PT  - JOURNAL ARTICLE
AU  - McLane, Patrick
AU  - Barnabe, Cheryl
AU  - Mackey, Leslee
AU  - Bill, Lea
AU  - Rittenbach, Katherine
AU  - Holroyd, Brian R.
AU  - Bird, Anne
AU  - Healy, Bonnie
AU  - Janvier, Kris
AU  - Louis, Eunice
AU  - Rosychuk, Rhonda J.
TI  - First Nations status and emergency department triage scores in Alberta: a retrospective cohort study
AID  - 10.1503/cmaj.210779
DP  - 2022 Jan 17
TA  - Canadian Medical Association Journal
PG  - E37--E45
VI  - 194
IP  - 2
4099  - http://www.cmaj.ca/content/194/2/E37.short
4100  - http://www.cmaj.ca/content/194/2/E37.full
SO  - CMAJ2022 Jan 17; 194
AB  - Background: Previous studies have found that race is associated with emergency department triage scores, raising concerns about potential health care inequity. As part of a project on quality of care for First Nations people in Alberta, we sought to understand the relation between First Nations status and triage scores.Methods: We conducted a population-based retrospective cohort study of health administrative data from April 2012 to March 2017 to evaluate acuity of triage scores, categorized as a binary outcome of higher or lower acuity score. We developed multivariable multilevel logistic mixed-effects regression models using the levels of emergency department visit, patient (for patients with multiple visits) and facility. We further evaluated the triage of visits related to 5 disease categories and 5 specific diagnoses to better compare triage outcomes of First Nations and non–First Nations patients.Results: First Nations status was associated with lower odds of receiving higher acuity triage scores (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.92–0.94) compared with non–First Nations patients in adjusted models. First Nations patients had lower odds of acute triage for all 5 disease categories and for 3 of 5 diagnoses, including long bone fractures (OR 0.82, 95% CI 0.76–0.88), acute upper respiratory infection (OR 0.90, 95% CI 0.84–0.98) and anxiety disorder (OR 0.67, 95% CI 0.60–0.74).Interpretation: First Nations status was associated with lower odds of higher acuity triage scores across a number of conditions and diagnoses. This may reflect systemic racism, stereotyping and potentially other factors that affected triage assessments.