First Nations emergency care in Alberta: descriptive results of a retrospective cohort study

Patrick Mclane,Rhonda J Rosychuk,Bonnie Healy,Cheryl Barnabe,Chyloe Healy,Brian R Holroyd,Lea Bill,Amy Colquhoun,Katherine Rittenbach,Kayla M Fitzpatrick

doi:10.1186/s12913-021-06415-2

Abstract

BackgroundWorse health outcomes are consistently reported for First Nations people in Canada. Social, political and economic inequities as well as inequities in health care are major contributing factors to these health disparities. Emergency care is an important health services resource for First Nations people. First Nations partners, academic researchers, and health authority staff are collaborating to examine emergency care visit characteristics for First Nations and non-First Nations people in the province of Alberta.MethodsWe conducted a population-based retrospective cohort study examining all Alberta emergency care visits from April 1, 2012 to March 31, 2017 by linking administrative data. Patient demographics and emergency care visit characteristics for status First Nations persons in Alberta, and non-First Nations persons, are reported. Frequencies and percentages (%) describe patients and visits by categorical variables (e.g., Canadian Triage and Acuity Scale). Means, medians, standard deviations and interquartile ranges describe continuous variables (e.g., age).ResultsThe dataset contains 11,686,288 emergency care visits by 3,024,491 unique persons. First Nations people make up 4% of the provincial population and 9.4% of provincial emergency visits. The population rate of emergency visits is nearly 3 times higher for First Nations persons than non-First Nations persons. First Nations women utilize emergency care more than non-First Nations women (54.2% of First Nations visits are by women compared to 50.9% of non-First Nations visits). More First Nations visits end in leaving without completing treatment (6.7% v. 3.6%).ConclusionsFurther research is needed on the impact of First Nations identity on emergency care drivers and outcomes, and on emergency care for First Nations women.

Highlights

Worse health outcomes are consistently reported for First Nations people in Canada
The objective of this study is to report population rates of emergency care use for First Nations (FN) and non-FN populations, as well as quantitative differences in emergency visit characteristics, between FN and non-FN persons in Alberta, Canada
We recognize that Indigenous knowledge systems encompass quantitative components [35], such as the Blackfoot Winter Count, and that statistical analysis methods can be utilized within research guided by Indigenous principles [36]

Summary

Introduction

Worse health outcomes are consistently reported for First Nations people in Canada. Political and economic inequities as well as inequities in health care are major contributing factors to these health disparities. Emergency care is an important health services resource for First Nations people. First Nations partners, academic researchers, and health authority staff are collaborating to examine emergency care visit characteristics for First Nations and non-First Nations people in the province of Alberta. Health disparities for FN persons in Canada [5, 6] are recognized as related to persistent social, political and economic inequities, including inequities in health care services and delivery [6,7,8,9,10]. Nonacademic and academic literature shows that Indigenous persons rely more heavily on emergency services than non-Indigenous persons [15,16,17]

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