Differences in the surgical admissions to hospital between the indigenous and non-indigenous populations of Australia.

BACKGROUND: The overall rate of admission to hospital for indigenous Australians is in general much higher than that for the non-indigenous Australians. However, this result is not uniform for surgical and medical admissions. Previous studies in the Northern Territory have suggested a cultural aversion to surgery among indigenous Australians. In the present study the current data of admission to hospital are analysed to explore the pattern for surgical procedures in the indigenous population and to determine whether the disparity between indigenous and non-indigenous populations still exists at this later period.

METHODS: Admission data for all acute public and private hospitals in New South Wales (NSW) for the 6-year period 1989-1995 are used for this analysis.

RESULTS: It is shown that when adjustments have been made for the differing age composition of the two populations in NSW, the medical admission rate for the indigenous population is approximately double that for the non-indigenous population. In contrast, the non-indigenous admission rate for surgical procedure is approximately 1.3 times the indigenous surgical admission rate. In addition, while approximately one-third of non-indigenous admissions are for surgical procedure, this proportion is only one-sixth of the indigenous admissions. Indigenous people are more likely to be admitted for emergency surgery rather than planned surgery. and while approximately 25% of the surgical admissions in the indigenous population are through emergency, this proportion is only 14% in the non-indigenous population.

CONCLUSIONS: It seems that the disparity between admission patterns for indigenous and non-indigenous populations still exists in NSW at this later period, particularly in rural areas. There appears to be a need to find ways to overcome a possible bias within the indigenous population against surgery. It is possible that medical treatments are being substituted for surgical procedures.