Gaps in surgery outcomes for Inuit in Canada identified through new study

Researchers in Canada have identified gaps in surgery outcomes in Inuit patients.

Using data from The Ottawa Hospital, which is the quaternary care provider to the Qikiqtani-Qikiqtaaluk Region, home to half of the Nunavut Inuit population, researchers found that Nunavut Inuit were 25% more likely to experience serious complications after surgery. The study found the death or complication rate among the general population to be 16%.

The team had previously found that little research has been done on Indigenous Peoples’ outcomes after of surgery in Canada, and none about Inuit patients.

The researchers think these poorer outcomes may be due to barriers in accessing timely and culturally appropriate healthcare, causing Nunavut Inuit to arrive at surgery with more advanced disease which increases their risk of complications.

The research team looked at outcomes one month after surgery for all inpatient surgeries at The Ottawa Hospital between 2011 and 2018, not including obstetric or cardiac surgeries. Nunavut Inuit patients made up 928 (0.9%) of the 98,701 surgeries.

Nunavut Inuit patients who had elective surgeries and cancer surgeries were respectively 58% and 63% more likely to have complications compared to non-Inuit patients. There was no difference in outcomes after emergency surgery between Inuit and non-Inuit patients.

Compared to non-Inuit patients, Nunavut Inuit had higher rates of hospital readmission, greater length of stay, higher cost of hospital care, and a greater chance of being sent to long-term care or other assisted living facility instead of going home after surgery.

The researchers also showed for the first time that Inuit and non-Inuit patients coming for surgery had different baseline health characteristics. Inuit patients were on average eight years younger than non-Inuit patients, and had a different distribution of chronic diseases and conditions.

The researchers were able to identify Nunavut Inuit in this study thanks to a code in their Nunavut health card number that indicates they are an Inuit Land Claim Beneficiary. Indigenous identity data isn’t routinely collected by healthcare organizations, making this kind of research difficult. For example, patients from the large urban Inuit population in Ottawa could not be identified as Inuit in this study, because their Inuit identity is not collected in health data.

The researchers want to reassure Inuit patients who need surgery at The Ottawa Hospital that surgery is still very safe and that they will receive the best possible care.

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