ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2022
First Nations status and emergency department triage scores in Alberta: a retrospective cohort study.
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Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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29 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
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- Emergency department visits among First Nations female adults in Alberta: a population-based study.CJEM · 2025Article
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- Leaving emergency departments without completing treatment among First Nations and non-First Nations patients in Alberta: a mixed-methods study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- A logic framework for addressing medical racism in academic medicine: an analysis of qualitative data.BMC medical ethics · 2024Article
- Using a health equity lens to measure patient experiences of care in diverse health care settings.PloS one · 2024Article
- Racism as a determinant of health and health care: Rapid evidence narrative from the SAFE for Health Institutions project.Canadian family physician Medecin de famille canadien · 2023Article
- Disparities in primary and emergency health care among "off-reserve" Indigenous females compared with non-Indigenous females aged 15-55 years in Canada.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
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Authors and funding
11 authors at 3 institutions in 1 country.
Patrick McLaneAlberta Health Services (McLane, Rittenbach, Holroyd), Strategic Clinical Networks; Department of Emergency Medicine (McLane, Mackey, Holroyd), University of Alberta, Edmonton, Alta.; Departments of Medicine and of Community Health Sciences (Barnabe) University of Calgary; Alberta First Nations Information Governance Centre (Bill); Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Yellowhead Tribal Council (Bird), Edmonton, Alta.; Blackfoot Confederacy Tribal Council (Healy), Standoff, Alta.; Organization of Treaty 8 First Nations of Alberta (Janvier), Edmonton, Alta.; Maskwacis Health Services (Louis), Maskwacis, Alta.; Department of Pediatrics (Rosychuk), Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alta. mclane@ualberta.ca.
Cheryl BarnabeAlberta Health Services (McLane, Rittenbach, Holroyd), Strategic Clinical Networks; Department of Emergency Medicine (McLane, Mackey, Holroyd), University of Alberta, Edmonton, Alta.; Departments of Medicine and of Community Health Sciences (Barnabe) University of Calgary; Alberta First Nations Information Governance Centre (Bill); Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Yellowhead Tribal Council (Bird), Edmonton, Alta.; Blackfoot Confederacy Tribal Council (Healy), Standoff, Alta.; Organization of Treaty 8 First Nations of Alberta (Janvier), Edmonton, Alta.; Maskwacis Health Services (Louis), Maskwacis, Alta.; Department of Pediatrics (Rosychuk), Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alta.
Leslee MackeyAlberta Health Services (McLane, Rittenbach, Holroyd), Strategic Clinical Networks; Department of Emergency Medicine (McLane, Mackey, Holroyd), University of Alberta, Edmonton, Alta.; Departments of Medicine and of Community Health Sciences (Barnabe) University of Calgary; Alberta First Nations Information Governance Centre (Bill); Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Yellowhead Tribal Council (Bird), Edmonton, Alta.; Blackfoot Confederacy Tribal Council (Healy), Standoff, Alta.; Organization of Treaty 8 First Nations of Alberta (Janvier), Edmonton, Alta.; Maskwacis Health Services (Louis), Maskwacis, Alta.; Department of Pediatrics (Rosychuk), Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alta.
Lea BillAlberta Health Services (McLane, Rittenbach, Holroyd), Strategic Clinical Networks; Department of Emergency Medicine (McLane, Mackey, Holroyd), University of Alberta, Edmonton, Alta.; Departments of Medicine and of Community Health Sciences (Barnabe) University of Calgary; Alberta First Nations Information Governance Centre (Bill); Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Yellowhead Tribal Council (Bird), Edmonton, Alta.; Blackfoot Confederacy Tribal Council (Healy), Standoff, Alta.; Organization of Treaty 8 First Nations of Alberta (Janvier), Edmonton, Alta.; Maskwacis Health Services (Louis), Maskwacis, Alta.; Department of Pediatrics (Rosychuk), Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alta.
Katherine RittenbachAlberta Health Services (McLane, Rittenbach, Holroyd), Strategic Clinical Networks; Department of Emergency Medicine (McLane, Mackey, Holroyd), University of Alberta, Edmonton, Alta.; Departments of Medicine and of Community Health Sciences (Barnabe) University of Calgary; Alberta First Nations Information Governance Centre (Bill); Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Yellowhead Tribal Council (Bird), Edmonton, Alta.; Blackfoot Confederacy Tribal Council (Healy), Standoff, Alta.; Organization of Treaty 8 First Nations of Alberta (Janvier), Edmonton, Alta.; Maskwacis Health Services (Louis), Maskwacis, Alta.; Department of Pediatrics (Rosychuk), Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alta.
Brian R HolroydAlberta Health Services (McLane, Rittenbach, Holroyd), Strategic Clinical Networks; Department of Emergency Medicine (McLane, Mackey, Holroyd), University of Alberta, Edmonton, Alta.; Departments of Medicine and of Community Health Sciences (Barnabe) University of Calgary; Alberta First Nations Information Governance Centre (Bill); Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Yellowhead Tribal Council (Bird), Edmonton, Alta.; Blackfoot Confederacy Tribal Council (Healy), Standoff, Alta.; Organization of Treaty 8 First Nations of Alberta (Janvier), Edmonton, Alta.; Maskwacis Health Services (Louis), Maskwacis, Alta.; Department of Pediatrics (Rosychuk), Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alta.
Anne BirdAlberta Health Services (McLane, Rittenbach, Holroyd), Strategic Clinical Networks; Department of Emergency Medicine (McLane, Mackey, Holroyd), University of Alberta, Edmonton, Alta.; Departments of Medicine and of Community Health Sciences (Barnabe) University of Calgary; Alberta First Nations Information Governance Centre (Bill); Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Yellowhead Tribal Council (Bird), Edmonton, Alta.; Blackfoot Confederacy Tribal Council (Healy), Standoff, Alta.; Organization of Treaty 8 First Nations of Alberta (Janvier), Edmonton, Alta.; Maskwacis Health Services (Louis), Maskwacis, Alta.; Department of Pediatrics (Rosychuk), Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alta.
Bonnie HealyAlberta Health Services (McLane, Rittenbach, Holroyd), Strategic Clinical Networks; Department of Emergency Medicine (McLane, Mackey, Holroyd), University of Alberta, Edmonton, Alta.; Departments of Medicine and of Community Health Sciences (Barnabe) University of Calgary; Alberta First Nations Information Governance Centre (Bill); Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Yellowhead Tribal Council (Bird), Edmonton, Alta.; Blackfoot Confederacy Tribal Council (Healy), Standoff, Alta.; Organization of Treaty 8 First Nations of Alberta (Janvier), Edmonton, Alta.; Maskwacis Health Services (Louis), Maskwacis, Alta.; Department of Pediatrics (Rosychuk), Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alta.
Kris JanvierAlberta Health Services (McLane, Rittenbach, Holroyd), Strategic Clinical Networks; Department of Emergency Medicine (McLane, Mackey, Holroyd), University of Alberta, Edmonton, Alta.; Departments of Medicine and of Community Health Sciences (Barnabe) University of Calgary; Alberta First Nations Information Governance Centre (Bill); Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Yellowhead Tribal Council (Bird), Edmonton, Alta.; Blackfoot Confederacy Tribal Council (Healy), Standoff, Alta.; Organization of Treaty 8 First Nations of Alberta (Janvier), Edmonton, Alta.; Maskwacis Health Services (Louis), Maskwacis, Alta.; Department of Pediatrics (Rosychuk), Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alta.
Eunice LouisAlberta Health Services (McLane, Rittenbach, Holroyd), Strategic Clinical Networks; Department of Emergency Medicine (McLane, Mackey, Holroyd), University of Alberta, Edmonton, Alta.; Departments of Medicine and of Community Health Sciences (Barnabe) University of Calgary; Alberta First Nations Information Governance Centre (Bill); Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Yellowhead Tribal Council (Bird), Edmonton, Alta.; Blackfoot Confederacy Tribal Council (Healy), Standoff, Alta.; Organization of Treaty 8 First Nations of Alberta (Janvier), Edmonton, Alta.; Maskwacis Health Services (Louis), Maskwacis, Alta.; Department of Pediatrics (Rosychuk), Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alta.
Rhonda J RosychukAlberta Health Services (McLane, Rittenbach, Holroyd), Strategic Clinical Networks; Department of Emergency Medicine (McLane, Mackey, Holroyd), University of Alberta, Edmonton, Alta.; Departments of Medicine and of Community Health Sciences (Barnabe) University of Calgary; Alberta First Nations Information Governance Centre (Bill); Department of Psychiatry (Rittenbach), University of Calgary, Calgary, Alta.; Department of Psychiatry (Rittenbach), University of Alberta, Edmonton, Alta.; Yellowhead Tribal Council (Bird), Edmonton, Alta.; Blackfoot Confederacy Tribal Council (Healy), Standoff, Alta.; Organization of Treaty 8 First Nations of Alberta (Janvier), Edmonton, Alta.; Maskwacis Health Services (Louis), Maskwacis, Alta.; Department of Pediatrics (Rosychuk), Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alta.
Blue Quills First Nations College · CAAlberta Health Services · CAAlberta Health · CA
Funding
CIHR 156176
Abstract
backgroundPrevious studies have found that race is associated with emergency department triage scores, raising concerns about potential health care inequity. As part of a project on quality of care for First Nations people in Alberta, we sought to understand the relation between First Nations status and triage scores.
methodsWe conducted a population-based retrospective cohort study of health administrative data from April 2012 to March 2017 to evaluate acuity of triage scores, categorized as a binary outcome of higher or lower acuity score. We developed multivariable multilevel logistic mixed-effects regression models using the levels of emergency department visit, patient (for patients with multiple visits) and facility. We further evaluated the triage of visits related to 5 disease categories and 5 specific diagnoses to better compare triage outcomes of First Nations and non-First Nations patients.
resultsFirst Nations status was associated with lower odds of receiving higher acuity triage scores (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.92-0.94) compared with non-First Nations patients in adjusted models. First Nations patients had lower odds of acute triage for all 5 disease categories and for 3 of 5 diagnoses, including long bone fractures (OR 0.82, 95% CI 0.76-0.88), acute upper respiratory infection (OR 0.90, 95% CI 0.84-0.98) and anxiety disorder (OR 0.67, 95% CI 0.60-0.74).
interpretationFirst Nations status was associated with lower odds of higher acuity triage scores across a number of conditions and diagnoses. This may reflect systemic racism, stereotyping and potentially other factors that affected triage assessments.
Indexed as
Indigenous CanadiansAdultAlbertaEmergency Service, HospitalFemaleHealth Services AccessibilityHumansMaleMiddle AgedOutcome Assessment, Health CarePatient AcuityRetrospective StudiesSocial Determinants of HealthStereotypingSystemic RacismTriage
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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.