Article Figures & Tables
Tables
- Table 1:
Characteristics of patients and emergency department visits by First Nations status
Characteristic No. (%) of visits* First Nations
n = 1 055 043Non–First Nations
n = 10 161 195Age, yr, mean ± SD 31.21 ± 20.36 38.46 ± 24.52 Gender Male 478 870 (45.4) 4 942 934 (48.6) Female 576 173 (54.6) 5 218 261 (51.4) Comorbidity None 339 824 (32.2) 2 925 455 (28.8) 1 or more 715 219 (67.8) 7 235 740 (71.2) Income, $ < 42 000 445 829 (42.3) 1 948 075 (19.2) ≥ 42 000 609 214 (57.7) 8 213 120 (80.8) Zone of patient residence South 108 197 (10.3) 861 299 (8.5) Calgary 129 991 (12.3) 3 056 954 (30.1) Central 156 393 (14.8) 1 631 661(16.1) Edmonton 1 59 128 (15.1) 2 419 038 (23.8) North 501 334 (47.5) 2 192 243 (21.6) Travel distance, km ≤ 5 462 461 (43.8) 5 509 437 (54.2) > 5 592 582 (56.2) 4 651 758 (45.8) Ambulance arrival Yes 158 244 (15.0) 1 012 716 (10.0) No 896 799 (85.0) 9 148 479 (90.0) Shift Morning 121 112 (11.5) 1 177 637 (11.6) Day 472 573 (44.8) 5 115 377 (50.3) Evening 461 358 (43.7) 3 868 181 (38.1) Facility type Community ambulatory or urgent care centre 69 228 (6.6) 1 410 937 (13.9) Tertiary pediatric 28 837 (2.7) 569 843 (5.6) Tertiary mixed 78 750 (7.5) 957 747 (9.4) Regional hospital 174 717 (16.6) 3 010 641 (29.6) Large community hospital 130 373 (12.4) 775 638 (7.6) Medium community hospital 221 415 (21.0) 1 384 923 (13.6) Small community hospital 351 723 (33.3) 2 051 466 (20.2) Disposition Admitted 64 506 (6.1) 802 273 (7.9) Discharged 902 137 (85.5) 8 804 266 (86.6) Deceased in ED 430 (0.0) 6311 (0.1) Transferred 19 354 (1.8) 182 550 (1.8) Left without being seen 44 159 (4.2) 273 807 (2.7) Left against medical advice 24 457 (2.3) 91 988 (0.9) Note: ED = emergency department, SD = standard deviation.
↵* Unless indicated otherwise.
- Table 2:
Association of variables on higher triage acuity scores for all emergency care visits*
Variable OR 95 % LCL 95 % UCL First Nations status v. non–First Nations 0.93 0.92 0.94 Male sex v. female or other sex 1.12 1.11 1.12 Age, per 10-year increment 1.01 1.01 1.01 1 or more comorbidities v. 0 comorbidities 1.52 1.51 1.53 Neighbourhood income < $42 000 v. ≥ $42 000 1.02 1.01 1.02 Trip distance > 5 km v. ≤ 5 km 1.06 1.06 1.07 Arrival by air or ground ambulance v. not arriving by ambulance 2.60 2.59 2.62 Shift Day presentation (8:01–16:00) Ref. Ref. Ref. Evening presentation (16:01–00:00) 1.23 1.22 1.24 Night presentation (00:01–8:00) 1.34 1.33 1.35 Facility Large community hospital Ref. Ref. Ref. Community ambulatory or urgent care centre 1.24 1.23 1.26 Tertiary pediatric hospital 2.63 2.60 2.67 Tertiary mixed hospital 4.48 4.44 4.53 Regional hospital 3.25 3.22 3.28 Medium community hospital 1.06 1.04 1.07 Small community hospital 0.59 0.58 0.60 Zone Calgary Ref. Ref. Ref. North 0.37 0.36 0.37 Edmonton 0.55 0.55 0.56 Central 0.43 0.43 0.44 South 0.25 0.25 0.25 Note: LCL = lower confidence limit, OR = odds ratio, UCL = upper confidence limit, Ref. = reference.
↵* Multivariable, multilevel logistic mixed-effects regression model, with levels for emergency department visit, patient and facility. Models adjust for patient age, patient sex, comorbidities, area income, distance between patient residence and nearest hospital, mode of arrival (i.e., by ambulance or not), facility type presented to and zone of patient residence.
- Table 3:
Association of First Nations status with higher acuity triage scores derived from models for emergency department visits related to disease categories and diagnoses*
Variable OR 95 % LCL 95% UCL Disease category Trauma and injury 0.91 0.89 0.93 Infection 0.90 0.88 0.93 Substance use 0.83 0.79 0.86 Obstetrics and gynecology 0.89 0.84 0.94 Mental health 0.90 0.87 0.94 Specific diagnoses Long bone fractures 0.82 0.76 0.88 Acute upper respiratory infection, unspecified 0.90 0.84 0.98 Opioid-related diagnoses 1.12 1.00 1.26 Spontaneous abortion 0.99 0.89 1.09 Anxiety disorder, unspecified 0.67 0.60 0.74 Note: LCL = lower confidence limit, OR = odds ratio, UCL = upper confidence limit.
↵* Multivariable, multilevel logistic mixed-effects regression model, with levels for emergency department visit, patient and facility. Models adjust for patient age, patient sex, comorbidities, area income, distance between patient residence and nearest hospital, mode of arrival (i.e., by ambulance or not), facility type presented to and zone of patient residence.
- Table 4:
Interaction of First Nations status with variables predicting higher triage acuity for all emergency department visits*
Variable First Nations Non–First Nations p value† OR 95 % LCL 95 % UCL OR 95 % LCL 95 % UCL Male sex v. female sex 1.13 1.11 1.15 1.12 1.11 1.12 0.42 Age, per 10-year increment 1.00 0.99 1.00 1.01 1.01 1.01 < 0.001 1 or more comorbidities v. 0 comorbidities 1.31 1.28 1.34 1.57 1.56 1.58 < 0.001 Neighbourhood income < $42 000 v. ≥ $42 000 0.91 0.89 0.93 1.01 1.01 1.02 < 0.001 Trip distance > 5 km v. ≤ 5 km 1.04 1.01 1.06 1.06 1.05 1.06 0.35 Arrival by air or ground ambulance v. not arriving by ambulance 3.57 3.50 3.64 2.51 2.50 2.53 < 0.001 Shift Day presentation (8:01–16:00) Ref. Ref. Ref. Ref. Ref. Ref. Evening presentation (16:01–00:00) 1.18 1.16 1.20 1.24 1.23 1.24 < 0.001 Night presentation (00:01–8:00) 1.38 1.35 1.47 1.32 1.31 1.33 < 0.001 Facility Large community hospital Ref. Ref. Ref. Ref. Ref. Ref. Community ambulatory or urgent care centre 1.41 1.35 1.47 1.24 1.23 1.26 < 0.001 Tertiary pediatric hospital 4.15 3.97 4.34 2.56 2.52 2.59 < 0.001 Tertiary mixed hospital 4.58 4.43 4.72 4.55 4.50 4.60 0.74 Regional hospital 3.30 3.20 3.39 3.27 3.24 3.30 0.60 Medium community hospital 1.05 1.01 1.08 1.08 1.06 1.09 0.11 Small community hospital 0.47 0.44 0.49 0.62 0.61 0.63 < 0.001 Zone Calgary Ref. Ref. Ref. Ref. Ref. Ref. North 0.36 0.35 0.37 0.37 0.37 0.37 0.35 Edmonton 0.51 0.49 0.52 0.55 0.55 0.56 < 0.001 Central 0.43 0.41 0.44 0.43 0.42 0.43 0.96 South 0.21 0.20 0.22 0.26 0.25 0.26 < 0.001 Note: LCL = lower confidence limit, OR = odds ratio, UCL = upper confidence limit.
↵* Multivariable, multilevel logistic mixed-effects regression model, with levels for emergency department visit, patient and facility, and interaction terms between First Nations status and all independent variables. Models adjust for patient age, patient sex, comorbidities, area income, distance between patient residence and nearest hospital, mode of arrival (i.e., by ambulance or not), facility type presented to and zone of patient residence.
↵† p value represents significance of difference for the interaction of First Nations and non-First Nations status.