This retrospective cohort study compared rates of emergency department (ED) visits after a diagnosis of chronic obstructive pulmonary disease (COPD) in the three Aboriginal groups (Registered First Nations, Métis and Inuit) relative to a non-Aboriginal cohort.

We linked eight years of administrative health data from Alberta and calculated age- and sex-standardized ED visit rates in cohorts of Aboriginal and non-Aboriginal individuals diagnosed with COPD. Rate ratios (RR) with 95% confidence intervals (CIs) were calculated in a Poisson regression model that adjusted for important sociodemographic factors and comorbidities. Differences in ED length of stay (LOS) and disposition status were also evaluated.

A total of 2,274 Aboriginal people and 1,611 non-Aboriginals were newly diagnosed with COPD during the study period. After adjusting for important sociodemographic and clinical factors, the rate of all-cause ED visits in all Aboriginal people (RR=1.72, 95% CI: 1.67, 1.77), particularly among Registered First Nations people (RR=2.02; 95% CI: 1.97, 2.08) and Inuit (RR=1.28; 95% CI: 1.22, 1.35), were significantly higher than that in non-Aboriginals, while ED visit rates were significantly lower in the Métis (RR=0.94; 95% CI: 0.90, 0.98). The ED LOS in all Aboriginal groups were significantly lower than that of the non-Aboriginal group.

Aboriginal people with COPD use almost twice the amount of ED services compared to their non-Aboriginal counterparts. There are also important variations in patterns of ED services use among different Aboriginal groups with COPD in Alberta.

About one million accidents occur yearly in Finland (population 5.2 million), resulting in over 3,000 deaths, annually. The governmental and municipal authorities are responsible for the healthcare services that respond to these accidents. So far, resources for these services have been allocated according to regional equality, or in some cases, on the basis of population numbers. However, economical and effective resource allocation should be based on detailed risk analysis of the accidents.

In areas with more dense populations, the level of social activity is greater, which leads to an increased risk for accidents (traffic, civil disturbance, etc.).

The number of accidents was estimated on the basis of registered emergency trauma patients using the Finnish healthcare statistics for the year 1999. The emergency visits were compared to the populations and populations’ densities of the regional sub-units. The rate of emergency injuries was analysed by regression analysis according to varying population density in Finland.

The number of accidents per inhabitants was related directly to population density. There was a correlation between emergency visits per inhabitant and population density (p <0.0001). According to estimates, each 1% increase in population density is associated with a 0.4% increase in the risk of accidents.

The relationship between population density and rate of emergency visits is decisive for the planning of emergency services. Services should be placed in areas of high population densities where there are more people with greater risk of accidents.