3.77, P < 0.001). Patients were significantly less likely to take their own leave if they were >60 years (adjusted OR 0.69, 95% CI 1.01–1.36, P = 0.014) and had private health insurance (adjusted OR 0.61, 95% CI 0.45–0.84, P < 0.001). Patients were more likely to leave if they were women (adjusted OR 1.17, 95% CI 1.01–1.36, P = 0.04), had an unknown housing status (adjusted OR 1.76, 95% CI 1.44–2.15, P < 0.001), were homeless (adjusted OR 1.50, 95% CI 1.22–1.93, P < 0.001) or had a safety alert (adjusted OR 1.60, 95% CI 1.35–1.90, P < 0.001). CONCLUSION: A lower triage category is a strong predictor of First Nations patients taking their own leave. It has been documented that First Nations patients are under‐triaged. One proposed intervention in the metropolitan setting is to introduce practices which expediate the care of First Nations patients. Further qualitative studies with First Nations patients should be undertaken to determine successful approaches to create equitable access to emergency healthcare for this population. |
format |
Text |
author |
Hutton, Jennie Gunatillake, Tilini Barnes, Deborah Phillips, Georgina Maplesden, Jacqueline Chan, Andrew Shanahan, Prudence Zordan, Rachel Sundararajan, Vijaya Arabena, Kerry Quigley, Alyssa Pynor‐Greedy, T'ia Mason, Toni |
author_facet |
Hutton, Jennie Gunatillake, Tilini Barnes, Deborah Phillips, Georgina Maplesden, Jacqueline Chan, Andrew Shanahan, Prudence Zordan, Rachel Sundararajan, Vijaya Arabena, Kerry Quigley, Alyssa Pynor‐Greedy, T'ia Mason, Toni |
author_sort |
Hutton, Jennie |
title |
Characteristics of First Nations patients who take their own leave from an inner‐city emergency department, 2016–2020 |
title_short |
Characteristics of First Nations patients who take their own leave from an inner‐city emergency department, 2016–2020 |
title_full |
Characteristics of First Nations patients who take their own leave from an inner‐city emergency department, 2016–2020 |
title_fullStr |
Characteristics of First Nations patients who take their own leave from an inner‐city emergency department, 2016–2020 |
title_full_unstemmed |
Characteristics of First Nations patients who take their own leave from an inner‐city emergency department, 2016–2020 |
title_sort |
characteristics of first nations patients who take their own leave from an inner‐city emergency department, 2016–2020 |
publisher |
Wiley Publishing Asia Pty Ltd |
publishDate |
2022 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10087393/ http://www.ncbi.nlm.nih.gov/pubmed/36041727 https://doi.org/10.1111/1742-6723.14057 |
genre |
First Nations |
genre_facet |
First Nations |
op_source |
Emerg Med Australas |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10087393/ http://www.ncbi.nlm.nih.gov/pubmed/36041727 http://dx.doi.org/10.1111/1742-6723.14057 |
op_rights |
© 2022 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
op_doi |
https://doi.org/10.1111/1742-6723.14057 |
container_title |
Emergency Medicine Australasia |
container_volume |
35 |
container_issue |
1 |
container_start_page |
74 |
op_container_end_page |
81 |
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1767959872876314624 |