A/PROF PAUL PREISZ Director of Emergency Department, St Vincent’s Health Australia and Senior Staff Specialist at St Vincent’s Hospital Sydney
Dalarinji, ‘Ours, Belonging to Us’
A Flexible clinic in the Emergency Department Aboriginal people have long been underserved
the proportion of all patients who presented
by the Australian health care system. Structural
to the ED but did not wait to be seen by a
racism has been shown to be endemic,
healthcare professional — ‘Did Not Wait’ (DNW),
problematically perpetuating neo-colonialism and
and those who left before care was completed —
erroneous stigma. This is a medically vulnerable
‘Discharged Against Medical Advice’ (DAMA).
group of patients with a high proportion having
Typically, the rate of incomplete treatment
complex and chronic conditions, poor overall
would be expected to be 5% or so, however data
health outcomes and socio-economic disparity.
collected in 2019 at St Vincent’s Hospital Sydney
Recent figures show that life expectancy for
showed that for Aboriginal patients this number
Aboriginal men is 71.6 years and for women is 75.6 years, which is 8.6 years and 7.8 years
had climbed to more than 25%. Rigorous research in this field is very limited,
respectively less than their non-Aboriginal
and many prior change models failed to provide
counterparts.
sustained improvement. An extensive process
Aboriginal people have accounted for 6.7%
was undertaken to try to understand the causes
of the 2.8 million Emergency Department (ED)
for high rates of incomplete treatment for
presentations in NSW.
Aboriginal patients. The co-design approach
The rate of ‘Incomplete Treatment’ in
involved consultation with patients and health
Emergency Departments is a measure which
care professionals, and from inception was guided
particularly demonstrates that emergency
and supported by the Aboriginal Health Unit of St
healthcare is not equitably or optimally provided
Vincent’s Hospital Sydney, promoting a culturally
to First Nations Peoples. This measure comprises
safe model. The Health Advocate • FEBRUARY 2022
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