Exploring equity of care for Aboriginal and Torres Strait Islander peoples within the state-wide Musculoskeletal Physiotherapy Screening Clinic and Multi-disciplinary Service in Queensland Health

Alistair McDougall; Maree Raymer; Peter Window; Michelle Cottrell; Curtley Nelson; Carl Francia; Eliza Watson; Shaun O’Leary

doi:10.1071/AH24063

RESEARCH ARTICLE (Open Access)

Exploring equity of care for Aboriginal and Torres Strait Islander peoples within the state-wide Musculoskeletal Physiotherapy Screening Clinic and Multi-disciplinary Service in Queensland Health

Alistair McDougall ^A ^B , Maree Raymer ^B , Peter Window ^B ^C , Michelle Cottrell ^B ^C , Curtley Nelson ^A ^D , Carl Francia ^A ^D ^E , Eliza Watson ^A ^B and Shaun O’Leary ^A ^B ^*

+ Author Affiliations

- Author Affiliations

^A School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia.

^B Physiotherapy Department, Royal Brisbane and Women’s Hospital, Brisbane, Qld, Australia.

^C STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service, Metro North Health and University of Queensland, Brisbane, Qld, Australia.

^D The Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Qld, Australia.

^E Physiotherapy Department, The Prince Charles Hospital, Brisbane, Qld, Australia.

^* Correspondence to: s.oleary@uq.edu.au

Australian Health Review https://doi.org/10.1071/AH24063

Submitted: 27 February 2024 Accepted: 4 June 2024 Published: 24 June 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Objective

This study aimed to explore equity of care for Aboriginal and Torres Strait Islander peoples compared to non-Indigenous Australians within a Queensland-wide musculoskeletal service.

Method

The service database was analysed between July 2018 and April 2022 across 18 Queensland Health facilities. Representation of Aboriginal and Torres Strait Islander peoples within the service’s patient population was first explored. Second, service and patient-related characteristics and outcomes between Aboriginal and Torres Strait Islander patients and non-Indigenous patients undergoing an episode of care in the service were compared using analysis of variance and chi-squared tests.

Results

A greater proportion of Aboriginal and Torres Strait Islander peoples (4.34%) were represented within the service’s patient population than in the general population (3.61%) state-wide. Aboriginal and Torres Strait Islander patients presented with a generally higher severity of clinical presentation across measures at initial consult. Very similar proportions of Aboriginal and Torres Strait Islander (63.2%) and non-Indigenous (64.3%) patients reported clinically meaningful treatment benefits. While a higher proportion of Aboriginal and Torres Strait Islander patients (69.7%) were discharged from the service without requiring specialist review compared to non-Indigenous patients (65.6%), Aboriginal and Torres Strait Islander patients had higher rates of discharge due to non-attendance (20.8%) when compared to non-Indigenous (10.6%) patients (P < 0.01).

Conclusions

Disparity in care retention for Aboriginal and Torres Strait Islander patients compared to non-Indigenous patients was observed within the musculoskeletal service. Consultation with Aboriginal and Torres Strait Islander communities is needed to address access barriers once in the service to guide service improvement.

Keywords: Aboriginal and Torres Strait Islander peoples, advanced practice, equity, musculoskeletal, neurosurgery, orthopaedics, outcomes, outpatients.

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