• Lucinda Parsonage, Stephen Gourley, Shahid Ullah, and Richard Johnson.
• Alice Springs Hospital, Alice Spring, Northern Territory, Australia.
• Emerg Med Australas. 2025 Feb 1; 37 (1): e14558e14558.

BackgroundFirst Nations patients often experience poorer health outcomes than non-First Nations patients. Despite emergency triage primarily focusing on severity, implying comparable outcomes for patients in the same triage group regardless of demographics, the precision of triage for First-Nations Australians may be undermined by multiple factors, although research in this area is scarce.ObjectiveTo compare admission rates, service utilisation and mortality for First Nations and non-First Nations patients, based on their triage categories.MethodsThis retrospective cohort study utilised data for all adults presenting between January 2016 and May 2021, to Alice Springs Hospital; totalling 175 199 presentations from 39 882 individual patients. Data were analysed for differences between First Nations and non-First nations patients for outcomes including 30-day mortality, admission to hospital and admission to ICU.ResultsFirst Nations patients had significantly higher admission than non-First Nations patients across all triage categories (P < 0.001). First Nations patients in categories 3 and 4 had a significantly higher 30-day mortality (P = 0.039, P = 0.045, respectively). First Nations patients in categories 2 and 3 were significantly more likely to be admitted to ICU (P < 0.001).ConclusionFirst Nations patients appear to have worse outcomes than non-First Nations patients in the same triage category. Socio-economic factors and high discharge against advice rates from wards may explain the significantly higher admission rate. Under-recognition of serious illness at triage could be attributed to communication issues or a 'well bias'. The results raise many questions and further investigation is required.© 2025 Australasian College for Emergency Medicine.

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