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Canadian Respiratory Journal
Volume 11, Issue 5, Pages 336-342
Original Article

Hospitalization for Community Acquired Pneumonia in Alberta First Nations Aboriginals Compared with Non-First Nations Albertans

Thomas J Marrie,1 Keumhee C Carriere,2 Yan Jin,3 and David H Johnson4

1Department of Medicine, University of Alberta, Edmonton, Canada
2Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Canada
3Research and Evidence, Alberta Health and Wellness, Edmonton, Canada
4Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada

Copyright © 2004 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: The rates and outcomes of hospital admission for community-acquired pneumonia between First Nations Aboriginal and non-First Nations groups were compared.

METHODS: Alberta administrative hospital abstracts from April 1, 1997, to March 31, 1999, were analyzed, and each case of a First Nations Aboriginal person with pneumonia was matched by age and sex with three non-First Nations persons with pneumonia.

RESULTS: The First Nations Aboriginal age and sex-adjusted hospital discharge rate was 22 per 1000 (95% CI 20.7 to 23.6) compared with 4.4 per 1000 (95% CI 4.4 to 4.5) for the general population of Alberta. After accounting for comorbidity and severity of pneumonia, in-hospital mortality and hospital length of stay were lower for First Nations Aboriginals compared with the matched non-First Nations group (odds ratio 0.49; 95% CI 0.37 to 0.66, and odds ratio 0.87; 95% CI 0.79 to 0.97, respectively). The odds for 30-day hospital readmission were higher in First Nations Aboriginals compared with the non-First Nations group (odds ratio 1.42; 95% CI 1.21 to 1.68). The cost per hospital admission for First Nations Aboriginals was 94% of the average cost for the matched non-First Nations group (CDN$4,206). However, their median daily cost was 1.25 times higher (95% CI 1.14 to 1.36) than the matched non-First Nations group.

CONCLUSIONS: First Nations Aboriginals had higher rates of hospitalization, rehospitalization and hospital costs for community-acquired pneumonia than non-First Nations Albertans. It was unlikely that the high rate of hospitalizations in First Nations Aboriginals was due to more severe pneumonia or greater comorbidity. Other unexplained factors increase the burden of this disease in First Nation Aboriginals.