Unpacking High Self-Discharge Rates for Aboriginal Cardiac Patients

Katharine McBride, Janet Kelly, Anna Dowling, Wendy Keech, Alex Brown

Research output: Contribution to conferenceAbstract


Introduction: Aboriginal patients are over-represented in acute cardiac events. However, a significant number self discharge, jeopardising care and outcomes.
Method: Multivariate logistic regression analysis of South Australian (SA) hospital data to investigate self-discharge rates of CVD (ICD-10: I00-I99) in-patients, July 2010-June 2015. Interviews and focus groups with Aboriginal cardiac
patients, families, and staff at a metropolitan and rural hospital in SA.
Results: Aboriginal patients with a principal diagnosis of CVD are significantly more likely to self-discharge compared to non-Aboriginal patients (OR: 4.1, 95% CI: 3.3-5.1)(Fig 1). Potential reasons for self-discharge include: competing family and community obligations; a lack of communication on the importance of staying in hospital; grief, loss and fear; loneliness and dislocation from family and community, and; perceptions of inadequate or racist treatment. Active involvement of family, community and Aboriginal staff were key in reversing patient self-discharge.
Discussion: Given high rates of self-discharge amongst Aboriginal CVD patients in SA, there is significant work required to better support these patients to remain in hospital during treatment and recovery. Responsive strategies that enable culturally-competent care, two-way communication and involvement of family and community in care and decision making need to be implemented.
Original languageEnglish
Publication statusPublished - Aug 2017
Event65th Cardiac Society of Australia and New Zealand Annual Scientific Meeting - Perth, Australia
Duration: 10 Aug 201713 Aug 2017


Conference65th Cardiac Society of Australia and New Zealand Annual Scientific Meeting

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