Parsonage, Lucinda

Gourley, Stephen

Ullah, Shahid

Johnson, Richard

2025-02-01

First Nations patients often experience poorer health outcomes than non-First Nations patients. Despite emergency triage primarily focusing on severity, implying comparable outcomes for patients in the same triage group regardless of demographics, the precision of triage for First-Nations Australians may be undermined by multiple factors, although research in this area is scarce.To compare admission rates, service utilisation and mortality for First Nations and non-First Nations patients, based on their triage categories.This retrospective cohort study utilised data for all adults presenting between January 2016 and May 2021, to Alice Springs Hospital; totalling 175 199 presentations from 39 882 individual patients. Data were analysed for differences between First Nations and non-First nations patients for outcomes including 30-day mortality, admission to hospital and admission to ICU.First Nations patients had significantly higher admission than non-First Nations patients across all triage categories (P < 0.001). First Nations patients in categories 3 and 4 had a significantly higher 30-day mortality (P = 0.039, P = 0.045, respectively). First Nations patients in categories 2 and 3 were significantly more likely to be admitted to ICU (P < 0.001).First Nations patients appear to have worse outcomes than non-First Nations patients in the same triage category. Socio-economic factors and high discharge against advice rates from wards may explain the significantly higher admission rate. Under-recognition of serious illness at triage could be attributed to communication issues or a 'well bias'. The results raise many questions and further investigation is required.

Alice Springs Hospital, Alice Spring, Northern Territory, Australia.

Alice Springs Hospital, Alice Spring, Northern Territory, Australia.

University of Queensland, Brisbane, Queensland, Australia.

Flinders University, Adelaide, South Australia, Australia.

Flinders University, Adelaide, South Australia, Australia.

Alice Springs Hospital, Alice Spring, Northern Territory, Australia.

Flinders University, Adelaide, South Australia, Australia.

Charles Darwin University, Darwin, Northern Territory, Australia.

Emerg Med Australas . 2025 Feb;37(1):e14558. doi: 10.1111/1742-6723.14558.

1742-6723

https://pubmed.ncbi.nlm.nih.gov/39868650/?otool=iaurydwlib

https://hdl.handle.net/10137/13941

admission rates

emergency triage

first nations

mortality

Humans

Triage

Male

Retrospective Studies

Female

Middle Aged

Adult

Emergency Service, Hospital

Aged

Australia

Cohort Studies

Patient Admission

Hospitalization

Patient Acceptance of Health Care

Triage gap? Analysis of admission rates, service utilisation and mortality for First Nations patients compared to non-First Nations patients, stratified by ED triage category.

Journal Article

Publication