Factors Increasing Burns Hospital Length of Stay for Aboriginal and Torres Strait Islander Children

Dr Courtney Ryder1, Associate Professor Tamara  Mackean1, Dr Kate Hunter2, Associate Professor Kris  Rogers3, Professor Andrew J A Holland4, Professor Rebecca Ivers5

1Discipline of Public Health, College of Medicine and Public Health, Flinders University, Adelaide, Australia, 2Aboriginal and Torres Strait Islander Health Research Program,  The George Institute for Global Health, Sydney, Australia, 3Graduate School of Health, University of Technology Sydney, Sydney, Australia, 4The Children’s Hospital at Westmead Clinical School, University of Sydney, Westmead, Australia, 5School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, Australia


Greater incidence, severity and longer hospital length of stay (LOS) are inequities impacting on Aboriginal and Torres Strait Islander children as compared to other Australian children who sustain an acute burns injury. This study examined prognostic factors contributing to longer LOS for Aboriginal and Torres Strait Islander children.
We analysed data from the Burns Registry of Australian and New Zealand (October 2009 – June 2018), on children aged <16 years with an acute burns admission. Characteristics associated with longer LOS were estimated through four cox-regression models in SAS. Knowledge Interface methodology and Indigenous research methods were used throughout.
A total of 6980 patients were included, with 723 children identified as Aboriginal and Torres Strait Islander. Aboriginal and Torres Strait Islander children had a median hospital LOS of 5 days (CI 5-6), 4 days longer that other Australian children (1 day [CI 1–2]). Prognostic factors for LOS in Aboriginal and Torres Strait Islander children included remoteness, %TBSA, flame and full thickness burns. Similar LOS prognostic factors were identified in other Australian children, but with lower prevalence levels.
Hospital LOS prognostic factors of remoteness, flame burns, %TBSA, and full thickness are more prevalent in Aboriginal and Torres Strait Islander children. These identified health inequities need to be considered in injury prevention development strategies and the clinical management of burn injuries in Aboriginal and Torres Strait Islander children and their families.


Dr Courtney Ryder is Teaching Program Director Public Health, Senior Lecturer in Aboriginal and Torres Strait Islander Public Health at Flinders University. She is also an early career researcher and Nunga woman from Southern South Australia.

As an ECR Dr Ryder is establishing a research track record on understanding the nuanced ways in which health inequity manifestations impact on Aboriginal and Torres Strait Islander families. This includes work on Indigenous Data Sovereignty with a particular focus on injury epidemiology. Dr Ryder is also a world leader in Aboriginal health education, having spent over a decade revolutionising Aboriginal health education at Flinders University. Currently she oversees all public health courses at Flinders University and has designed and coordinated large and complex topics, pertaining to Aboriginal health and social health sciences in the Doctor of Medicine, Nursing, Midwifery, Health Science and Public Health programs. Work which has transformed student learning, and been recognised nationally and internationally.

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