title: Acute care hospitalization by Aboriginal identity, Canada, 2006 through 2008.
abstract: BACKGROUND
  National data about acute care hospitalization of Aboriginal people are scarce. This study addresses that information gap by describing patterns of hospitalization by Aboriginal identity for leading diagnoses for all provinces and territories except Quebec.
  
  
  METHODS
  The 2006 Census was linked to the 2006/2007-to-2008/2009 Discharge Abstract Database, which contains hospital records from all acute care facilities in Canada (excluding Quebec). With these linked data, hospital records could be examined by Aboriginal identity, as reported to the census. Hospitalizations were grouped by International Classification of Diseases (ICD-10) chapters based on "the most responsible diagnosis." Age-standardized hospitalization rates were calculated per 100,000 population, and rate ratios (RR) were calculated for Aboriginal groups relative to non-Aboriginal people.
  
  
  RESULTS
  Hospitalization rates were almost invariably higher for First Nations living on and off reserve, Métis, and Inuit living in Inuit Nunangat than for the non-Aboriginal population, regardless of ICD diagnostic chapter. The ranking of age-standardized hospitalization rates by frequency of diagnoses varied slightly by Aboriginal identity. RRs were highest among First Nations living on reserve, especially for endocrine, nutritional and metabolic diseases (RR = 4.9), mental and behavioural disorders (RR = 3.6), diseases of the respiratory system (RR = 3.3), and injuries (RR = 3.2). As well, the rate for endocrine, nutritional and metabolic diseases was high among First Nations living off reserve (RR = 2.7). RRs were also high among Inuit for mental and behavioural disorders (RR = 3.3) and for diseases of the respiratory system (RR = 2.7).
  
  
  CONCLUSIONS
  Hospitalization rates varied by Aboriginal identity, and were consistent with recognized health disparities between Aboriginal and non-Aboriginal people. Because many factors besides health affect hospital use, further research is required to understand differences in hospital use by Aboriginal identity. These national data are relevant to health policy formulation and service delivery planning.
authors.affiliation: Health Analysis Division, Statistics Canada, Ottawa, Ontario.
authors.forename: Gisèle
authors.initials: G
authors.lastname: Carrière
authors.affiliation: Health Analysis Division, Statistics Canada, Ottawa, Ontario.
authors.forename: Evelyne
authors.initials: E
authors.lastname: Bougie
authors.affiliation: Health Analysis Division, Statistics Canada, Ottawa, Ontario.
authors.forename: Dafna
authors.initials: D
authors.lastname: Kohen
authors.affiliation: Health Analysis Division, Statistics Canada, Ottawa, Ontario.
authors.forename: Michelle
authors.initials: M
authors.lastname: Rotermann
authors.affiliation: Health Analysis Division, Statistics Canada, Ottawa, Ontario.
authors.forename: Claudia
authors.initials: C
authors.lastname: Sanmartin
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D019352:Censuses; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007198:Indians, North American; D007223:Infant; D007231:Infant, Newborn; D004930:Inuit; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
keywords: Administrative data; First Nations; Inuit; Métis; census; data linkage; health care; hospital records; medical record linkage; on reserve