Ethnicity bias in post-fracture care
A Geelong-based researcher has been working closely with the Regional Bone Density Program at University of Manitoba, Canada, and reports that a larger post-fracture care gap existed for Canadian First Nations peoples (Canadian Indigenous) compared to non-First Nations people.
First Nations peoples were eight times less likely to receive post-fracture care compared to non-First Nations peoples, representing a clinically significant ethnic difference in post-fracture care.
“A clear difference in post-fracture care existed for Canadian First Nations peoples despite targeted attempts to reduce disparities in the care gap and to reduce the risk of recurrent fractures,” said Research Fellow Dr Sharon Brennan, who is affiliated with the Barwon Epidemiology and Biostatistics Unit, Deakin University, and the NorthWest Academic Centre, University of Melbourne.
“This study suggested that applying specific evaluation frameworks to health policy may assist in directing attention to modifiable organizational practice and policies such as physician referral practices and/or adoption (and demand) of post-fracture care by the public.
“It is imperative that further work be undertaken to elucidate underlying mechanisms for such a large ethnicity difference in post-fracture care and to address failure to initiate treatment by either the medical practitioner or the patient, or a combination of both.
“A total of 11,234 major osteoporotic fracture cases were examined in this study. Of those fractures, 3058 occurred at the spine (21.5%), 3058 at the hip (27.2%), and 5760 at the wrist (51.3%).
“These findings are important because Canada has publically accessible health care options, which is similar to the Australian health care system, suggesting that disparities in health care should be less evident than in countries where populations have no, or limited, access to publically funded health care systems. Yet that was not observed to be the case in this study,” Dr Brennan said.
“These findings suggest that a comprehensive rethink of how best to direct health policy related to post-fracture care with efficacy and equality for Canadian First Nations peoples is needed. However, it also highlights that there is much work to be done in Australia to examine post-fracture care, especially for the Australian Indigenous peoples.”
Dr Brennan holds a prestigious and highly competitive Fellowship from the National Health and Medical Research Council of Australia.
This research has won the collaboration between Dr Brennan and Professor Leslie’s team further international recognition, and was published on 3 January 2012 in Osteoporosis International; a leading international journal in the field of bone and mineral research.