Utilisation of inpatient cardiology services including by Māori: a study of hospital discharges for patients enrolled with Partnership Health practices for the 2 years ending June 2007.
OBJECTIVE
Some previous studies have shown that Māori utilise cardiology inpatient services at a much lower rate than would be expected by their health status and mortality. Using more recent data, this study seeks to determine whether this is still the case by examining Māori rates of utilisation of cardiology inpatient services.


METHODS
Practice enrolment data for 354,383 patients, including age, gender, ethnicity (19,712 Māori), deprivation score (patient domicile) and other variables were sent by the Partnership Health Primary Health Organisation (PHO) to NZHIS. Discharge data for 127,426 patients for the 2 years ending June 2007 were attached to the enrolment data. These were analysed for rates of utilisation including cardiology in patient services by diagnosis related groups (DRGs). Māori rates were standardised to the age mix of the total population.


RESULTS
Standardised Māori rates of utilisation for almost all major cardiology diagnosis related groups (DRG) categories were substantially higher than the non-Māaori population. Overall rates for cardiology DRGs were 1.47 times higher for Māori. Standardised Māori rates were higher than the non-Māori population for higher deprivation scores. Māori cardiology inpatients had almost twice the level of Care Plus levels than the non-Māori population.


CONCLUSIONS
The findings indicate that Māori have much better access to cardiology inpatient services than shown in some previous studies. They therefore appear to be benefiting from such services. However the higher rate of hospital utilisation suggests that improved data rather than increased access is the explanation, It raises questions as to whether the additional Care Plus funding being received is having the desired outcomes. Further perhaps targeted action is needed at the primary care level to improve both access to and utilisation of such services.
Community Health of University of Otago and Aotearoa Health, RD 1 Lyttelton, New Zealand. lm@cyberxpress.co.nz
Laurence
L
Malcolm
Ross
R
Barnett
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016507:Cardiology Service, Hospital / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006331:Heart Diseases / Q000453:epidemiology* / Q000208:ethnology* / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010343:Patient Admission / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data; D044382:Population Groups / Q000706:statistics & numerical data*; D011203:Poverty / Q000208:ethnology / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014600:Utilization Review / Q000706:statistics & numerical data