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Health Services Use of Manitoba First Nations People: Is It Related to Underlying Need?

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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.

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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Author information

Authors and Affiliations

  1. Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, 4th Floor, Room 408, 727 McDermot Avenue, Winnipeg, MB, R3E 3P5, Canada

    Patricia J. Martens PhD & Laurel Jebamani MSc

  2. Health Information Research Committee of the Assembly of Manitoba Chiefs, Canada

    Doreen Sanderson

Authors
  1. Patricia J. Martens PhD
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  2. Doreen Sanderson
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  3. Laurel Jebamani MSc
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Corresponding author

Correspondence to Patricia J. Martens PhD.

Additional information

The full report “The Health and Health Care Use of Registered First Nations People Living in Manitoba: A Population-Based Study” on which this article is based is available from the Manitoba Centre for Health Policy at the above address or on-line at: https://doi.org/www.umanitoba.ca/centres/mchp/reports.htm

Acknowledgements of Sources of Support: This work was supported as part of a project on First Nations health in Manitoba, one of several projects undertaken each year by the Manitoba Centre for Health Policy under contract to Manitoba Health. The results and conclusions are those of the authors and no official endorsement by Manitoba Health was intended or should be inferred. Dr. Martens is also supported by a Community Alliances for Health Research Program grant from the Canadian Institutes of Health Research (CIHR), as well as a CIHR New Investigator’s Award. The authors are indebted to Health Information Services, Manitoba Health, First Nations and Inuit Health Branch, Indian and Northern Affairs Canada, and the Office of Vital Statistics in the Agency of Consumer and Corporate Affairs for the provision of data. Thanks to the Health Information Research Committee of the Assembly of Manitoba Chiefs, who acted as the Working Group (1999-2002) for the First Nations Report from which this paper was derived.

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Martens, P.J., Sanderson, D. & Jebamani, L. Health Services Use of Manitoba First Nations People: Is It Related to Underlying Need?. Can J Public Health 96 (Suppl 1), S39–S44 (2005). https://doi.org/10.1007/BF03405315

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