Urban Aboriginal health care utilization : a comparative study of Winnipeg Status Indians and other Winnipeg residents

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Gudmundson, Brian I.
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The purpose of this study was to compare urban health care service utilization between Winnipeg Status Indians and Other Winnipeg Residents. This study distinguished between a downtown Core Area (low income) and the Suburbs (higher income) of Winnipeg, Manitoba. Detailed morbidity was documented in all 18 major diagnostic categories (ICD-9-CM), providing comparisons among five age cohorts and four subpopulations defined by ethnicity (Status Indians or Other Residents) and by geography (Core Area or Suburbs). This study utilized the Manitoba provincia1 health care data base to observe and analyze a total urban Aboriginal population, specifically Status Indians (N = 12, 168) who were residents within Winnipeg. Such findings were compared with all Other Winnipeg Residents (N = 634,936). This study subdivided the Winnipeg population into four subpopulations: Core Area Status lndians; Core Area Other Residents; Suburbs Status Indians and Suburbs Other Residents. This descriptive study quantified demographic profiles and health care service utilization. The research methodology incorporated small area analysis, using a larqe data base. Analysis focused upon observations of complete hospital utilization (in-patient days per 1,000 population) and complete medical utilization (annual per capita costs) by diagnosis and five age cohorts for a twelve month period, during the 1990-91- fiscal year. Findings provided descriptive comparisons among all four study groups to Manitoba norms specified for each of 18 major diagnostic cateqories and specific for each age cohort. Data produced three products for each of the four subpopulations, including: Product. #1: Population profile by age cohort. Product #2: Hospital in-patient morbidity ratios. Product #3: Medical (physician only) services annual- per capita morbidity ratios. Results indicated that Winnipeg Status Tndians' use of health care services (both Core Area and Suburbs) was substantially higher than Other Residents of Winnipeg. Core Area Status Indians demonstrated the highest combined hospital inpatient and medical services utilization of Winnipeg's four subpopulations. Suburbs Status Indians ranked second in high health care service utilization. Core Area Other Residents ranked third, demonstrating only a few high hospital inpatient utilization findings. Suburbs Other Residents ranked fourth, demonstrating all utilization rates close to the Manitoba averages. These findings suggest that ethnicity (i.e., being a Status Indian) was a greater factor than poverty in affecting high health care service utilization in Winnipeg.