Acute health care among Indigenous patients in Canada: a scoping review

Abstract

A recent report by the Chief Public Health Officer of Canada demonstrates the inferior health status of Indigenous Peoples in Canada when compared to non-Indigenous populations. This scoping review maps out the available literature concerning acute health care for Indigenous Peoples in Canada in order to better understand the health care issues they face. All existing articles concerning health care provided to Indigenous Peoples in Canada in acute settings were included in this review. The targeted studied outcomes were access to care, health care satisfaction, hospital visit rates, mortality, quality of care, length of stay and cost per hospitalisation. 114 articles were identified. The most studied outcomes were hospitalisation rates (58.8%), length of stay (28.0%), mortality (25.4%) and quality of care (24.6%) Frequently studied topics included pulmonary disease, injuries, cardiovascular disease and mental illness. Indigenous Peoples presented lower levels of satisfaction and access to care although they tend to be over-represented in hospitalisation rates for acute care. Greater inclusion of Indigenous Peoples in the health care system and in the training of health care providers is necessary to ensure a better quality of care that is culturally safe for Indigenous Peoples.

Access to Cardiovascular Care for Indigenous Peoples in Canada: A Rapid Review

“… 20 Furthermore, Indigenous peoples present more commonly for acute health care but report lower levels of satisfaction with and access to health care, illustrating the need for both a better understanding of gaps across the care continuum and the development of a culturally safe environment. 33 We found that contemporary issues pertaining to systemic barriers and the social determinants of health of Indigenous peoples in Canada are generally well described, although a minority of articles discussed the historical context and drivers of current disparities and inequities. Additionally, none of the identified studies applied indigenous methods or methodologies in conducting their research, limiting the integration of traditional medicine and a qualitative understanding of Indigenous peoples’ barriers to and lived experiences with cardiovascular care in Canada, based on the current review.…”

“…As a result, Indigenous peoples in Canada are faced with substantially longer times between the onset of symptoms and hospital presentation compared to those in the general population. 33 …”

“…This is particularly problematic for acute cardiovascular events, such as acute myocardial infarction, aortic dissection, and cardiac arrest. As a result, Indigenous Peoples in Canada are faced with substantially longer times between the onset of symptoms and hospital presentation compared to the general population (33).…”

“…Indigenous Peoples present more commonly for acute health care but report lower levels of satisfaction with and access to health care, which illustrates the need for a better understanding of gaps across the care continuum as well as for the development of a culturally safe environment (33). We found that contemporary issues pertaining to systemic barriers and the social determinants of health of Indigenous Peoples in Canada are generally well-described, although a minority of articles discussed the historical context and drivers of current disparities and inequities.…”

Factors influencing survival and mortality among adult Aboriginal Australians with bronchiectasis—A 10-year retrospective study

“…Across various ethnically diverse non-Indigenous populations, hospitalisation and mortality data have been well documented in the literature ( 3 – 9 , 21 – 23 , 28 – 31 ). Although the available reports suggest that the burden of chronic respiratory disorders is much higher among global First Nations Indigenous people (including higher heath care utilisation and hospital admission rates), there is scant evidence pertaining to factors that may predict mortality or survival among First Nations Indigenous people ( 20 , 32 – 38 ).…”