First Nations status and emergency department triage scores in Alberta: a retrospective cohort study

Abstract

Background: Previous studies have We developed multivariable multilevel patients in adjusted models. First found that race is associated with emerlogistic mixed-effects regression models Nations patients had lower odds of gency department triage scores, raising using the levels of emergency depart-acute triage for all 5 disease categories concerns about potential health care ment visit, patient (for patients with and for 3 of 5 diagnoses, including long inequity. As part of a project on quality multiple visits) and facility. We further bone fractures (OR 0.82, 95% CI 0.76–of care for First Nations people in evaluated the triage of visits related to 0.88), acute upper respiratory infection Alberta, we sought to understand the 5 disease categories and 5 specific diag(OR 0.90, 95% CI 0.84–0.98) and anxiety relation between First Nations status noses to better compare triage out-disorder (OR 0.67, 95% CI 0.60–0.74). and triage scores. comes of First Nations and non–First Nations patients. Interpretation: First Nations status was Methods: We conducted a population-associated with lower odds of higher based retrospective cohort study of Results: First Nations status was associacuity triage scores across a number of health administrative data from April ated with lower odds of receiving higher conditions and diagnoses. This may 2012 to March 2017 to evaluate acuity of acuity triage scores (odds ratio [OR] 0.93, reflect systemic racism, stereotyping triage scores, categorized as a binary 95% confidence interval [CI] 0.92–0.94) and potentially other factors that outcome of higher or lower acuity score. compared with non–First Nations affected triage assessments.