ArticleCMAJ open
Health care utilization differences between First Nations people and the general population with inflammatory bowel disease: a retrospective cohort study from Saskatchewan, Canada.
Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 7 citations in OpenAlex.
- Crohn's and bones: assessing bone microarchitecture using high-resolution peripheral quantitative computed tomography.JBMR plus · 2026Article
- Inflammatory Bowel Disease in Indigenous Populations: A Scoping Review.Crohn's & colitis 360 · 2025Article
- Ethnic Disparities in the Management of Inflammatory Bowel Disease in Israel and Impact on Outcomes.Crohn's & colitis 360 · 2025Article
- Storytelling of Indigenous patient and family advocates engaged in patient-oriented research initiatives in the field of inflammatory bowel disease.Journal of the Canadian Association of Gastroenterology · 2024Article
- Patient and Public Involvement in Inflammatory Bowel Disease Research-A Scoping Review.Journal of the Canadian Association of Gastroenterology · 2024Article
- The 2023 Impact of Inflammatory Bowel Disease in Canada: Direct Health System and Medication Costs.Journal of the Canadian Association of Gastroenterology · 2023Review
- Rural Residence Is Associated With Telephone Care Satisfaction Among Individuals With Inflammatory Bowel Disease: Cross-Sectional Study From Saskatchewan, Canada.Inquiry : a journal of medical care organization, provision and financingArticle
Corrections and comments
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Authors and funding
8 authors at 1 institution in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIndigenous people in Canada often face barriers to access specialized care, with limited data in evaluating health care utilization among Indigenous people with inflammatory bowel disease (IBD). We aimed to compare health care utilization between First Nations patients and those in the general population diagnosed with IBD in Saskatchewan.
methodsWe conducted a patient-oriented, population-based, retrospective cohort study by linking administrative health databases of Saskatchewan between fiscal years 1998/99 and 2017/18. We designed and completed this study in partnership with Indigenous patients and family advocates. We applied a validated algorithm to identify IBD incident cases and then used the self-declared First Nations status variable to divide those cases. We applied a 1:5 ratio for age and sex matching and used Cox proportional models to assess associations. Hazard ratios (HRs) and 95% confidence intervals (CIs) were reported.
resultsWe created a matched cohort with 696 IBD incident cases: 116 First Nations patients and 580 patients in the general population. We observed differences between the groups for IBD-specific hospital admissions (HR 1.33, 95% CI 1.01-1.75), IBD-related hospital admissions (HR 1.55, 95% CI 1.20-2.01), medication claims for IBD (HR 0.52, 95% CI 0.41-0.65) and 5-aminosalicylic acid claims (HR 0.56, 95% CI 0.45-0.71) adjusting by rural or urban residence and diagnosis type. There were no significant differences in the hazard rate of outpatient gastroenterology visits (HR 1.13, 95% CI 0.90-1.41), colonoscopies (HR 1.14, 95% CI 0.92-1.41) and surgeries for IBD (HR 1.14, 95% CI 0.80-1.64).
interpretationWe identified that First Nations patients diagnosed with IBD had a higher rate of hospital admissions owing to IBD than patients in the general population diagnosed with IBD. We also found an inverse association between First Nations status and having prescription medication claims for IBD.
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