Study design

Retrospective observational cohort study.

Objectives

Estimate spinal cord injury (SCI) prevalence in First Nations and non-First Nations populations and compare healthcare utilization as an indirect marker of health inequities.

Setting

Alberta, Canada.

Methods

We created a prevalent adult SCI cohort by identifying cases between April 1, 2002 and December 31, 2017 who were followed for common SCI complications and location of healthcare access from January 1, 2018 to December 31, 2019 using administrative data sources housed within Alberta Health Services (AHS). First Nations and non-First Nations SCI cohorts were divided into SCI etiology: traumatic SCI (TSCI) and non-traumatic SCI (NTSCI). Statistical analyses compared prevalence, demographics, healthcare utilization, and SCI complication rates. A secondary analysis was performed using case matching for demographics, injury type, injury level, and comorbidities.

Results

TSCI prevalence: 248 and 117 per 100,000 in First Nations and non-First Nations cohorts, respectively. NTSCI prevalence: 74 and 50 per 100,000 in First Nations and non-First Nations cohorts, respectively. Visit rates were higher in the TSCI First Nations cohort for visits to General Practitioner (GP), Emergency Department (ED), inpatient visits, and inpatient days with higher complication rates due to pulmonary, genitourinary, skin, and ‘other’ causes after case matching. Visits rates were higher in the NTSCI First Nations cohort for GP and specialists without differences in complication types after case matching.

Conclusions

Significant differences exist between First Nations and non-First Nations cohorts living with SCI in Alberta, suggesting healthcare inequities against First Nations Peoples in this province.

中文翻译：

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艾伯塔省脊髓损伤原住民的流行病学和医疗保健利用：一项探索健康不平等的观察性研究

学习规划

回顾性观察队列研究。

目标

估计原住民和非原住民人群的脊髓损伤 (SCI) 患病率，并将医疗保健利用率作为健康不平等的间接标志进行比较。

环境

加拿大艾伯塔省。

方法

我们使用艾伯塔省卫生局内的管理数据源，通过识别 2002 年 4 月 1 日至 2017 年 12 月 31 日之间的病例，创建了一个流行的成人 SCI 队列，并跟踪了这些病例的常见 SCI 并发症以及 2018 年 1 月 1 日至 2019 年 12 月 31 日期间的医疗保健获取地点服务（AHS）。原住民和非原住民 SCI 队列分为 SCI 病因：创伤性 SCI (TSCI) 和非创伤性 SCI (NTSCI)。统计分析比较了患病率、人口统计、医疗保健利用率和 SCI 并发症发生率。使用病例匹配对人口统计、损伤类型、损伤程度和合并症进行二次分析。

结果

TSCI 患病率：原住民和非原住民群体中每 10 万人中分别有 248 例和 117 例 TSCI。NTSCI 患病率：原住民和非原住民群体中分别为每 10 万人中 74 人和 50 人。TSCI 原住民队列中全科医生 (GP)、急诊科 (ED) 就诊、住院就诊和住院天数的就诊率较高，并且由于肺部、泌尿生殖系统、皮肤和病例后“其他”原因导致的并发症发生率较高匹配。NTSCI 原住民队列中全科医生和专家的就诊率较高，病例匹配后并发症类型没有差异。

结论

艾伯塔省的原住民和非原住民群体之间存在着显着差异，这表明该省的原住民存在医疗保健不平等。