Study suggests First Nations people in Alberta tend to receive lower level of emergency care

EDMONTON — Alberta hospital emergency rooms are likely to rate complaints from First Nations people as less urgent than those from other patients, even when their problems are the same, according to a new study that examined million of these visits.

“If people have a long bone fracture, you might expect the treatment to be the same between the groups,” said Patrick McLane of the University of Alberta, co-author of the study published Monday. in the Canadian Medical Association Journal.

“First Nations people in emergency departments were less likely to have the highest triage score, which would lead to higher urgency for treatment.”

McLane and his colleagues analyzed more than 11 million emergency room visits between 2012 and 2017 from across Alberta. They looked at five different categories of injuries or illnesses as well as five specific diagnoses.

The data revealed that emergency room staff consistently viewed First Nations people as less urgent than non-Indigenous people.

Overall, the study found that 12% of non-Aboriginal patients were rated at the most severe levels, while 8% of First Nations people received this rating.

The finding was consistent across all visit types – trauma, infection, substance abuse, obstetrics, and mental health – with the largest gap between First Nations and non-Indigenous ratings being for substance abuse.

The pattern also held true in three of the five specific diagnoses the team examined.

A First Nations person presenting to the emergency room with a broken bone had an 82% chance of receiving an assessment as urgent as a non-Aboriginal person with the same problem. For a respiratory infection, the figure was 90%.

If a First Nations person presented with an anxiety disorder, they had a two-thirds chance of scoring high as a non-Aboriginal person.

The work is part of a larger effort to address systemic racism in Alberta’s health care system, said co-author Bonnie Healy, a former triage nurse and Blackfoot member of the Center for Governance in Alberta. Alberta First Nations information.

“We’re all working on better relationships, better partnerships, to work together to close the gaps in some of the health outcomes,” she said.

The two said the study was not conclusive evidence of systemic racism in emergency rooms across the province.

“The differences we see could be multicausal,” McLane said.

But the authors point out that their new findings dovetail well with previous work they have done. Interview-based studies have revealed that Aboriginal people are very concerned about racism and profiling in emergency rooms.

The same results are found in studies conducted in other jurisdictions.

“It fits an image that comes from literature,” McLane said.

Healy said many First Nations people, without family doctors, use emergency departments as their primary care. If they are not treated in the same way as other patients, it raises concerns about access to health care in general as well as emergency response, she said.

“A lot of doctors and nurses don’t understand that First Nations don’t have funded primary care networks in their communities,” she said. “We really wanted to gain some understanding on both sides.”

Healy said the study will be presented to a group comprised of representatives from Alberta Health and First Nations in the province who have been convened to discuss racism in health care.

This report from The Canadian Press was first published on January 17, 2022.

— Follow Bob Weber on Twitter at @row1960

Bob Weber, The Canadian Press

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