Despite increasing pressure to include ethnicity/race in health data, there is considerable debate about whether this information will result in reduced disadvantage or will simply contribute to the reification of ethnic origin as a cause of health problems. We conducted a study to identify promising strategies to improve the identification of Aboriginal and Torres Strait Islander people in general practice.
Methods Methods included a systematic review of the literature on interventions to improve identification, analysis of Primary Health Care Research and Information Service and Medicare general practice data, and a series of key informant interviews, workshops and case studies.
Results Both clinicians and community members recognised the population health imperatives to reduce ethnic disparities in health but they also had difficulty conceptualising how information about a patient's ethnicity could be clinically useful. Clinicians who were able to articulate how ethnic identification was linked to their practice were the most willing to ask patients about their ethnic status. This was supported by health service data which suggested that increasing awareness around health services specifically available to Aboriginal and Torres Strait Islander people in significant increases in identification and completed health assessments (Aged 15–54 years: OR 95% CI 2.38, 1.78 to 3.19 Aged 55 years: OR 95% CI 2.92, 2.46 to 3.47).
Conclusion Improving the willingness of physicians to enquire about ethnicity will require strengthening the link between knowing a patients ethnicity and quality of care. This will require having systems in place that enable information about ethnicity to contribute to improved quality of care in an explicit way.
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