Markers of access to and quality of primary care for aboriginal people in Ontario, Canada.
OBJECTIVE
We evaluated primary care accessibility and quality for Ontario's aboriginal population.


METHODS
We compared a defined aboriginal cohort with nonaboriginal populations with analogous geographic isolation and low socioeconomic status. We determined rates of hospitalization for the following indicators of adequacy of primary care: ambulatory care-sensitive (ACS) conditions and utilization of referral care-sensitive (RCS) procedures from administrative databases.


RESULTS
ACS hospitalization rates, relative to the general population, were 2.54, 1.50, and 1.14 for the aboriginal population, the geographic control populations, and the socioeconomic control populations, respectively. The relative RCS procedure utilization rates were 0.64, 0.91, and 1.00, respectively.


CONCLUSIONS
The increased ACS hospitalization rate and reduced RCS procedure utilization rate suggest that northern Ontario's aboriginal residents have insufficient or ineffective primary care.
Shah
Baiju R
BR
Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue, Toronto, Ontario, Canada M4N 3M5.
Gunraj
Nadia
N
Hux
Janet E
JE
D000208:Acute Disease / Q000145:classification / Q000453:epidemiology; D000553:Ambulatory Care / Q000145:classification*; D044467:American Indian or Alaska Native / Q000706:statistics & numerical data*; D019352:Censuses; D002908:Chronic Disease / Q000145:classification / Q000453:epidemiology; D015331:Cohort Studies; D003628:Database Management Systems; D005843:Geography; D006297:Health Services Accessibility; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008507:Medically Underserved Area; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D040442:Public Health Informatics; D019984:Quality Indicators, Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014600:Utilization Review