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Characterizing the medical and social complexity experienced by Inuit children and their families from Nunavut who access care at an urban Canadian tertiary level paediatric hospital.

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Title: Characterizing the medical and social complexity experienced by Inuit children and their families from Nunavut who access care at an urban Canadian tertiary level paediatric hospital.
Authors: Ge Y; Public Health and Preventive Medicine Resident Physician, University of Ottawa, Ottawa, ON, Canada., Mills A; Undergraduate Medical Education Program, Queen's University, Kingston, ON, Canada., McCann V; Undergraduate Medical Education Program, Queen's University, Kingston, ON, Canada., Trincao-Batra S; Undergraduate Medical Education Program, University of Ottawa, Ottawa, ON, Canada., Reddy D; Biostatistician, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada., Newhook D; Research Analyst and Qualitative Methods Consultant, Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada., Webster RJ; Scientific Director, Clinical Research Unit, CHEO Resaerch Institute, Ottawa, Canada., Sutherland S; Research and Evaluation Consultant, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada., Weber M; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada., Jetty R; Pediatric Medicine Children's Hospital of Eastern Ontario, Associate Professor of Pediatrics, University of Ottawa, Ottawa, ON, Canada.
Source: International journal of circumpolar health [Int J Circumpolar Health] 2025 Dec; Vol. 84 (1), pp. 2444122. Date of Electronic Publication: 2025 Jan 11.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Taylor & Francis Country of Publication: United States NLM ID: 9713056 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2242-3982 (Electronic) Linking ISSN: 12399736 NLM ISO Abbreviation: Int J Circumpolar Health Subsets: MEDLINE
Imprint Name(s): Publication: 2016- : Philadelphia, PA : Taylor & Francis
Original Publication: Oulu, Finland : International Union for Circumpolar Health and the Nordic Society of Arctic Medicine, [1997-
MeSH Terms: Inuit*/psychology , Hospitals, Pediatric* , Tertiary Care Centers* , Health Services Accessibility*, Humans ; Child, Preschool ; Infant ; Male ; Retrospective Studies ; Female ; Child ; Ontario ; Nunavut ; Social Determinants of Health ; Comorbidity ; Adolescent
Abstract: We aimed to characterise the medical and social complexities experienced by Inuit children and their families from Nunavut who were cared for at a general paediatrics clinic at an urban tertiary-level hospital located in Eastern Ontario. A retrospective chart review of this cohort was completed between 2016 and 2019. Two independent reviewers extracted data from charts. The cohort included 36 children, median (interquartile range [IQR]) age 13.5 (6.8, 28.2) months and full age range (1,140) months. They had a median (IQR) of 12.5 (7.8, 18.0) comorbidities, 11 (8.0, 14.2) healthcare services accessed and 3 (2, 5) medications. Almost all children (97.2%) had been hospitalised and the median number of days spent as an inpatient was 31.5. With respect to social complexity variables, 51.9% of clinical interactions (14 of 27 charts reviewed) at any point would have benefitted from an interpreter and 96.7% of 30 patient escorts/companions showed evidence of having difficulty in coping with homesickness. Improving social history taking and integrating screening for social determinants of health within the clinic should be considered. A dedicated interdisciplinary team approach focused on integrative care could be an effective method to improve communication and collaboration between service providers and with Inuit children and their families to reduce systemic health and social inequities.
References: Int J Nurs Stud Adv. 2022 Nov 24;4:100109. (PMID: 38745637)
Healthc Q. 2021 Apr;24(1):10-13. (PMID: 33864435)
Paediatr Child Health. 2024 Feb 06;29(1):43-49. (PMID: 38332981)
Can J Public Health. 2002 Mar-Apr;93(2):149-52. (PMID: 11963522)
Pediatrics. 2016 Sep;138(3):. (PMID: 27516527)
BMC Health Serv Res. 2021 Jan 28;21(1):94. (PMID: 33509188)
J Immigr Minor Health. 2009 Dec;11(6):437-45. (PMID: 19127431)
Paediatr Child Health. 2012 Aug;17(7):381-4. (PMID: 23904782)
Int J Circumpolar Health. 2009 Dec;68(5):471-87. (PMID: 20044965)
Int J Circumpolar Health. 2013 Aug 05;72:. (PMID: 23984305)
Sociol Health Illn. 2021 Jul;43(6):1405-1421. (PMID: 34145599)
Pediatrics. 2011 Mar;127(3):529-38. (PMID: 21339266)
Med J Aust. 2017 Jul 3;207(1):13-15. (PMID: 28659103)
J Hosp Med. 2016 Nov;11(11):750-756. (PMID: 27378587)
Pediatrics. 2016 Dec;138(6):. (PMID: 27940731)
Int J Circumpolar Health. 2020 Dec;79(1):1766319. (PMID: 32449489)
Contributed Indexing: Keywords: Inuit child health; Inuit health; Social paediatrics; chart review; complex care; coordination of care; medical complexity; social complexity
Entry Date(s): Date Created: 20250111 Date Completed: 20250111 Latest Revision: 20250514
Update Code: 20260130
PubMed Central ID: PMC11727173
DOI: 10.1080/22423982.2024.2444122
PMID: 39797716
Database: MEDLINE
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  Data: Characterizing the medical and social complexity experienced by Inuit children and their families from Nunavut who access care at an urban Canadian tertiary level paediatric hospital.
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  Data: <searchLink fieldCode="AU" term="%22Ge+Y%22">Ge Y</searchLink>; Public Health and Preventive Medicine Resident Physician, University of Ottawa, Ottawa, ON, Canada.<br /><searchLink fieldCode="AU" term="%22Mills+A%22">Mills A</searchLink>; Undergraduate Medical Education Program, Queen's University, Kingston, ON, Canada.<br /><searchLink fieldCode="AU" term="%22McCann+V%22">McCann V</searchLink>; Undergraduate Medical Education Program, Queen's University, Kingston, ON, Canada.<br /><searchLink fieldCode="AU" term="%22Trincao-Batra+S%22">Trincao-Batra S</searchLink>; Undergraduate Medical Education Program, University of Ottawa, Ottawa, ON, Canada.<br /><searchLink fieldCode="AU" term="%22Reddy+D%22">Reddy D</searchLink>; Biostatistician, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.<br /><searchLink fieldCode="AU" term="%22Newhook+D%22">Newhook D</searchLink>; Research Analyst and Qualitative Methods Consultant, Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.<br /><searchLink fieldCode="AU" term="%22Webster+RJ%22">Webster RJ</searchLink>; Scientific Director, Clinical Research Unit, CHEO Resaerch Institute, Ottawa, Canada.<br /><searchLink fieldCode="AU" term="%22Sutherland+S%22">Sutherland S</searchLink>; Research and Evaluation Consultant, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.<br /><searchLink fieldCode="AU" term="%22Weber+M%22">Weber M</searchLink>; Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.<br /><searchLink fieldCode="AU" term="%22Jetty+R%22">Jetty R</searchLink>; Pediatric Medicine Children's Hospital of Eastern Ontario, Associate Professor of Pediatrics, University of Ottawa, Ottawa, ON, Canada.
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  Data: <searchLink fieldCode="MM" term="%22Inuit%22">Inuit*</searchLink>/<searchLink fieldCode="MM" term="%22Inuit+psychology%22">psychology</searchLink> <br /><searchLink fieldCode="MM" term="%22Hospitals%2C+Pediatric%22">Hospitals, Pediatric*</searchLink> <br /><searchLink fieldCode="MM" term="%22Tertiary+Care+Centers%22">Tertiary Care Centers*</searchLink> <br /><searchLink fieldCode="MM" term="%22Health+Services+Accessibility%22">Health Services Accessibility*</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Child%2C+Preschool%22">Child, Preschool</searchLink> ; <searchLink fieldCode="MH" term="%22Infant%22">Infant</searchLink> ; <searchLink fieldCode="MH" term="%22Male%22">Male</searchLink> ; <searchLink fieldCode="MH" term="%22Retrospective+Studies%22">Retrospective Studies</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Child%22">Child</searchLink> ; <searchLink fieldCode="MH" term="%22Ontario%22">Ontario</searchLink> ; <searchLink fieldCode="MH" term="%22Nunavut%22">Nunavut</searchLink> ; <searchLink fieldCode="MH" term="%22Social+Determinants+of+Health%22">Social Determinants of Health</searchLink> ; <searchLink fieldCode="MH" term="%22Comorbidity%22">Comorbidity</searchLink> ; <searchLink fieldCode="MH" term="%22Adolescent%22">Adolescent</searchLink>
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  Data: We aimed to characterise the medical and social complexities experienced by Inuit children and their families from Nunavut who were cared for at a general paediatrics clinic at an urban tertiary-level hospital located in Eastern Ontario. A retrospective chart review of this cohort was completed between 2016 and 2019. Two independent reviewers extracted data from charts. The cohort included 36 children, median (interquartile range [IQR]) age 13.5 (6.8, 28.2) months and full age range (1,140) months. They had a median (IQR) of 12.5 (7.8, 18.0) comorbidities, 11 (8.0, 14.2) healthcare services accessed and 3 (2, 5) medications. Almost all children (97.2%) had been hospitalised and the median number of days spent as an inpatient was 31.5. With respect to social complexity variables, 51.9% of clinical interactions (14 of 27 charts reviewed) at any point would have benefitted from an interpreter and 96.7% of 30 patient escorts/companions showed evidence of having difficulty in coping with homesickness. Improving social history taking and integrating screening for social determinants of health within the clinic should be considered. A dedicated interdisciplinary team approach focused on integrative care could be an effective method to improve communication and collaboration between service providers and with Inuit children and their families to reduce systemic health and social inequities.
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  Data: Int J Nurs Stud Adv. 2022 Nov 24;4:100109. (PMID: <searchLink fieldCode="PM" term="%2238745637%22">38745637)</searchLink><br />Healthc Q. 2021 Apr;24(1):10-13. (PMID: <searchLink fieldCode="PM" term="%2233864435%22">33864435)</searchLink><br />Paediatr Child Health. 2024 Feb 06;29(1):43-49. (PMID: <searchLink fieldCode="PM" term="%2238332981%22">38332981)</searchLink><br />Can J Public Health. 2002 Mar-Apr;93(2):149-52. (PMID: <searchLink fieldCode="PM" term="%2211963522%22">11963522)</searchLink><br />Pediatrics. 2016 Sep;138(3):. (PMID: <searchLink fieldCode="PM" term="%2227516527%22">27516527)</searchLink><br />BMC Health Serv Res. 2021 Jan 28;21(1):94. (PMID: <searchLink fieldCode="PM" term="%2233509188%22">33509188)</searchLink><br />J Immigr Minor Health. 2009 Dec;11(6):437-45. (PMID: <searchLink fieldCode="PM" term="%2219127431%22">19127431)</searchLink><br />Paediatr Child Health. 2012 Aug;17(7):381-4. (PMID: <searchLink fieldCode="PM" term="%2223904782%22">23904782)</searchLink><br />Int J Circumpolar Health. 2009 Dec;68(5):471-87. (PMID: <searchLink fieldCode="PM" term="%2220044965%22">20044965)</searchLink><br />Int J Circumpolar Health. 2013 Aug 05;72:. (PMID: <searchLink fieldCode="PM" term="%2223984305%22">23984305)</searchLink><br />Sociol Health Illn. 2021 Jul;43(6):1405-1421. (PMID: <searchLink fieldCode="PM" term="%2234145599%22">34145599)</searchLink><br />Pediatrics. 2011 Mar;127(3):529-38. (PMID: <searchLink fieldCode="PM" term="%2221339266%22">21339266)</searchLink><br />Med J Aust. 2017 Jul 3;207(1):13-15. (PMID: <searchLink fieldCode="PM" term="%2228659103%22">28659103)</searchLink><br />J Hosp Med. 2016 Nov;11(11):750-756. (PMID: <searchLink fieldCode="PM" term="%2227378587%22">27378587)</searchLink><br />Pediatrics. 2016 Dec;138(6):. (PMID: <searchLink fieldCode="PM" term="%2227940731%22">27940731)</searchLink><br />Int J Circumpolar Health. 2020 Dec;79(1):1766319. (PMID: <searchLink fieldCode="PM" term="%2232449489%22">32449489)</searchLink>
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