Improved health outcomes for Aboriginal children hospitalised with chest infections

Introduction: Aboriginal children hospitalised with acute lower respiratory infections (ALRIs) are vulnerable to developing bronchiectasis. Post-hospitalisation follow-up at 4-weeks allows for timely detection and management of chronic wet cough that typically represents protracted bacterial bronchitis (PBB). Treatment of PBB could prevent progression to bronchiectasis.

Aim: To improve health outcomes of Aboriginal children through implementing a programme addressing the barriers to medical follow-up post-hospitalisation for ALRIs.

Methods: An Aboriginal participatory action and implementation science study was conducted at the only tertiary paediatric hospital in Western Australia from October 2019-December 2021. We implemented a programme to facilitate medical follow-up, which included 1) staff training, 2) information resources for parents, and 3) improved discharge summary processes. Outcomes were measured over 3 stepped time-periods: nil-intervention, health-information only and post-intervention.

Results: 136 of the 180 recruited participants~completed the study. Significantly more post-intervention participants received culturally secure health information (55 and medical follow-up advice by clinicians (53 compared to pre-intervention participants (19.5 respectively) (plt;0.001). Medical follow-up rates at 4 weeks post-discharge increased (14intervention, 51intervention) (plt;0.001) and the parent-reported cough-related quality of life measure significantly improved (p=0.003).

Conclusion: Respiratory health outcomes of Aboriginal children hospitalised with ALRIs can be improved through implementing a programme to facilitate effective and timely medical follow-up.