Use of health services by remote dwelling Aboriginal infants in tropical northern Australia: a retrospective cohort study

Data on 413 infants were analysed. Following birth, one third of infants were admitted to the regional hospital neonatal nursery, primarily for preterm birth. Once home, most (98%) health service utilisation occurred at the remote primary health centre, infants presented to the centre about once a fortnight (mean 28 presentations per year, 95%CI 26.4-30.0). Half of the presentations were for new problems, most commonly for respiratory, skin and gastrointestinal symptoms. Remaining presentations were for reviews or routine health service provision. By one year of age 59% of infants were admitted to hospital at least once, the rate of hospitalisation per infant year was 1.1 (95%CI 0.9-1.2).The hospitalisation rate is high and admissions commence early in life, visits to the remote primary health centre are frequent. Half of all presentations are for new problems. These findings have important implications for health service planning and delivery to remote dwelling Aboriginal families.Australian Aboriginal people have dramatically worse health outcomes than non-Aboriginal people by every measure, and this is true for children as it is for adults [1]. Although most Aboriginal people reside in cities and regional areas, approximately one quarter live in remote communities [2]. Health outcomes for Aboriginal people in remote communities tend to be worse than those in larger rural or urban centres [3].Aboriginal newborns have higher rates of perinatal mortality, preterm birth and low birth weight than non-Aboriginal newborns [4]. Aboriginal infants also have a higher burden of illness and hospitalisation than non-Aboriginal infants [5]. Despite improvements in perinatal mortality [6] incidence rates of certain infectious diseases continue to be among the highest in the world [7]. In the Northern Territory (NT), where Aboriginal Australians comprise 30% of the population [8], respiratory and diarrhoeal diseases are the leading causes of hospitalisation for Aboriginal infant