Markers of access to and quality of primary care for aboriginal people in Ontario, Canada

Abstract

Objectives: 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.

FIGURE 1

—Relative admission rates for ambulatory care–sensitive conditions for the aboriginal population and the geographic and socioeconomic control populations, compared with the general population: Ontario, Canada, 1994–1995 and 1998–1999.

FIGURE 2

—Relative utilization rates for referral care–sensitive procedures for the aboriginal population and the geographic and socioeconomic control populations, compared with the general population: Ontario, Canada, 1994–1995 and 1998–1999.

FIGURE 3

—Relative admission rates for insensitive conditions for the aboriginal population and the geographic and socioeconomic control populations, compared with the general population: Ontario, Canada, 1994–1995 and 1998–1999.