Challenges in Aboriginal Patient Care

Apr 1, 2025

Aboriginal Patients Self-Discharge from Hospital

Key Points

  • Aboriginal patients discharge themselves from hospitals at a rate 10 times higher than non-Indigenous patients.
  • 4.9% of Aboriginal patients discharge against medical advice compared to 0.4% of non-Aboriginal patients.
  • 7.5% of Aboriginal patients leave emergency departments without being seen, compared to 2.7% of non-Aboriginal patients.

Causes and Contributing Factors

  • Institutional Racism: Highlighted as a significant issue within the healthcare system.
  • Cultural Barriers: Discomfort due to language barriers and cultural differences.
  • Fear and Isolation: Feelings of fear and isolation among remote area patients.

Challenges Faced by Aboriginal Patients

  • Lack of Support: Changes to the WA Government's Patient Assisted Travel Scheme (PATS) have led to less support for regional patients.
    • Patients traveling for medical appointments often lack family support.
    • Difficulty in adjusting to an unfamiliar mainstream hospital environment.
  • Rehospitalization: Patients often need to be re-hospitalized soon after discharge without proper treatment.
  • Language Barriers: The need for interpreters to assist patients from remote areas.

Recommendations

  • Improve cultural training for healthcare staff to address institutionalized racism.
  • Enhance support systems for Aboriginal patients traveling from remote areas.
  • Implement better patient communication strategies to reduce fear and isolation.

Expert Opinions

  • David Russell-Weisz: Director General of Health in WA; emphasized the impact of cultural capability on patient treatment outcomes.
  • Maureen Carter: CEO of Nindilingarri Cultural Health Service; noted the impact of PATS changes on patient support.
  • Michelle Nelson-Cox: Chair of the Aboriginal Health Council of WA; stressed the importance of interpreters.

Conclusion

  • Aboriginal patients face significant challenges in the healthcare system leading to high rates of self-discharge and potential medical complications. There is a need for systemic changes to improve support and outcomes for Indigenous patients.