This presentation shares findings from the PEACH program, which examines persistent inequities in hospital outcomes for children and young people from priority populations, including Aboriginal and Torres Strait Islander, refugee/asylum-seeking, interpreter-required, out-of-home care, and NDIS participants. (PEACH program’s Evaluation was made possible with the support of Luminesce Alliance)

Using linked hospital data (2015–2024) and lived experience insights, the study highlights significant differences in outcomes such as mortality, readmission, length of stay, and discharge against medical advice. 
Analysis of over 250,000 inpatient and 440,000 ED encounters found that one-third involved priority population CYP. These children experienced significantly poorer outcomes, including:

• 29% higher odds of in-hospital mortality
• Increased risk of discharge against medical advice 
• Higher readmission rates 
• Longer hospital and ED stays

Inequities were compounded across multiple risk factors. For example, Aboriginal and Torres Strait Islander CYP living with disability had more than three times the risk of readmission compared with those without these intersecting risks. The total cost associated with poorer outcomes was estimated at $87 million (excluding mortality). Furthermore, our findings highlight the value of the patient and family voice, which remains a challenge for health systems to capture through routine patient experience mechanisms. We will also share findings from co-design work with consumers and staff that has informed practical system-level interventions to reduce inequity across care pathways.

Key messages include:

• Almost all health outcomes exhibit excess risk for priority population CYP, with striking cumulative risk
• Interventions to address inequity are required at clinical and systems level to achieve change, with a focus on identification, enhanced access and cultural change
• Co-design with priority populations is feasible is designing sustainable and scalable solutions to inequity in care
• Comparison with CHA data will contextualise whether SCHN trends are consistent with those in other children’s hospitals nationally.