Healthcare utilization for arthritis by indigenous populations of Australia, Canada, New Zealand, and the United States: A systematic review ☆

Adalberto Loyola Sánchez · Kelle Hurd · Cheryl C.M. Barnabe

44 citations0/0 files storedSeminars in Arthritis and Rheumatism

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Indigenous Health, Education, and Rights Musculoskeletal pain and rehabilitation Indigenous Health and Education

Abstract

PURPOSE: Indigenous populations of Australia, Canada, New Zealand, and the United States of America (USA) experience a higher prevalence of arthritis conditions. Differences in clinical outcomes and mortality may reflect healthcare service use inequities. The objective of this study was to summarize healthcare service use patterns described in the existing literature in order to identify gaps and inform strategies to limit the pronounced negative impact of arthritis on Indigenous populations. METHODS: Medline, EMBASE, CINAHL, and Indigenous-specific electronic databases (to June 2015) were used to identify cohort, case-control and cross-sectional studies describing healthcare service use by Indigenous populations with specified inflammatory arthritis, osteoarthritis, or rheumatic disease conditions. We extracted information on the study setting and methodology, primary outcome and assessed study quality, and risk of bias. RESULTS: In total, 19 studies were identified describing three types of healthcare service use: physician visits, hospitalizations, and surgeries. In Canada and New Zealand, Indigenous populations had 36-51% fewer visits to specialists than the non-Indigenous population. Indigenous populations in Canada, New Zealand, and the USA had 37-300% more hospitalizations due to arthritis complications than the non-Indigenous population. Indigenous populations in Australia, Canada, and New Zealand had 27-85% fewer arthroplasties for osteoarthritis than the non-Indigenous population. CONCLUSIONS: Indigenous populations had higher hospitalization rates but lower use of specialized services for arthritis conditions. Strategies to improve access to specialized arthritis services might reduce health outcome inequities.

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References

2011GRADE guidelines: 3. Rating the quality of evidence 2005The Embodiment of Inequity: Health Disparities in Aboriginal Canada 2000Socio-economic status and the utilisation of physicians' services: results from the Canadian National Population Health Survey 2009Access as a policy-relevant concept in low- and middle-income countries 2007Understanding barriers to health care: a review of disparities in health care services among indigenous populations 2014Discordant indigenous and provider frames explain challenges in improving access to arthritis care: a qualitative study using constructivist grounded theory 2010Indigenous Health – Australia, Canada, New Zealand and the United States - Laying Claim to a Future that Embraces Health for Us All.2008Arthritis in Aboriginal Manitobans: evidence for a high burden of disease.

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2016Systematic review of rheumatic disease phenotypes and outcomes in the Indigenous populations of Canada, the USA, Australia and New Zealand 2018Characterization of indigenous community engagement in arthritis studies conducted in Canada, United States of America, Australia and New Zealand

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