Burn injuries affect 11 million people globally, with the majority occurring in low and middle income countries. In Australia, these inequities are similarly reflected in the disproportionate incidence of burns amongst Aboriginal and Torres Strait Islander people. Despite this, there have been no studies that quantify the scale of this concern amongst adults at a national scale. Therefore, this study was the first to investigate inequities in acute burn outcomes nationally for Aboriginal and Torres Strait Islander adults.
Methods
This was a retrospective cohort study of all adults admitted to an Australian Burn Unit between 2010 and 2020. Data was extracted from the Burns Registry of Australia and New Zealand.
Results
A total of 13,513 patients were included in this study, of which 6.8% (n=780) identified as Aboriginal or Torres Strait Islander. Despite no differences in age or burn severity, First Nations people experienced an 83% higher in-hospital mortality and a significantly longer length of stay (6.9 days vs. 4.9 days). Lower rates of basic first aid treatment (30%) were reported for First Nations patients, along with significant delays to treatment (59 hours vs 22 hours). Burns occurring in very remote regions were greater for First Nations patients (67% vs 2.1%). Additionally, intentional injury reporting was 10 times higher amongst First Nations communities.
Conclusion
This study identified significant inequities in acute burn outcomes impacting Aboriginal and Torres Strait Islander communities. Improving access to burn care in regional areas, co-design of community specific burns education along with delivery of culturally responsive healthcare are critical steps towards closing the gap in health outcomes for First Nations communities. Further research is needed to identify complex factors contributing to these disparities, assess the long-term quality of life and functional outcomes of First Nations burn patients and evaluate the effectiveness of equitable treatment initiatives.