Open Collections

UBC Faculty Research and Publications

Imbalance of Prevalence and Specialty Care for Osteoarthritis for First Nations People in Canada Barnabe, Cheryl; Hemmelgarn, Brenda R.; Jones, Catherine Allyson, 1959-; Peschken, Christine A.; Voaklander, Don; Joseph, Lawrence; Bernatsky, Sasha, 1967-; Esdaile, John; Marshall, Deborah A.

Abstract

Objective: Estimate the population-based prevalence and healthcare use for osteoarthritis (OA) by First Nations (FN) and non-First Nations (non-FN) in Alberta. Methods: A cohort of adults with OA (≥2 physician claims in 2 years or 1 hospitalization with ICD-9-CM code 715x or ICD-10-CA code M15-19, years 1993-2010) was defined, with FN determination by premium payer status. Prevalence rates (2007/8) were estimated from the cohort and the population registered with the Alberta Health Care Insurance Plan. Rates of outpatient primary care and specialist (orthopedics, rheumatology, internal medicine) visits; arthroplasty (hip and knee); and all-cause hospitalization were estimated. Results: OA prevalence in FN was twice that of the non-FN population (16.1 vs 7.8 cases/100 population; standardized rate ratio (SRR) adjusted for age and sex 2.06, 95%CI 2.00-2.12). The SRR (adjusted for age, sex and location of residence) for primary care visits for OA was nearly double in FN compared to non-FN (SRR 1.88, 95%CI 1.87-1.89), and internal medicine visits were increased (SRR 1.25, 95%CI 1.25-1.26). Visit rates with an orthopedic surgeon (SRR 0.49, 95%CI 0.48-0.50) or rheumatologist (SRR 0.62, 95%CI 0.62-0.63) were substantially lower in FN with OA. Hip and knee arthroplasties were performed less frequently in FN with OA (SRR 0.48, 95%CI 0.47-0.49), but all-cause hospitalization rates were higher (SRR 1.59, 95%CI 1.58-1.60). Conclusion: We estimate a 2-fold higher prevalence of OA in the FN population, with differential healthcare use. Reasons for higher use of primary care and lower use of specialty services and arthroplasty compared to the general population are not yet understood.

Item Metadata

Title
Imbalance of Prevalence and Specialty Care for Osteoarthritis for First Nations People in Canada
Creator
Barnabe, Cheryl; Hemmelgarn, Brenda R.; Jones, Catherine Allyson, 1959-; Peschken, Christine A.; Voaklander, Don; Joseph, Lawrence; Bernatsky, Sasha, 1967-; Esdaile, John; Marshall, Deborah A.
Date Issued
2014-11-29
Description
Objective: Estimate the population-based prevalence and healthcare use for osteoarthritis (OA) by First Nations (FN) and non-First Nations (non-FN) in Alberta. Methods: A cohort of adults with OA (≥2 physician claims in 2 years or 1 hospitalization with ICD-9-CM code 715x or ICD-10-CA code M15-19, years 1993-2010) was defined, with FN determination by premium payer status. Prevalence rates (2007/8) were estimated from the cohort and the population registered with the Alberta Health Care Insurance Plan. Rates of outpatient primary care and specialist (orthopedics, rheumatology, internal medicine) visits; arthroplasty (hip and knee); and all-cause hospitalization were estimated. Results: OA prevalence in FN was twice that of the non-FN population (16.1 vs 7.8 cases/100 population; standardized rate ratio (SRR) adjusted for age and sex 2.06, 95%CI 2.00-2.12). The SRR (adjusted for age, sex and location of residence) for primary care visits for OA was nearly double in FN compared to non-FN (SRR 1.88, 95%CI 1.87-1.89), and internal medicine visits were increased (SRR 1.25, 95%CI 1.25-1.26). Visit rates with an orthopedic surgeon (SRR 0.49, 95%CI 0.48-0.50) or rheumatologist (SRR 0.62, 95%CI 0.62-0.63) were substantially lower in FN with OA. Hip and knee arthroplasties were performed less frequently in FN with OA (SRR 0.48, 95%CI 0.47-0.49), but all-cause hospitalization rates were higher (SRR 1.59, 95%CI 1.58-1.60). Conclusion: We estimate a 2-fold higher prevalence of OA in the FN population, with differential healthcare use. Reasons for higher use of primary care and lower use of specialty services and arthroplasty compared to the general population are not yet understood.
Subject
Osteoarthritis; Epidemiology; Health services research; American Native continental ancestry group
Genre
Article; Postprint
Type
Text
Language
eng
Date Available
2020-01-09
Provider
Vancouver : University of British Columbia Library
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
DOI
10.14288/1.0388217
URI
http://hdl.handle.net/2429/73239
Affiliation
Medicine, Faculty of; Non UBC; Population and Public Health (SPPH), School of
Citation
Barnabe C, Hemmelgarn B, Jones CA, Preschken CA, Voaklander D, Joseph L, Bernatsky S, Esdaile JM, Marshall DA. Imbalance of prevalence and specialty care for osteoarthritis for First Nations people in Alberta, Canada. J Rheumatol. 2015 Feb;42(2):323-8.
Publisher DOI
10.3899/jrheum.140551
Peer Review Status
Reviewed
Scholarly Level
Faculty
Rights URI
http://creativecommons.org/licenses/by-nc-nd/4.0/
Aggregated Source Repository
DSpace

Item Media

Item Citations and Data

Rights

Attribution-NonCommercial-NoDerivatives 4.0 International