Lung health care for Aboriginal and Torres Strait Islander Queenslanders: breathing easy is not so easyKerry-Ann F. O’Grady A J , Amber Revell B , Graeme P. Maguire C D , Renate Millonig E , Michael A. Newman F , David W. Reid G , Deborah C. Hill H and Anne B. Chang A B I
A Queensland Children’s Medical Research Institute, Level 4, Foundation Building, Royal Children’s Hospital, Herston Road, Herston, QLD 4029, Australia.
C School of Medicine and Dentistry, Faculty of Medicine, Health and Molecular Sciences, James Cook University, Cairns Base Hospital, PO Box 902, Cairns, QLD 4870, Australia. Email: firstname.lastname@example.org
D Australian Lung Foundation, PO Box 847, Lutwyche, QLD 4030, Australia.
E Sunshine Coast Division of General Practice, PO Box 389, Cotton Tree, QLD 4558, Australia. Email: email@example.com
F Mt Isa Hospital, 30 Camooweal Street, Mt Isa, QLD 4825, Australia. Email: firstname.lastname@example.org
G Department of Thoracic Medicine, The Prince Charles Hospital, 672 Gympie Road, Chermside, QLD 4032, Australia. Email: email@example.com
H Patient Safety & Quality Improvement Service, Centre for Healthcare Improvement, Queensland Health, Royal Brisbane & Women’s Hospital, Herston Road, Herston, QLD 4029, Australia. Email: firstname.lastname@example.org
I Department of Respiratory Medicine, Royal Children’s Hospital, Herston Road, Herston QLD 4029, Australia.
J Corresponding author. Email: email@example.com
Australian Health Review 35(4) 512-519 http://dx.doi.org/10.1071/AH10973
Submitted: 20 October 2010 Accepted: 31 January 2011 Published: 30 September 2011
Objectives. In Aboriginal and Torres Strait Islander peoples in Queensland, to (a) determine the disease burden of common chronic lung diseases and (b) identify areas of need with respect to lung health services.
Methods. Literature reviews and analyses of hospitalisation and mortality data were used to describe disease epidemiology and available programs and services. Key stakeholder interviews and an online survey of health professionals were used to evaluate lung health services across the state and to identify services, needs and gaps.
Results. Morbidity and mortality from respiratory diseases in the Indigenous population is substantially higher than the non-Indigenous population across all age groups and regions. There are inadequate clinical services and resources to address disease prevention, detection, intervention and management in an evidence-based and culturally acceptable fashion. There is a lack of culturally appropriate educational resources and management programs, insufficient access to appropriately engaged Indigenous health professionals, a lack of multi-disciplinary specialist outreach teams, fragmented information systems and inadequate coordination of care.
Conclusions. Major initiatives are required at all levels of the healthcare system to adequately address service provision for Indigenous Queenslanders with lung diseases, including high quality research to investigate the causes for poor lung health, which are likely to be multifactorial.
What is known about the topic? Chronic diseases, including lung disease contribute to, and influence outcomes of, the well-known health and socioeconomic disadvantage among Aboriginal and Torres Strait Islander Australians. Nationwide, the most common reason for hospitalisation of Indigenous Australians is for lung diseases (after renal dialysis).
What does this paper add? There is currently no state- or nation-wide comprehensive review of chronic lung disease burden and the health services available to prevent, treat and manage lung disease. This review fills this gap in Queensland and has found that chronic lung disease burden is not homogenous. There are substantial gaps in, and barriers to, the provision of high quality, evidence based services and a paucity of well-designed research to inform policy and health service delivery.
What are the implications for practitioners? Evidence-based strategies are needed at the primary, secondary and tertiary levels of the healthcare system. Fourteen recommendations relevant to practitioners and policy makers were formulated.
Additional keywords: health policy, Indigenous, needs assessment.
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