ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2008
Access to health care among status Aboriginal people with chronic kidney disease.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02203084 (The Influence of Social Determinants and Access to Health Care on the Outcome of Children With Chronic Health Problems in British Columbia), which is not on this map. Cited by 50 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Influence of Social Determinants and Access to Health Care on the Outcome of Children With Chronic Health Problems in British Columbia
Who cites it
50 citing papers in PubMed, 2 syntheses or guidelines pooled it, 106 citations in OpenAlex.
- Effective primary care management of type 2 diabetes for indigenous populations: A systematic review.PloS one · 2022Pooled it
- Reported sources of health inequities in Indigenous Peoples with chronic kidney disease: a systematic review of quantitative studies.BMC public health · 2021Pooled it
- Assessment of the Siksika chronic disease nephropathy-prevention clinic.Canadian family physician Medecin de famille canadien · 2013Trial
- Integrated, Community-Led, Culturally Safe Implementation of a Chronic Kidney Disease Detection Program for Indigenous Communities of Canada: The Kidney Check Program Report.Canadian journal of kidney health and disease · 2026Article
- Examining Inequities in Clinical Outcomes for Indigenous Patients Treated With Dialysis in Canada: A Scoping Review.Kidney medicine · 2025Review
- Clinical Integration and Evaluation of the STrategic Optimization of Prescription Medication Use in Patients on HemoDialysis (STOPMed-HD) Intervention.Canadian journal of kidney health and disease · 2025Article
- A comprehensive exploration of chronic kidney disease and dialysis in Canada's Indigenous population: from epidemiology to genetic influences.International urology and nephrology · 2024Review
- Emergency Department Use Among Adults Receiving Dialysis.JAMA network open · 2024Article
- Telemonitoring and Case Management for Hypertensive and Remote-Dwelling Patients With Chronic Kidney Disease-The Telemonitoring for Improved Kidney Outcomes Study (TIKO): A Clinical Research Protocol.Canadian journal of kidney health and disease · 2022Article
- Creating an Indigenous Māori-centred model of relational health: A literature review of Māori models of health.Journal of clinical nursing · 2021Review
- Impact of a screen, triage and treat program for identifying chronic disease risk in Indigenous children.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021Observational
- Impact of point-of-care screening for hypertension, diabetes and progression of chronic kidney disease in rural Manitoba Indigenous communities.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021Article
- Cost of Potentially Preventable Hospitalizations Among Adults With Chronic Kidney Disease: A Population-Based Cohort Study.Canadian journal of kidney health and disease · 2021Article
- Mortality from cervical cancer in Brazil: an ecological epidemiologic study of a 22-year analysis.Ecancermedicalscience · 2020Article
- Canadian Senior Renal Leaders Community of Practice: Vulnerable Populations With Chronic Kidney Disease-Evidence to Inform Policy.Canadian journal of kidney health and disease · 2020Article
- Association of Specialist Physician Payment Model With Visit Frequency, Quality, and Costs of Care for People With Chronic Disease.JAMA network open · 2019Article
- Association of Mental Health Disorders With Health Care Utilization and Costs Among Adults With Chronic Disease.JAMA network open · 2019Article
- Validation of Self-Reported Race in a Canadian Provincial Renal Administrative Database.Canadian journal of kidney health and disease · 2019Article
- Indigenous patient experiences of returning to country: a qualitative evaluation on the Country Health SA Dialysis bus.BMC health services research · 2018Article
- Screening for kidney disease in Indigenous Canadian children: The FINISHED screen, triage and treat program.Paediatrics & child health · 2018Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEthnic disparities in access to health care and health outcomes are well documented. It is unclear whether similar differences exist between Aboriginal and non-Aboriginal people with chronic kidney disease in Canada. We determined whether access to care differed between status Aboriginal people (Aboriginal people registered under the federal Indian Act) and non-Aboriginal people with chronic kidney disease.
methodsWe identified 106 511 non-Aboriginal and 1182 Aboriginal patients with chronic kidney disease (estimated glomerular filtration rate less than 60 mL/min/1.73 m(2)). We compared outcomes, including hospital admissions, that may have been preventable with appropriate outpatient care (ambulatory-care-sensitive conditions) as well as use of specialist services, including visits to nephrologists and general internists.
resultsAboriginal people were almost twice as likely as non-Aboriginal people to be admitted to hospital for an ambulatory-care-sensitive condition (rate ratio 1.77, 95% confidence interval [CI] 1.46-2.13). Aboriginal people with severe chronic kidney disease (estimated glomerular filtration rate < 30 mL/min/1.73 m(2)) were 43% less likely than non-Aboriginal people with severe chronic kidney disease to visit a nephrologist (hazard ratio 0.57, 95% CI 0.39-0.83). There was no difference in the likelihood of visiting a general internist (hazard ratio 1.00, 95% CI 0.83-1.21).
interpretationIncreased rates of hospital admissions for ambulatory-care-sensitive conditions and a reduced likelihood of nephrology visits suggest potential inequities in care among status Aboriginal people with chronic kidney disease. The extent to which this may contribute to the higher rate of kidney failure in this population requires further exploration.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.