Department of Radiology
University of Wisconsin School of Medicine and Public Health

Batta 2019

 

Year: 2019

Title: Equality of care between First Nations and nonFirst Nations patients in Saskatoon emergency departments

Country: Canada

Age: All Ages

Sex: All Sexes

Population: Indigenous

Care Setting: Emergency Department

Clinical Setting: General Diagnostic Imaging

Data Level: Multi-Institution

Data Type: EHR

Data Source: Local data

Conclusion: No Disparities Based on Patient Race/Ethnicity

Health OutComes Reported: No

Mitigation: No

Free Text Conclusion: First Nations patients equally likely to get imaging in the ED in controlled model.

Abstract: Objective: Studies show that First Nations patients have worse health outcomes than non-First Nations patients, raising concerns that treatment within the healthcare system, including emergency care, is inequitable. Methods: We performed a retrospective chart review of Status First Nations and non-First Nations patients presenting to two emergency departments in Saskatoon, Saskatchewan with abdominal pain and a Canadian Triage and Acuity Scale score of 3. From 190 charts (95 Status First Nations and 95 non-First Nations), data extracted included time to doctor, time to analgesia, length of stay, specialist consult, bloodwork, imaging, physical exam and history, and disposition. Univariate comparisons and multiple regression modelling were performed to compare care outcomes between patient groups. Equivalence testing comparing time intervals was also undertaken. Results: No statistically significant differences in presentation characteristics were observed, although Status First Nations subjects showed a greater tendency towards weekend presentation and younger age. Care parameters were similar, although a marginally significant difference was observed in Status First Nations versus non-First Nations subjects for imaging (46% versus 60%, p=0.06), which resolved on adjustment for age and weekend presentation. Time to physician was found to be similar among First Nations patients on equivalence testing within a 15-minute margin. Conclusion: In this study, First Nations patients presenting with abdominal pain did not receive delayed care. There were no detectable differences in the time-related care parameters/variables that were provided relative to non-First Nations patients. Meaningful and important qualitative factors need to be examined in the future.