Cultural safety is defined with reference to the experience of Aboriginal and Torres Strait Islander people who access and use health care services, including their treatment by health care professionals and their feelings of cultural safety. It also includes some indirect measures of cultural safety where clients take their own leave from hospitals. These measures suggest that there are situations where Indigenous patients do not find the hospital environment to be culturally safe.
What data are available?
The data sources include the ABS national Aboriginal and Torres Strait Islander health and social surveys, surveys of public hospital patients in New South Wales, and Queensland and Reconciliation Australia’s Australian Reconciliation Barometer survey. There are also data from the national hospital data collections on indirect measures of cultural safety.
For further information on the data sources used in this module, see Module 2 – Data sources and data gaps.
The National Aboriginal and Torres Strait Islander Health Survey shows that in 2018–19:
- 88% of Indigenous Australians aged 15 and over in non-remote areas reported that doctors always/often explained things in a way that could be understood
- 91% of Indigenous Australians aged 15 and over in non-remote areas reported that doctors always/often showed respect for what was said
- 32% of Indigenous Australians who did not access health services when they needed to, indicated this was due to cultural reasons, such as language problems, discrimination and cultural appropriateness.
Data from the 2020 Australian Reconciliation Barometer indicate that 22% of Indigenous Australians or their families were racially discriminated against by doctors, nurses and/or medical staff in the last 12 months.
The differences in rates of Indigenous and non-Indigenous hospital patients who choose to leave prior to commencing or completing treatment are frequently used as indirect measures of cultural safety.
- In relation to admitted patient hospitalisations, Indigenous Australians were discharged against medical advice for 3.9% of hospitalisations in 2018–20. Based on age standardised rates, Indigenous patients were discharged against medical advice at over 5 times the rate of non-Indigenous Australians.
- In relation to emergency department care, based on age standardised rates, Indigenous patients left at own risk or did not wait at 1.5 times the rate of non-Indigenous patients.
See Module 2 data tables for all data presented in this module.
Data gaps and limitations
Data from Indigenous health care users about the health care that they receive are limited. Data from surveys of hospital patients in all states and territories are required, as well as additional national data on patient satisfaction with different types of health care services. However, data from these surveys are not always available by Indigenous status and may not include questions that relate to cultural safety for Indigenous Australians.
Module 2 domains: