“They just don’t like to wait”—A comparative study of Aboriginal and non-Aboriginal people who did not wait for treatment or discharged against medical advice from rural emergency departments: Part 1☆

Summary 

Aboriginal people are consistently over reported in data looking at those who either did not wait or discharged themselves against medical advice from emergency departments. This study adds to current knowledge by providing a rural perspective on this problem.

Methods

This comparative descriptive study examines demographic patterns of people who utilise emergency departments in the North Coast Area Health Service of New South Wales in a 12-month period.

Results

Aboriginal people were 1.5 times more likely to leave emergency departments prior to being seen by the medical officer, and 2.5 times more likely to discharge against medical advice than non-Aboriginal people. Descriptive analysis revealed that those Aboriginal people who did not wait were more likely to be younger, female, arrived by ambulance, and present on a Monday, Tuesday, or Sunday in the early evening. A correlation between triage categories and did not wait revealed the majority of Aboriginal people who did not wait had been triaged to a category 4 or 5. Those triaged to category 4 were 4.5 times more likely to leave than those triaged category 5.

Conclusion

This study reveals the urban trend of rates for did not wait and discharged against medical advice for Aboriginal people is replicated in rural/regional areas in NSW supporting indirect evidence of service dissatisfaction for this group.

Keywords: Aboriginal, Emergency Department, Did not wait, Discharge against medical advice, Triage, Culture