HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (19) Citing Articles via Google Scholar Google Scholar Articles by Shah, B. R. Articles by Hux, J. E. Search for Related Content PubMed PubMed Citation Articles by Shah, B. R. Articles by Hux, J. E. Related Collections Access to Care Quality of Care Native Americans Rural Health Socioeconomic Factors

Baiju R. Shah, MD, Nadia Gunraj, MPH and Janet E. Hux, MD, SM

The authors are with the Institute for Clinical Evaluative Sciences, Toronto, Ontario. Baiju R. Shah and Janet E. Hux are also with the Department of Medicine and the Clinical Epidemiology and Health Care Research Program, University of Toronto.

Correspondence: Requests for reprints should be sent to Janet E. Hux, MD, SM, Institute for Clinical Evaluative Sciences, Rm G1 06, 2075 Bayview Ave, Toronto, ON, Canada, M4N 3M5 (e-mail: jan{at}ices.on.ca).

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.

This article has been cited by other articles:

				S. Gao MSc, B. J. Manns MD MSc, B. F. Culleton MD, M. Tonelli MD SM, H. Quan PhD, L. Crowshoe MD, W. A. Ghali MD MPH, L. W. Svenson BSc, S. Ahmed MD MMSc, B. R. Hemmelgarn PhD MD, et al. Access to health care among status Aboriginal people with chronic kidney disease Can. Med. Assoc. J., November 4, 2008; 179(10): 1007 - 1012. [Abstract] [Full Text] [PDF]

				S. Gao, B. J. Manns, B. F. Culleton, M. Tonelli, H. Quan, L. Crowshoe, W. A. Ghali, L. W. Svenson, B. R. Hemmelgarn, and for the Alberta Kidney Disease Network Prevalence of Chronic Kidney Disease and Survival among Aboriginal People J. Am. Soc. Nephrol., November 1, 2007; 18(11): 2953 - 2959. [Abstract] [Full Text] [PDF]

				E. Wood MD PhD, J. S. Montaner MD, K. Li MSc, L. Barney RN MSN, M. W. Tyndall MD ScD, and T. Kerr PhD Rate of methadone use among Aboriginal opioid injection drug users Can. Med. Assoc. J., July 3, 2007; 177(1): 37 - 40. [Abstract] [Full Text] [PDF]

				S. W. Tobe, G. Pylypchuk, J. Wentworth, A. Kiss, J. P. Szalai, N. Perkins, S. Hartman, L. Ironstand, and J. Hoppe Effect of nurse-directed hypertension treatment among First Nations people with existing hypertension and diabetes mellitus: the Diabetes Risk Evaluation and Microalbuminuria (DREAM 3) randomized controlled trial Can. Med. Assoc. J., April 25, 2006; 174(9): 1267 - 1271. [Abstract] [Full Text] [PDF]

				S. H. Chou, M. Tonelli, J. S. Bradley, S. Gourishankar, B. R. Hemmelgarn, and for the Alberta Kidney Disease Network Quality of Care among Aboriginal Hemodialysis Patients Clin. J. Am. Soc. Nephrol., January 1, 2006; 1(1): 58 - 63. [Abstract] [Full Text] [PDF]

				G. L. Booth, J. E. Hux, J. Fang, and B. T.B. Chan Time Trends and Geographic Disparities in Acute Complications of Diabetes in Ontario, Canada Diabetes Care, May 1, 2005; 28(5): 1045 - 1050. [Abstract] [Full Text] [PDF]

				M. Tonelli, B. Hemmelgarn, B. Manns, G. Pylypchuk, C. Bohm, K. Yeates, S. Gourishankar, and J. S. Gill Death and renal transplantation among Aboriginal people undergoing dialysis Can. Med. Assoc. J., September 14, 2004; 171(6): 577 - 582. [Abstract] [Full Text] [PDF]