Minore Bruce, Katt Mae, Hill Mary Ellen
Centre for Rural and Northern Health Research, Thunder Bay, Ontario, Canada.
J Agromedicine. 2009;14(2):90-6. doi: 10.1080/10599240902739802.
The majority of First Nations, Metis, and Inuit people living in the Canadian province of Ontario have less access to quality health care than the population as a whole. Yet improving the situation is hampered by the lack of an information system that documents fundamental facts about Aboriginal people's health status and services utilization. Without a means to collect such data, these knowledge deficits will persist, making the planning and provision of culturally appropriate services impossible. The Ontario Health Quality Council commissioned a study to (1) review data collection systems in other Canadian jurisdictions and (2) determine what Ontario needs in order to have a comprehensive Aboriginal health information system. The study involved a review of 177 policy and technical documents and interviews with 20 key informants in Ontario, as well as Canada's other provinces and territories. Results showed that the capacity to document Aboriginal peoples' health and service utilization varies significantly, depending on existing provincial/territorial health data sets and the ability to cross-link health data using unique identifiers. Some jurisdictions can locate Aboriginal data using health cards, health benefits payment information, or vital statistics identifiers; others rely on linkages using federal or provincial Aboriginal registry and membership lists. All have the capability to conduct geographical analyses to identify health and service utilization for communities or regions that have significant Aboriginal populations. To improve health information in Ontario, Aboriginal people's collective entitlements to information about their communities must be recognized. The authors outline implications of a set of principles that Canada's First Nations have adopted, commonly referred to as OCAP (Ownership, Control, Access, and Possession), on the collection, storage, use, and interpretation of health data. Only through negotiation with Aboriginal peoples can health information systems be established that meet their needs, as well as those of decision-makers and care providers.
居住在加拿大安大略省的大多数原住民、梅蒂斯人和因纽特人，相比全体人口而言，获得优质医疗保健的机会更少。然而，由于缺乏一个记录原住民健康状况和服务利用基本事实的信息系统，改善这种状况受到了阻碍。如果没有收集此类数据的手段，这些知识缺口将持续存在，从而无法规划和提供符合文化习俗的服务。安大略省卫生质量委员会委托开展了一项研究，以（1）审查加拿大其他司法管辖区的数据收集系统，以及（2）确定安大略省建立一个全面的原住民健康信息系统需要哪些条件。该研究包括对177份政策和技术文件进行审查，并与安大略省以及加拿大其他省份和地区的20名关键信息提供者进行访谈。结果表明，记录原住民健康和服务利用情况的能力差异很大，这取决于现有的省级/地区健康数据集以及使用唯一标识符交叉链接健康数据的能力。一些司法管辖区可以通过健康卡、健康福利支付信息或人口动态统计标识符来查找原住民数据；其他司法管辖区则依赖于使用联邦或省级原住民登记册和成员名单进行链接。所有这些司法管辖区都有能力进行地理分析，以确定原住民人口众多的社区或地区的健康和服务利用情况。为了改善安大略省的健康信息，必须承认原住民对有关其社区信息的集体权利。作者概述了加拿大原住民所采用的一组原则（通常称为OCAP，即所有权、控制权、获取权和拥有权）对健康数据的收集、存储、使用和解释的影响。只有通过与原住民进行谈判，才能建立满足他们以及决策者和医疗服务提供者需求的健康信息系统。
