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Canadian Journal of Public Health

, Volume 96, Supplement 1, pp S39–S44 | Cite as

Health Services Use of Manitoba First Nations People

Is It Related to Underlying Need?
  • Patricia J. MartensEmail author
  • Doreen Sanderson
  • Laurel Jebamani
Article

Abstract

Background

To compare health status and health services use of Registered First Nations to all other Manitobans (AOM). If the Canadian health care system is meeting underlying need, those experiencing the greatest burden of morbidity and mortality should show the highest rates of health service use.

Methods

Registered First Nations’ (n=85,959) hospitalization and physician visit rates were compared to rates of all other Manitobans (n=1,054,422) for fiscal year 1998/99. The underlying “need” for health care was measured using premature mortality (PMR), an age-and sex-adjusted rate of death before age 75. Data were derived from Manitoba’s Population Health Research Data Repository, linked to federal Status Verification System files to determine Registered First Nations status.

Results

Registered First Nations’ PMR was double the rate of all other Manitobans (6.61 vs. 3.30 deaths per thousand, p<0.05). Registered First Nations ambulatory physician visit rates (6.13 vs. 4.85 visits per person, p<0.05), hospital separation rates (0.348 vs. 0.156 separations per person, p<0.05) and total days of hospital care (1.75 vs. 1.05 days per person, p<0.05) were higher than AOM rates. Consultation rates (first visit to a specialist) were slightly higher for Registered First Nations (0.29 vs. 0.27 visits per person, p<0.05), and overall specialist visit rates were lower (0.895 vs. 1.284 visits per person, p<0.05) compared with AOM.

Conclusion

Although hospitalization and ambulatory physician visit rates for First Nations reflect their poorer health status, consult and specialist rates do not reflect the underlying need for health care services.

MeSH terms

Indians North American health services research use of physicians, specialists Canada 

Résumé

Contexte

Cette étude visait à comparer l’état de santé des membres inscrits des Premières nations et leur utilisation des services de santé par rapport au reste de la population du Manitoba. Si le système de soins de santé canadien répond vraiment aux besoins sous-jacents, les personnes dont le fardeau de morbidité et de mortalité est le plus élevé devraient présenter les taux d’utilisation des services de santé les plus élevés.

Méthode

Nous avons comparé les taux d’hospitalisation et de visites chez le médecin des membres inscrits des Premières nations (n = 85 959) aux taux comparables dans le reste de la population du Manitoba (n = 1 054 422) pour l’exercice 1998–1999. Pour mesurer le „ besoin ” sous-jacent en services de santé, nous avons utilisé le taux de mortalité prématurée (TMP) - un taux de décès avant 75 ans ajusté selon l’âge et le sexe. Les données ont été dérivées du registre Population Health Research Data Repository du Manitoba, une base de données liée au Système de vérification du statut fédéral, pour déterminer le statut de membre inscrit des Premières nations.

Résultats

Le TMP des membres inscrits des Premières nations était le double du taux dans le reste de la population du Manitoba (6,61 c. 3,30 décès p. 1 000, p<0,05). Le nombre de visites dans les cliniques de soins ambulatoires effectuées par les membres inscrits des Premières nations (6,13 c. 4,85 visites par personne, p<0,05), les taux de diagnostic-congé (0,348 c. 0,156 congé par personne, p<0,05) et le nombre total de journées de soins hospitaliers (1,75 c. 1,05 jour par personne, p<0,05) étaient plus élevés que dans le reste de la population du Manitoba. Les taux de consultation (première visite chez un spécialiste) étaient légèrement supérieurs chez les membres inscrits des Premières nations (0,29 c. 0,27 visite par personne, p<0,05), et les taux globaux de visites chez les spécialistes étaient inférieurs (0,895 c. 1,284 visite par personne, p<0,05) aux taux dans le reste de la population du Manitoba.

Conclusion

Les taux d’hospitalisation et de visites dans les cliniques de soins ambulatoires relevés chez les membres des Premières nations sont conformes à leur moins bon état de santé, mais les taux de consultation et de visites chez les spécialistes ne correspondent pas aux besoins sous-jacents des Premières nations sur le plan des services de santé.

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Copyright information

© The Canadian Public Health Association 2005

Authors and Affiliations

  • Patricia J. Martens
    • 1
    Email author
  • Doreen Sanderson
    • 2
  • Laurel Jebamani
    • 1
  1. 1.Manitoba Centre for Health Policy, Department of Community Health SciencesUniversity of ManitobaWinnipegCanada
  2. 2.Health Information Research Committee of the Assembly of Manitoba ChiefsCanada

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