MULTIPLE ACUTE HEALTH PROBLEMS (n = 15)
Author (year, journal)	Setting	Topic	Populations’ characteristics	Outcomes	Main results	STROBE
Carrière (2016, Health Rep) (41)	All provinces except Quebec Retrospective	Acute care Hospitalisation	First Nations people on-reserve (Gr 1) First Nations people off-reserve (Gr 2) Metis (Gr 3) Inuit (Gr 4) Non-Indigenous people (Gr 5) All ages F/M	Age-standardised acute care hospitalisation rates/100,000 (95% CI)	Gr 1: 17,042 (16,901-17,183); Gr 2: 11,190 (11,005-11,379); Gr 3: 9535 (9360-9713); Gr 4: 13,227 (12,865-13,598); Gr 5: 6459 (6440-6479)	17/22
Firestone (2014, BMJ) (31)	Ontario Retrospective	ED visits, Hospitalisation	First Nations people (Gr 1) Non-First Nations people (Gr 2) ≥ 18 y.o. F/M	Number (%) of ED visits for acute reason (95% CI) Gr 1/Gr 2 Number (%) of ED visits for non-acute reasons (95% CI) Gr 1/Gr 2 Perception of availability of healthcare among First Nations adults (95% CI) Hospitalisation rates	None: 50.2% (43.9-57.5)/80.1% 1: 24.7% (18.7-30.1)/13.1% 2-5: 20.7% (15.3-26.1)/6.3% ≥ 6: 4% (1.6-6.9)/0.6% None: 54.3% (47.6-61.2)/81.2% 1: 22.4% (17.3-28.5)/12.2% 2-5: 20.4% (14.5-25.4)/6% ≥ 6: 2.9% (1-5.6)/0.6% Excellent: 16.7% (11.4-22.1); Good: 43.3% (36.1-49.6) Fair: 28.9% (23.3-35.2); Poor: 11.1% (7.9-15.6) Slightly higher among the First Nations population	18/22
Kashuba (1994, C J Public Health) (42)	Alberta Retrospective	Acute diseases Hospitalisation	Blood Indian Band people (Gr 1) Alberta’s population (Gr 2) All ages F/M	Hospital separation rate ratio for Gr 1 Patient days rate ratio for Gr 1 Age-adjusted separation rate ratio for Gr 1	Males: 2.59; Females: 2.65 Males: 2.18; Females: 2.26 Infectious and parasitic diseases: 4.09 Neoplasms: 0.32 Endocrine, nutritional and metabolic diseases: 7.48 Diseases of blood: 2.09 Mental disorders: 6.81 Diseases of the nervous system: 3.23 Diseases of the circulatory system: 1.58 Diseases of the respiratory system: 2.92 Diseases of the digestive system: 2.43 Diseases of the genitourinary system: 1.66 Diseases of the skin: 5.16 Diseases of the musculoskeletal system: 1.88 Conditions originating in the perinatal period: 1.14 Injury and poisoning: 2.79	13/22
Kendall (2016, Harm Reduct J) (43)	Ontario Retrospective	ED visits, Hospitalisation for people who use drugs	Indigenous people (Gr 1) Ottawa’s population (Gr 2) ≥ 16 y.o. F/M	Risk ratio for Gr 1 to have ≥ 2 ED visits (95% CI) Risk ratio for Gr 1 to have ≥ 1 hospitalisation (95% CI)	1.58 (0.98-2.55) 2.39 (95% CI 1.38-4.13)	19/22
Khan (2008, Crit Care Med) (119)	British Columbia Retrospective	Critical diseases Hospitalisation, ICU admissions	First Nations people (Gr 1) European descent people (Gr 2) ≥ 18 y.o. F/M	Median hospital length of stay (days) ICU median length of stay (days) ICU mortality, % (95% CI) Adjusted OR for hospital mortality (95% CI)	Gr 1: 16; Gr 2: 16 Gr 1: 5.7; Gr 2: 8.3 Gr 1: 22.2 (17.4-27.0); Gr 2: 19.0 (18.0-20.1) Gr 1: 1.24 (1.21-1.29)	19/22
Kliewer (2002, CCM and Manitoba Health) (44)	Manitoba Retrospective	Hospitalisation	Metis people (Gr 1) Manitoba’s general population (Gr 2) >15 y.o. F/M	Age-standardised hospitalisation rates/1000	Gr 1, males: 293.4; Gr 1, females: 454.2 Gr 2, males: 228.6; Gr 2, females: 301.9	15/22
Lafond (2016, J Eval Clin Pract) (104)	Saskatchewan Retrospective	ED visits, Hospitalisation	First Nations people (Gr 1) (n = 203) Non-First Nations people (Gr 2) (n = 200) All ages F/M	Emergency department admissions Adjusted mean length of stay (days) (p=0.064) Delay in discharge for Gr 1	Gr 1: 82.8%; Gr 2: 92.5% Gr 1: 12.01; Gr 2: 9.05 17.7% (Delays were related to transportation, bed availability, lack of medical equipment in the community and lack of family support)	20/22
Laupland (2006, J Crit Care) (45)	Alberta Prospective	Critical illnesses ICU admission	Indigenous people (Gr 1) Non-Indigenous people (Gr 2) ≥ 18 y.o. F/M	Annual incidence of critical illness/100,000 Annual incidence of critical illness rate ratio (95% CI; p) Odds ratio for in-hospital death for Status-Aboriginals (95% CI; p) Median ICU length of stay (p = 0.9) Overall median length of hospital stay (p <0.1)	Gr 1: 620.6; Gr 2: 302.6 2.1 (1.78-2.35; p < 0.001) 1.40 (0.88-2.23; p = 0.15) Gr 1: 1.8 days; Gr 2: 1.9 days Gr 1: 9 days; Gr 2: 11 days	16/22
Martens (2005, C J Public Health) (46)	Manitoba Retrospective	Hospitalisation	First Nations people (Gr 1) Manitoba’s general population (Gr 2) All ages F/M	Overall hospitalisation rate per person (p <0.05) Premature mortality rate/1000 (p<0.05) Overall hospital days of care per person (p<0.05)	Gr 1: 0.35; Gr 2: 0.16 Gr 1: 6.61; Gr 2: 3.30 Gr 1: 1.75; Gr 2: 1.05	15/22
Martens (2010, MCHP) (47)	Manitoba Retrospective	Hospitalisation	Metis people (Gr 1) Manitoba’s general population (Gr 2) All ages F/M	Total mortality rates/1000 Premature mortality rates/1000 Hospital separation rates/1000	Gr 1: 9.7; Gr 2: 8.4 (RR for Gr 1 = 1.15) Gr 1: 4.0; Gr 2: 3.3 (RR for Gr 1 = 1.21) Gr 1: 194; Gr 2: 154	16/22
Rivers (2013, J Adolescent Health) (19)	British Columbia Prospective	Health care access	Marginalised young men (22% were Indigenous people) 19-25 y.o. Male	Perception of health care Access to health care	Most youth had positive experiences with nurses and doctors. They preferred immediate access services (emergency room, clinics). Most youth avoided care until their problem couldn’t be ignored. Marginalised young men were more likely to have accessed emergency room.	13/22
Shah (2003, Am J Public Health) (48)	Ontario Retrospective	Hospital admissions for ambulatory care-sensitive conditions (ACSC)	Indigenous people (Gr 1) Ontario’s general population (Gr 2) All ages F/M	Risk ratio for admission for ACSC Risk ratio for utilisation of specialist procedures Risk ratio for utilisation of acute care for insensitive conditions	Gr 1: 2.54 (p <0.001) Gr 1: 0.64 (p <0.001) Gr 1: 1.39 (p <0.001)	14/22
Stergiopoulos (2016, Psychiatr Serv) (26)	British Columbia, Manitoba, Ontario, Quebec, New Brunswick Retrospective	ED visits	Indigenous people (Gr 1) White people (Gr 2) Black people (Gr 3) Adults F/M	Unmet need for health care Adjusted RR for ED visits for Gr 1 (95% CI; p) Adjusted RR for hospital days for Gr 1 (95% CI; p)	Gr 1: 52%; Gr 2: 50%; Gr 3: 32% 0.85 (0.71-1.01; p = 0.07) 0.91 (0.64-1.29; 0.60)	14/22
Waldram (1991, Artic Med Res) (27)	Saskatchewan Prospective	ED visits	Indigenous people (Gr 1) Non-Indigenous people (Gr 2) All ages F/M	Time from onset of symptoms to contact with a physician (not statistically significant) % of patients who visited an ED in the past year (not statistically significant)	Gr 1: 3.8 days Gr 2 5.0 days Gr 1: 51% Gr 2: 47.6%	11/22
Wen (1996, Ethnic Health) (100)	Ontario Retrospective	ED visits	Indigenous people (Gr 1) Ontario’s general population (Gr 2) 16-64 y.o. F/M	% of people who had an ED visits in the past year Odds ratio for Gr 1 to visit the ED (95% CI)	Gr 1: 32.2%; Gr 2: 22.6% 1.39 (1.00-1.94)	17/22