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First Nations' hospital readmission ending in death: a potential sentinel indicator of inequity?

Authors
  • Lavoie, Josée1
  • Phillips-Beck, Wanda2
  • Kinew, Kathi Avery2
  • Kyoon-Achan, Grace3
  • Katz, Alan4
  • 1 Community Health Sciences, University of Manitoba , Winnipeg, Manitoba, Canada. , (Canada)
  • 2 First Nations Health and Social Secretariat of Manitoba , Winnipeg.
  • 3 Department of Community Health Science, University of Manitoba , Winnipeg, Manitoba, Canada. , (Canada)
  • 4 Manitoba Centre for Health Policy, University of Manitoba , Winnipeg, Manitoba, Canadag. , (Canada)
Type
Published Article
Journal
International Journal of Circumpolar Health
Publisher
Informa UK (Taylor & Francis)
Publication Date
Dec 01, 2021
Volume
80
Issue
1
Pages
1859824–1859824
Identifiers
DOI: 10.1080/22423982.2020.1859824
PMID: 33308085
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

In this study, we focused on readmissions for Ambulatory Care Sensitive Conditions (ACSC) ending in death, to capture those admissions and readmissions that might have been prevented if responsive primary healthcare was accessible. We propose this as a sentinel indicator of equity. We conducted analyses of Manitoba-based 30-day hospital readmission rates for ACSC which resulted in death, using data from 1986-2016 adjusted for age, sex, and socio-economic status. Our findings show that, across Manitoba, overall rates of readmissions ending in death are slowly increasing, and increasing more dramatically among northern First Nations, larger First Nations not affiliated with Tribal Councils, and in the western region of the province. These regions have continuously been highlighted as disadvantaged in terms of access to care, suggesting that the time for action is overdue. Rising rates of readmissions for ACSC ending in death suggest that greater attention should be placed on access to responsive primary healthcare. These findings have broader implications for territorial healthcare systems which purchase acute care services from provinces south of them. As an indicator of quality, monitoring readmissions ending in death could provide territorial governments insights into the quality of care provided to their constituents by provincial authorities.

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