The New Zealand mobile surgical bus service: what is it achieving?
OBJECTIVE
Equitable access and provision of healthcare is a cornerstone of New Zealand Government health planning. Recent closures of rural hospitals have lead to difficulties with access to surgical services. The mobile surgical service has been developed to help; partly to address this issue as well as to address several other stated goals in the provision of rural heath. This study aims to audit the goals set out for the mobile surgical service and determine if they are been achieved.


METHODS
The following outcome measures were assessed: number and type of procedure, length of stay, complications, services for Maori, upskilling for rural staff, social benefits, impact on child health, improved training with telepresence surgery, and the cost.


RESULTS
Over the first 2 years (1 March 2002 to 28 February 2004) of service provision, 1901 procedures were undertaken; 57 patients had complications. The most common complication was wound infection, which occurred in 5% of operations. One in 3 treated patients were Maori and 40% of those treated were 15 years of age or younger. The mobile surgical bus service also appears to be meeting its social benefit, upskilling goals, and educational goals.


CONCLUSIONS
The provision of specialist services to the rural communities is a difficult problem faced not only in New Zealand. Though still on a trial basis, the mobile surgical service bus appears to be meeting its stated goals to be addressing one of the important goals of the Government health policy: equitable access and provision to surgical care.
Bax
Kevin
K
Department of Surgery, Christchurch Hospital, Christchurch.
Shedda
Susan
S
Frizelle
Frank
F
D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000191:economics / Q000193:education / Q000706:statistics & numerical data*; D002648:Child; D003362:Cost-Benefit Analysis; D004501:Education, Medical / Q000379:methods; D006297:Health Services Accessibility / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008952:Mobile Health Units / Q000458:organization & administration* / Q000706:statistics & numerical data*; D009520:New Zealand / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D017064:Process Assessment, Health Care; D011785:Quality Assurance, Health Care / Q000379:methods; D019035:Rural Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data*; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods