Identifying Indigenous patients a health priority

Identifying Indigenous patients a health priority

Why is it relevant to identify a patient as being Aboriginal  or Torres Strait Islander? Researchers working on a project aimed at doing just  that often encountered this question, and both health professionals and  indigenous communities raised it.

However, strong goodwill for the project was generated once  the link between identifying Indigenous Australians and providing them with  better health care was understood, says one of its lead researchers, Associate  Professor Margaret Kelaher, Deputy Director of CHPPE (Centre for Health Policy,  Programs and Economics) at the Melbourne School of Population and Global Health. “As part  of the Commonwealth Government’s ‘Closing the Gap’ initiative, new measures were introduced to improve Indigenous  people’s access to medical services,” she says. “One of the major barriers to  having people take up some of those services was the problem of identifying who  is Indigenous and therefore eligible for them.”

In simple  terms, the project’s aim was to make it easier for health professionals to ask  patients another question, one that could help improve their lifelong health:  Are you of Aboriginal or Torres Strait Islander descent? This could lead to  preventative health measures, such as immunisations, and/or earlier diagnosis  and treatment for chronic diseases like diabetes, for which Indigenous people  are at higher risk.
 
CHPPE’s involvement was as a member of the Cooperative  Research Centre for Aboriginal Health. The project, Improving the  Identification of Aboriginal and Torres Strait Islander People in Mainstream  General Practice, produced a series of recommendations (see link below) to  apply at practice level, community and regional level, and national level.
 
The project’s report emphasised that for identification  strategies to be effective, they had to be relevant to both health  professionals and Indigenous people, attractive to introduce, achievable and  necessary. Recommendations for the latter included tightening accreditation to  require GPs to do cultural competency training to ensure their practices were  safe places for patients to identify themselves as being Indigenous.
 
Consultations with Indigenous leaders had confirmed that the  option to do so had to be voluntary. “From the outset of the project we explored with  community leaders what they thought best practice was and they rejected some  options, such as putting a permanent marker on your Medicare card,” Associate  Professor Kelaher says. “This  was seen as negative because people don’t get to choose under what  circumstances they get to identify and it could make them potentially  vulnerable to discrimination.”
 
The researchers  identified attitudinal, administrative and organisational barriers to better  identification. An organisational barrier at a health clinic, for example,  might include poor communication between reception staff and health  professionals about a patient’s Indigenous status.
 
The project’s  recommendations have been well received by GPs attending General Practice  Network workshops. “People have been very positive and there have been a whole  lot of new Aboriginal health care workers employed as part of the Government’s  indigenous chronic disease initiative,” Associate Professor Kelaher says. “They say they’ve found the research we did very  useful in guiding their activities.”
 
For a full list  of the recommendations, visit the Indigenous health link at: http://www.anu.edu.au/aphcri/

Caption: Associate Professor Margaret Kelaher