Advancing health equity for Indigenous peoples in Canada: development of a patient complexity assessment framework

被引:1
作者
Sehgal, Anika [1 ]
Henderson, Rita [1 ]
Murry, Adam [2 ]
Crowshoe, Lynden [1 ]
Barnabe, Cheryl [3 ]
机构
[1] Univ Calgary, Cumming Sch Med, Dept Family Med, 3330 Hosp Dr NW, Calgary, AB T2N 4N1, Canada
[2] Univ Calgary, Dept Psychol, 2500 Univ Dr NW, Calgary, AB T2N 1N4, Canada
[3] Univ Calgary, Cumming Sch Med, Dept Med, 3330 Hosp Dr NW, Calgary, AB T2N 4N1, Canada
来源
BMC PRIMARY CARE | 2024年 / 25卷 / 01期
关键词
Health equity; Social determinants of health; Health care disparities; Health economics; Primary care; CONFIRMATORY FACTOR-ANALYSIS; PREDICTIVE-VALIDITY; CULTURAL-ADAPTATION; ABORIGINAL PEOPLES; BRITISH-COLUMBIA; DELPHI TECHNIQUE; PRIMARY-CARE; 1ST NATIONS; DETERMINANTS; INUIT;
D O I
10.1186/s12875-024-02362-z
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background Indigenous patients often present with complex health needs in clinical settings due to factors rooted in a legacy of colonization. Healthcare systems and providers are not equipped to identify the underlying causes nor enact solutions for this complexity. This study aimed to develop an Indigenous-centered patient complexity assessment framework for urban Indigenous patients in Canada.Methods A multi-phased approach was used which was initiated with a review of literature surrounding complexity, followed by interviews with Indigenous patients to embed their lived experiences of complexity, and concluded with a modified e-Delphi consensus building process with a panel of 14 healthcare experts within the field of Indigenous health to identify the domains and concepts contributing to health complexity for inclusion in an Indigenous-centered patient complexity assessment framework. This study details the final phase of the research.Results A total of 27 concepts spanning 9 domains, including those from biological, social, health literacy, psychological, functioning, healthcare access, adverse life experiences, resilience and culture, and healthcare violence domains were included in the final version of the Indigenous-centered patient complexity assessment framework.Conclusions The proposed framework outlines critical components that indicate the presence of health complexity among Indigenous patients. The framework serves as a source of reference for healthcare providers to inform their delivery of care with Indigenous patients. This framework will advance scholarship in patient complexity assessment tools through the addition of domains not commonly seen, as well as extending the application of these tools to potentially mitigate racism experienced by underserved populations such as Indigenous peoples.
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页数:15
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