Underutilized and undertheorized: the use of hospitalization for ambulatory care sensitive conditions for assessing the extent to which primary healthcare services are meeting needs in British Columbia First Nation communities
Abstract Background Since the 1960s, the federal government has been providing or funding a selection of community-based primary healthcare (PHC) programs on First Nations reserves. A key question is whether local access to PHC can help address health inequities in First Nations on-reserve communiti...
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| Format: | Article |
| Language: | English |
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BMC
2019-01-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-018-3850-y |
| _version_ | 1811207529064038400 |
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| author | Josée G. Lavoie Sabrina T. Wong Naser Ibrahim John D. O’Neil Michael Green Amanda Ward |
| author_facet | Josée G. Lavoie Sabrina T. Wong Naser Ibrahim John D. O’Neil Michael Green Amanda Ward |
| author_sort | Josée G. Lavoie |
| collection | DOAJ |
| description | Abstract Background Since the 1960s, the federal government has been providing or funding a selection of community-based primary healthcare (PHC) programs on First Nations reserves. A key question is whether local access to PHC can help address health inequities in First Nations on-reserve communities in British Columbia (BC). Objectives This paper examines whether hospitalization for Ambulatory Care Sensitive Conditions (1) can be used as a proxy measure for the organization of PHC in First Nations reserve areas; and (2) is associated with premature mortality rates. Methods In this descriptive correlational study, we used administrative data available through Population Data BC, including demographic and ecological information (i.e. geo-codes indicating location of residence). We used two different measures of hospitalization: rates of episodic hospital care and rates of length of stay. We correlated hospitalization rates with premature mortality rates and the level of care available in First Nations communities, which depends on a federal funding formula based upon community size and, more specifically, the level of isolation from a provincial point of care. Results First Nations communities in BC that have local 24/7 access to PHC services have similar rates of hospitalization for ACSC to those living in urban centres. This is demonstrated by the similarities in the strengths of the correlation between premature mortality rates and rates of avoidable hospitalization for conditions treatable in a PHC setting. This is not the case for communities served by a Health Centre (weaker correlation) and for communities serviced by a Health Station or with no on-reserve point of care (no correlation). Conclusions Improving access to PHC services in First Nations communities can be associated with a significant reduction in avoidable hospitalization and premature mortality rates. The method we tested is an important tool that could serve health care planning decisions in small communities. |
| first_indexed | 2024-04-12T04:06:01Z |
| format | Article |
| id | doaj.art-1a5bc58a61d746228b7cbd1aeebc3ede |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-12T04:06:01Z |
| publishDate | 2019-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-1a5bc58a61d746228b7cbd1aeebc3ede2022-12-22T03:48:37ZengBMCBMC Health Services Research1472-69632019-01-0119111010.1186/s12913-018-3850-yUnderutilized and undertheorized: the use of hospitalization for ambulatory care sensitive conditions for assessing the extent to which primary healthcare services are meeting needs in British Columbia First Nation communitiesJosée G. Lavoie0Sabrina T. Wong1Naser Ibrahim2John D. O’Neil3Michael Green4Amanda Ward5Dept of Community Health Sciences, University of ManitobaSchool of Nursing, University of British ColumbiaOngomiizwin Research, University of ManitobaSimon Fraser UniversityQueens UniversityFirst Nation Health AuthorityAbstract Background Since the 1960s, the federal government has been providing or funding a selection of community-based primary healthcare (PHC) programs on First Nations reserves. A key question is whether local access to PHC can help address health inequities in First Nations on-reserve communities in British Columbia (BC). Objectives This paper examines whether hospitalization for Ambulatory Care Sensitive Conditions (1) can be used as a proxy measure for the organization of PHC in First Nations reserve areas; and (2) is associated with premature mortality rates. Methods In this descriptive correlational study, we used administrative data available through Population Data BC, including demographic and ecological information (i.e. geo-codes indicating location of residence). We used two different measures of hospitalization: rates of episodic hospital care and rates of length of stay. We correlated hospitalization rates with premature mortality rates and the level of care available in First Nations communities, which depends on a federal funding formula based upon community size and, more specifically, the level of isolation from a provincial point of care. Results First Nations communities in BC that have local 24/7 access to PHC services have similar rates of hospitalization for ACSC to those living in urban centres. This is demonstrated by the similarities in the strengths of the correlation between premature mortality rates and rates of avoidable hospitalization for conditions treatable in a PHC setting. This is not the case for communities served by a Health Centre (weaker correlation) and for communities serviced by a Health Station or with no on-reserve point of care (no correlation). Conclusions Improving access to PHC services in First Nations communities can be associated with a significant reduction in avoidable hospitalization and premature mortality rates. The method we tested is an important tool that could serve health care planning decisions in small communities.http://link.springer.com/article/10.1186/s12913-018-3850-yAvoidable hospitalizationIndigenous populationsPrimary careRural and remote care |
| spellingShingle | Josée G. Lavoie Sabrina T. Wong Naser Ibrahim John D. O’Neil Michael Green Amanda Ward Underutilized and undertheorized: the use of hospitalization for ambulatory care sensitive conditions for assessing the extent to which primary healthcare services are meeting needs in British Columbia First Nation communities BMC Health Services Research Avoidable hospitalization Indigenous populations Primary care Rural and remote care |
| title | Underutilized and undertheorized: the use of hospitalization for ambulatory care sensitive conditions for assessing the extent to which primary healthcare services are meeting needs in British Columbia First Nation communities |
| title_full | Underutilized and undertheorized: the use of hospitalization for ambulatory care sensitive conditions for assessing the extent to which primary healthcare services are meeting needs in British Columbia First Nation communities |
| title_fullStr | Underutilized and undertheorized: the use of hospitalization for ambulatory care sensitive conditions for assessing the extent to which primary healthcare services are meeting needs in British Columbia First Nation communities |
| title_full_unstemmed | Underutilized and undertheorized: the use of hospitalization for ambulatory care sensitive conditions for assessing the extent to which primary healthcare services are meeting needs in British Columbia First Nation communities |
| title_short | Underutilized and undertheorized: the use of hospitalization for ambulatory care sensitive conditions for assessing the extent to which primary healthcare services are meeting needs in British Columbia First Nation communities |
| title_sort | underutilized and undertheorized the use of hospitalization for ambulatory care sensitive conditions for assessing the extent to which primary healthcare services are meeting needs in british columbia first nation communities |
| topic | Avoidable hospitalization Indigenous populations Primary care Rural and remote care |
| url | http://link.springer.com/article/10.1186/s12913-018-3850-y |
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