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Otitis media in Aboriginal children: The discordance between burden of illness and access to services in rural/remote and urban Australia
Author(s) -
Gunasekera Hasantha,
Morris Peter S,
Daniels John,
Couzos Sophie,
Craig Jonathan C
Publication year - 2009
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/j.1440-1754.2009.01532.x
Subject(s) - medicine , otitis , rural area , environmental health , intensive care medicine , medical emergency , pathology , surgery
Objective: To compare the burden of otitis media (OM) managed by Aboriginal Medical Service (AMS) practitioners and the availability of specialist ear health services in rural/remote versus urban Australian settings. Design, Setting and Participants: We mailed questionnaires to all Australian AMS medical practitioners managing children in December 2006. Questions addressed the frequency of childhood OM cases seen, and the availability and waiting times for audiology; ear, nose and throat (ENT); and hearing‐aid services. We compared rural/remote and urban practitioner's responses using the χ 2 test with clustering adjustments. Results: Questionnaires were returned by 63/87 (72%) AMSs and by 131/238 (55%) eligible practitioners. Rural/Remote practitioners reported managing a greater number of children with OM per week than urban practitioners (1 df, P = 0.02) and a larger proportion of the children they managed having OM (1 df, P = 0.009). More rural/remote than urban practitioners reported relevant services were not available locally: audiology (11.1 vs. 0%, P = 0.038), ENT (33.3 vs. 3.9%, P = 0.0004) and hearing‐aid provision (37.7 vs. 1.9%, P < 0.0001). More rural/remote practitioners reported audiology waiting times longer than the recommended 3 months (18.3 vs. 1.9%, P = 0.007). Equal proportions reported ENT waiting times longer than the recommended 6 months (13.9 vs. 11.3%, P = 0.7). Conclusions: Rural/Remote AMS practitioners manage a greater OM burden than urban AMS practitioners, but affected children have less access to specialist ear health services and longer waiting times. One in five rural/remote Aboriginal children wait longer than recommended for audiology testing, and one in eight Aboriginal children nationwide wait longer than recommended for ENT services.