Study finds failures in care among First Nations patients

First Nations patients are more likely to leave Alberta emergency departments before receiving care than other patients — and anti-Indigenous racism is a significant reason why, a new study says.

“The stories are incredibly powerful,” said Patrick McLane, the lead author of the study published Monday in the Canadian Medical Association Journal.

Although the study was conducted in Alberta, the findings likely apply to emergency department visits across Canada, he said.

The researchers had previously analyzed data from more than 11.6 million emergency department visits in Alberta between April 2012 and March 2017. More than one million of those visits were made by First Nations patients.

The analysis found 6.8 per cent of First Nations patients left emergency departments either before being seen or against medical advice. That’s compared with just 3.7 per cent of non-First Nations patients.

In the current study, the researchers wanted to see if there were any other factors that could explain the discrepancy, so they went back to the data and controlled for several variables. At the end of that analysis, First Nations status was the only apparent explanation for the difference in rates of leaving before receiving care, the study found.

“Leaving without completing care matters because it delays needed care and interrupts the care journey,” said Bonnie Healy, co-author of the study and former executive director of the Alberta First Nations Information Governance Center, which was a partner in conducting the research.

To dig deeper into why First Nations patients left before receiving care, the researchers did a qualitative study with 64 people — including sharing circles with First Nations participants — as well as interviews and a focus group with health-care providers. The qualitative study was conducted between 2019 and 2022.

One First Nations person who was in a vehicle crash and feeling dizzy said instead of being evaluated by a doctor, the emergency department immediately brought in an addictions counsellor.

Other study participants described First Nations patients being subjected to long waits.

“It’s almost like they’re put somewhere to wait it out,” a health director working with First Nations patients said.

“They’re basically left waiting so these people get frustrated and they walk out because they don’t feel important enough to be seen.”