Hospitalizations due to unintentional transport injuries among Aboriginal population of British Columbia, Canada: Incidence, changes over time and ecological analysis of risk markers

Brussoni, Mariana; George, M. Anne; Jin, Andrew; Amram, Ofer; McCormick, Rod; Lalonde, Christopher E.

doi:10.1371/journal.pone.0191384

Cited by 9 publications

(11 citation statements)

References 31 publications

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“…Transport injuries around the world often result in significant physical and psychological impairments and reduced quality of life [ 1 , 2 ]. Every year, road traffic accidents cost most countries in excess of 3% of their gross domestic product (GDP), and between 20 and 50 million people suffer non-fatal injuries, with many incurring a consequent disability [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of healthcare service utilization after transport-related injuries by a mixture of hidden Markov models

et al. 2018

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BackgroundTransport injuries commonly result in significant disease burden, leading to physical disability, mental health deterioration and reduced quality of life. Analyzing the patterns of healthcare service utilization after transport injuries can provide an insight into the health of the affected parties, allow improved health system resource planning, and provide a baseline against which any future system-level interventions can be evaluated. Therefore, this research aims to use time series of service utilization provided by a compensation agency to identify groups of claimants with similar utilization patterns, describe such patterns, and characterize the groups in terms of demographic, accident type and injury type.MethodsTo achieve this aim, we have proposed an analytical framework that utilizes latent variables to describe the utilization patterns over time and group the claimants into clusters based on their service utilization time series. To perform the clustering without dismissing the temporal dimension of the time series, we have used a well-established statistical approach known as the mixture of hidden Markov models (MHMM). Ensuing the clustering, we have applied multinomial logistic regression to provide a description of the clusters against demographic, injury and accident covariates.ResultsWe have tested our model with data on psychology service utilization from one of the main compensation agencies for transport accidents in Australia, and found that three clear clusters of service utilization can be evinced from the data. These three clusters correspond to claimants who have tended to use the services 1) only briefly after the accident; 2) for an intermediate period of time and in moderate amounts; and 3) for a sustained period of time, and intensely. The size of these clusters is approximately 67%, 27% and 6% of the number of claimants, respectively. The multinomial logistic regression analysis has showed that claimants who were 30 to 60-year-old at the time of accident, were witnesses, and who suffered a soft tissue injury were more likely to be part of the intermediate cluster than the majority cluster. Conversely, claimants who suffered more severe injuries such as a brain head injury or anon-limb fracture injury and who started their service utilization later were more likely to be part of the sustained cluster.ConclusionThis research has showed that clustering of service utilization time series is an effective approach for identifying the main user groups and utilization patterns of a healthcare service. In addition, using logistic regression to describe the clusters in terms of demographic, injury and accident covariates has helped identify the salient attributes of the claimants in each cluster. This finding is very important for the compensation agency and potentially other authorities as it provides a baseline to improve need understanding, resource planning and service provision.

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Section: Introductionmentioning

confidence: 99%

Analysis of healthcare service utilization after transport-related injuries by a mixture of hidden Markov models

et al. 2018

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“…This high rate extends into childhood and youth, where the risk of death due to suicide or homicide has been found to be 6.6 and 5.1 times higher among Indigenous children (Harrop et al 2007). Research in British Columbia has also indicated a high burden among Indigenous groups indicated by higher rates of hospitalization for injuries, with particularly high rates for intentional injuries (Brussoni et al 2016;George et al 2017;Jin et al 2015;Brussoni et al 2018). In the same line, compared with non-Indigenous peoples, injury-related mortality risk ratios were 2.65 and 1.89 among Métis males and females, respectively (Tjepkema et al 2009).…”

Section: Introductionmentioning

confidence: 99%

“…In the same line, compared with non-Indigenous peoples, injury-related mortality risk ratios were 2.65 and 1.89 among Métis males and females, respectively (Tjepkema et al 2009). Possible factors contributing to a high incidence of injury in Indigenous peoples include isolated residence, the physical environment, crowded and dilapidated housing conditions, lifestyle, education, occupational risk, and poor social and economic conditions (Health Canada 2001;George et al 2017;Brussoni et al 2018;Brussoni et al 2015;Jin et al 2017;George et al 2016).…”

Section: Introductionmentioning

confidence: 99%

“…More recent studies have shown that the burden of injury among Indigenous peoples is decreasing and the gap with non-Indigenous people has been narrowing in British Columbia (Brussoni et al 2016;Jin et al 2015;Brussoni et al 2018;George et al 2015). Injury hospitalizations among the Indigenous peoples of British Columbia decreased by 64.8% between 1986 and 2010 compared with a 52.6% decline across the entire province (Brussoni et al 2016).…”

Section: Introductionmentioning

confidence: 99%

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Injury-related health services use and mortality among Métis people in Alberta

Sanchez-Ramirez

Chen

Randall

et al. 2019

Can J Public Health

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Objectives To examine injury-related health services use, defined as hospital admissions and emergency department (ED) visits, as well as mortality among Métis people in Alberta, and to compare those results with the entire Alberta population. Methods This population-based descriptive epidemiological research used administrative data maintained by the Alberta Ministry of Health (AH), for the year 2013. Hospital morbidity data and Alberta Vital Statistics registry were extracted and included a unique personal number to identify individuals across multiple records. To identify injury and mortality cases among the Métis people in Alberta, administrative databases were linked to the Métis Nation of Alberta (MNA) Identification Registry. Age-standardized rates of injury-related health services usage and mortality were calculated and compared between Métis people and the entire Alberta population. Results Age-standardized incidence rates (ASIRs) of all causes combined of injury-related visits to the ED and hospital admissions were 35% (p < 0.01) and 26% (p = 0.05) higher among Métis people compared with the overall Alberta population. Among the MNA, ASIRs of health service use were higher in rural areas (p < 0.01) and among men (p < 0.01). The injury-related mortality rate was not significantly higher among the MNA compared with the Alberta population. However, among the MNA, Métis males had a significantly higher injury mortality rate than females (p < 0.02). Conclusion Results from the current study suggest that injuries are a concern among Métis people. Health planners should design and implement strategies directed to reduce the burden of injury and associated complications for Métis people, especially in rural areas and among Métis males. Résumé Objectifs Examiner l'utilisation des services de santé (hospitalisations et visites aux urgences) et la mortalité liées aux traumatismes chez les Métis de l'Alberta et comparer ces résultats à ceux de l'ensemble de la population albertaine. Méthode Pour cette étude épidémiologique populationnelle descriptive, nous avons utilisé les données administratives du ministère de la Santé de l'Alberta pour l'année 2013. Nous avons extrait les données sur la morbidité hospitalière et les statistiques de l'état civil de l'Alberta, qui incluent un numéro personnel unique permettant d'identifier les personnes d'un dossier à l'autre. Pour recenser les cas de traumatismes et de mortalité chez les Métis de l'Alberta, nous avons maillé les bases de données administratives au registre des Métis de la Nation métisse de l'Alberta (NMA). Nous avons calculé les taux d'utilisation des services de santé et de mortalité liés aux traumatismes, normalisés selon l'âge, et nous avons comparé les taux pour les Métis à ceux de l'ensemble de la population albertaine.

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“…2 More recently, a study in British Columbia found that Aboriginal people were 1.89 times more likely to experience transportrelated injury between 1991 and 2010 than the general BC population. 3 Disparities in health status as well as in Aboriginal populations' access to health care and in the quality of the care available to them have also been well documented. Traumatic spinal cord injury (TSCI) is a particularly devastating type of trauma, requiring substantial acute and chronic care.…”

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confidence: 99%

Traumatic spinal cord injuries among Aboriginal and non-Aboriginal populations of Saskatchewan: a prospective outcomes study

Ahmed¹,

Humphreys²,

Rivers³

et al. 2020

cjs

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Background: People of Aboriginal (Indigenous) ancestry are more likely to experience traumatic spinal cord injury (TSCI) than other Canadians; however, outcome studies are limited. This study aims to compare Aboriginal and non-Aboriginal populations with acute TSCI with respect to preinjury baseline characteristics, injury severity, treatment, outcomes and length of stay. Methods: This was a retrospective analysis of participants with a TSCI who were enrolled in the prospective Rick Hansen Spinal Cord Injury Registry (RHSCIR), Saskatoon site (Royal University Hospital), between Feb. 13, 2010, and Dec. 17, 2016. Demographic, injury and management data were assessed to identify any differences between the populations. Results: Of the 159 patients admitted to Royal University Hospital with an acute TSCI during the study period, 62 provided consent and were included in the study. Of these, 21 self-identified as Aboriginal (33.9%) and 41 as non-Aboriginal (66.1%) on treatment intake forms. Compared with non-Aboriginal participants, Aboriginal participants were younger, had fewer medical comorbidities, had a similar severity of neuro logic injury and had similar clinical outcomes. However, the time to discharge to the community was significantly longer for Aboriginal participants (median 104.0 v. 34.0 d, p = 0.016). Although 35% of non-Aboriginal participants were discharged home from the acute care site, no Aboriginal participants were transferred home directly. Conclusion: This study suggests a need for better allocation of resources for transition to the community for Aboriginal people with a TSCI in Saskatchewan. We plan to assess outcomes from TSCI for Aboriginal people across Canada. Contexte : Au Canada, les personnes d'origine autochtone sont plus susceptibles que les autres de vivre un traumatisme médullaire. Malgré cela, il y a peu d'études sur les conséquences de cet événement. Notre étude visait à comparer les cas de traumatisme médullaire aigu dans les populations autochtones et non autochtones sur plusieurs plans : les caractéristiques initiales des patients, la gravité du traumatisme, la nature du traitement, les issues cliniques et la durée de séjour. Méthodes : Nous avons fait une analyse rétrospective des dossiers de personnes ajoutées au Rick Hansen Spinal Cord Injury Registry (RHSCIR) [Registre des traumatismes médullaires Rick Hansen] entre le 13 février 2010 et le 17 décembre 2016 pour l'établissement de Saskatoon (l'Hôpital universitaire Royal). Nous avons comparé les renseignements de base des patients ainsi que les données sur le traumatisme et la prise en charge afin de cerner toute différence entre les populations. Résultats : Sur les 159 traumatisés médullaires admis à l'Hôpital universitaire Royal pendant la période à l'étude, 62 ont consenti à l'utilisation de leurs données. Parmi eux, 21 s'étaient identifiés comme Autochtones (33,9 %) sur le formulaire d'hospitalisation, et 41 comme non-Autochtones (66,1 %). Par rapport aux non-Autochtones, les Autochtones étaient plus jeunes, avaient moi...

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Hospitalizations due to unintentional transport injuries among Aboriginal population of British Columbia, Canada: Incidence, changes over time and ecological analysis of risk markers

Abstract: Background

Cited by 9 publications

References 31 publications

Analysis of healthcare service utilization after transport-related injuries by a mixture of hidden Markov models

Analysis of healthcare service utilization after transport-related injuries by a mixture of hidden Markov models

Injury-related health services use and mortality among Métis people in Alberta

Traumatic spinal cord injuries among Aboriginal and non-Aboriginal populations of Saskatchewan: a prospective outcomes study

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