title: Ethnic disparities in the quality of hospital care in New Zealand, as measured by 30-day rate of unplanned readmission/death.
abstract: OBJECTIVE
  To compare the quality of hospital care for New Zealand (NZ) Māori and NZ European adult patients, using the rate of unplanned readmission or death within 30 days of discharge as an indicator of quality.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  NZ public hospitals.
  
  
  METHODS
  Data from 89 658 patients who were admitted for one of a defined set of surgical procedures at NZ public hospitals 2002-8 were obtained from the NZ Ministry of Health. Outcome The odds of readmission for NZ Māori when compared with NZ European patients were calculated using logistic regression, incorporating variables for age, sex, comorbidity, index procedure, hospital volume and socioeconomic position.
  
  
  RESULTS
  NZ Māori had 16% higher odds of readmission or death when compared with NZ European patients (OR = 1.16; 95% CI 1.08-1.24) after adjusting for all covariates. Readmission or death was also associated with being female (OR = 1.09; 1.03-1.15), older age (OR = 1.33; 1.19-1.48, for >79 years compared with 18-39 years), higher comorbidity (OR = 2.08; 1.89-2.31, for Charlson score 3+ compared with 0) and higher hospital volume (OR = 0.81; 0.76-0.86, for lowest volume compared with highest).
  
  
  CONCLUSIONS
  This study suggests ethnic disparities in the quality of hospital care in NZ using unplanned readmission rate as an indicator of quality. There are well-documented differences in health outcomes between Māori and NZ Europeans, and it is possible that differential treatment within the health system contributes to these health status inequalities.
authors: Department of Public Health and General Practice, University of Otago, PO Box 4345, Christchurch, New Zealand. jrs@otagoalumni.ac.nz
authors: Juliet
authors: J
authors: Rumball-Smith
authors: Diana
authors: D
authors: Sarfati
authors: Phil
authors: P
authors: Hider
authors: Tony
authors: T
authors: Blakely
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009520:New Zealand / Q000453:epidemiology; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
keywords: New Zealand; cross cultural comparison; health-care disparities; patient readmission; quality of health care