Non-resident orthopaedic admissions to Dunedin Hospital, New Zealand: 1997 to 2004.
OBJECTIVE
The purpose of this study is to audit the numbers of non-residents requiring orthopaedic admission to our hospital and determine the effect of increasing tourist numbers and changes in Accident ACC regulations on healthcare resources.


METHODS
Details of non-resident orthopaedic admissions for fiscal years 1997/8 to 2003/4 were analysed with respect to country of residence, mechanism of injury, case weights consumed, and actual costs.


RESULTS
There has been no change in numbers of admissions or cost, averaging 32 cases (50 case weights [CWs]) per year. Most patients came from Asia (59 cases; 26%), then Australia (52 cases; 23%) and UK (40 cases; 18%). Snowsports accounted for 40% of admissions, Motor vehicle accidents (MVA) for 17%, and falls for 29%. Non-resident, non-MVA admissions have averaged 21 CWs per year since the changes in ACC regulations in 1999.


CONCLUSIONS
Despite increasing tourist numbers, there has been no increase in numbers or CW of non-residents requiring orthopaedic admission. Although representing only a small proportion of the orthopaedic budget, they generate many hidden costs. The 50 CWs annually equates to approximately 13 major joint replacements per year. The increase in CWs consumed due to the ACC changes have had no corresponding increase in contracted orthopaedic volumes.
Department of Orthopaedic Surgery, Dunedin Hospital, Dunedin, New Zealand. david.gwynne-jones@stonebow.otago.ac.nz
David
D
Gwynne Jones
D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D001208:Asia / Q000208:ethnology; D001265:Athletic Injuries / Q000453:epidemiology*; D001315:Australia / Q000208:ethnology; D002017:Budgets; D017048:Health Care Costs; D006801:Humans; D008485:Medical Audit / Q000706:statistics & numerical data; D009520:New Zealand / Q000453:epidemiology; D009985:Orthopedics / Q000191:economics / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data* / Q000639:trends; D012865:Skiing / Q000293:injuries; D013503:Surgery Department, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D014195:Travel / Q000706:statistics & numerical data*; D006113:United Kingdom / Q000208:ethnology