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Effectiveness of the Koorliny Moort out-of-hospital health care program for Aboriginal and Torres Strait Islander children in Western Australia

Rebecca Cresp, Karen Clarke, Kimberley E McAuley, Daniel McAullay, Carolyn A Moylan, Sue Peter, Gervase Ml Chaney, Angus Cook and Karen M Edmond
Med J Aust 2016; 204 (5): 197. || doi: 10.5694/mja15.00827

Summary

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 0–16 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, 0.43–0.53; P < 0.001), of hospitalisation (IRR, 0.70; 95% CI, 0.62–0.79; P < 0.001), and of non-attended appointments (IRR, 0.83; 95% CI, 0.74–0.94; P < 0.001), as well as in the mean length of hospital stay (IRR, 0.23; 95% CI, 0.21–0.25; 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.

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  • Rebecca Cresp1
  • Karen Clarke1
  • Kimberley E McAuley2
  • Daniel McAullay2
  • Carolyn A Moylan1,2
  • Sue Peter1
  • Gervase Ml Chaney1
  • Angus Cook2
  • Karen M Edmond2

  • 1 Princess Margaret Hospital for Children, Perth, WA
  • 2 University of Western Australia, Perth, WA


Acknowledgements: 

We acknowledge the contributions to this project of Leah Bonson, Ilana Stack, Barbara Ahmat, Alan Kuipers Chan, Georgia Werner, Natalie Strobel and Julie Bradley.

Competing interests:

No relevant disclosures.

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