First Nations patients more likely to leave hospitals without care

According to the study (new window) (in English) published Monday in the Journal of the Canadian Medical Association, provincial data from 2012 to 2017 shows that 6.8% of First Nations members left emergency departments before being seen or against the advice of a doctor. This figure compares to only 3.7% of people who are not members of the First Nations.

According to Patrick McLaneadjunct associate professor in the department of emergency medicine at the University of Alberta and co-author of the study, after analyzing variables such as patient demographics, geography or diagnosis type, patient status Belonging to a First Nation is the only apparent explanation that can be given.

When we control for all of these factors, First Nations people are more likely to be discharged from hospital without completing care.

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Concurring testimonies

This finding was supported by interviews conducted from 2019 to 2022 with First Nations people who said they were asked stereotypical questions about substance use, heard racist comments, and the feeling of having been forced to wait longer than others to obtain care.

Participants also mentioned other barriers to obtaining care, such as long wait times, availability of transportation, and health care professionals’ use of medical jargon that patients do not understand. .

According to Samuel Crowfoot, councilor of the Siksika Nation, the study reflects what members of his community, located southeast of Calgary, have been experiencing for a long time, namely erroneous diagnoses or even being targeted by security a hospital.

The Siksika Nation thus encourages its members to talk about situations related to racism and discrimination that they experience in health care. Last September, she signed an agreement with Alberta doctors (new window) to resolve these problems.

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Benedict Crow Chiefa member of this community, filed a human rights complaint last year against Alberta Health Services (AHS) and a hospital, which he accused of discrimination leading to the death of his wife (new window), Myra Crow.

At the time, the provincial public health authority said racism and discrimination had no place within the organization.

Friday, Kerry Williamsonspokesperson forAlberta Health ServicesAHSsaid the agency recognizes that some First Nations people face barriers in accessing care because they do not feel safe or welcome in the health system.

He added thatAlberta Health ServicesAHS is working to remedy this situation by notably implementing a new roadmap for this purpose.

Same situation elsewhere in the country?

Although the research was conducted in Alberta, Patrick McLane argues that the findings likely apply to emergency room visits across Canada.

Benedict Crow Chief also believes the problem is not limited to Alberta. He hopes other First Nations will file complaints on behalf of their discriminated members.

It’s very frustrating because these stories are common. We will present them as many times as necessary until we see significant changes.

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Recommendations

The study authors suggest that health care providers and emergency services work with First Nations on strategies to retain patients who are members of their communities.

James Makokisfamily doctor of the Cree Nation of Saddle Lake, for its part, recommends that emergency care providers respect the basic principles of triage, take the vital signs of First Nations members and take additional measures to better communicate with them and ensure that they are well supported.

The availability of 24-hour transportation services could help members of these communities living in areas far from a hospital.

Improving access to primary care could also reduce pressure on emergency room staff.

Until we are prepared to address these issues in a real, fundamental, sincere and transformative way, we will continue to see results like this concludes Dr. Makokis.

With information from Madeleine Cummings and The Canadian Press