Effectiveness of the Koorliny Moort out-of-hospital health care program for Aboriginal and Torres Strait Islander children in Western Australia
Australasian Medical Publishing Company Pty. Ltd.
Objectives: To determine whether the Koorliny Moort program could reduce emergency department presentations, hospital admissions and length of stay, and improve attendance at out-of-hospital appointments for Aboriginal and Torres Strait Islander children in Western Australia. Design: Children were enrolled in the program from 1 August 2012. Each child acted as their own control. Evaluation data were collected from 1 August 2010 to 31 July 2014. Occasions of service and person-time in days were compared for each child before and after referral to the program. Setting and participants: Aboriginal children aged 0e16 years residing in three WA regions (Kimberley, Pilbara, Perth metropolitan) who were referred to the Koorliny Moort program. Interventions: Partnerships with primary care providers; nurse-led care coordination; and outreach care by paediatricians, nurses and social workers closer to the home of the child. Main outcome measures: Emergency department presentations; hospital admissions; length of hospital stay; non-attended appointments. Results: A total of 942 children were referred to the program. There were significant decreases after referral to the program in the incidence of emergency department presentations (incident rate ratio [IRR], 0.47; 95% CI, 0.43e0.53; P<0.001), of hospitalisation (IRR, 0.70; 95% CI, 0.62e0.79; P<0.001), and of non-attended appointments (IRR, 0.83; 95% CI, 0.74e0.94; P<0.001), as well as in the mean length of hospital stay (IRR, 0.23; 95% CI, 0.21e0.25; P<0.001). Conclusions: Health-seeking behaviour and health outcomes for Aboriginal children can be improved by engaging Aboriginal families in their health care, providing effective communication between health service providers, and delivering a coordinated program of Aboriginal service provider-led care.