Hospital use for potentially preventable conditions in Aboriginal and Torres Strait Islander and other Australian populations

The poor state of Aboriginal and Torres Strait Islander health has been doc umented in many ways, most obviously by comparing the relatively higher age -specific mortality and morbidity rates.' This paper demonstrates the use o f acute hospital separation data as a way to identify potential deficiencie s in providing appropriate primary health care services for Aboriginal and Torres Strait Islander populations. It does so by using 'ambulatory sensiti ve conditions': those conditions (and procedures) for which high-quality ap propriate primary health services deliverable under ideal circumstances are thought to potentially reduce or eliminate the need for hospitalisation. P otential or realised access to primary care is not analysed directly using primary health service data. In this study, 1993-94 acute hospital separati on data from NSW, Queensland, South Australia, Western Australia and the No rthern Territory were used to calculate separation rates and odds ratios fo r Aboriginal and Torres Strait Islander and non-Aboriginal and Torres Strai t Islander populations. Age-specific acute hospital separation rates for am bulatory sensitive conditions were 1.7 to 11 times higher for the Aborigina l and Torres Strait Islander populations studied. This supports clinical co ntentions that much Aboriginal and Torres Strait Islander morbidity and mor tality is preventable and that further consideration is needed to service d elivery reform at all levels in the health system and the distribution of f unding.