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Baiju R. Shah, MD, Nadia Gunraj, MPH and Janet E. Hux, MD, SM

The authors are with the Institute for Clinical Evaluative Sciences, Toronto, Ontario. Baiju R. Shah and Janet E. Hux are also with the Department of Medicine and the Clinical Epidemiology and Health Care Research Program, University of Toronto.

Correspondence: Requests for reprints should be sent to Janet E. Hux, MD, SM, Institute for Clinical Evaluative Sciences, Rm G1 06, 2075 Bayview Ave, Toronto, ON, Canada, M4N 3M5 (e-mail: jan{at}ices.on.ca).

Objectives. We evaluated primary care accessibility and quality for Ontario’s aboriginal population.

Methods. We compared a defined aboriginal cohort with nonaboriginal populations with analogous geographic isolation and low socioeconomic status. We determined rates of hospitalization for the following indicators of adequacy of primary care: ambulatory care–sensitive (ACS) conditions and utilization of referral care–sensitive (RCS) procedures from administrative databases.

Results. ACS hospitalization rates, relative to the general population, were 2.54, 1.50, and 1.14 for the aboriginal population, the geographic control populations, and the socioeconomic control populations, respectively. The relative RCS procedure utilization rates were 0.64, 0.91, and 1.00, respectively.

Conclusions. The increased ACS hospitalization rate and reduced RCS procedure utilization rate suggest that northern Ontario’s aboriginal residents have insufficient or ineffective primary care.

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