title: Inequities in provision of seizure care across the Wellington Region.
abstract: OBJECTIVE
  We wanted to determine whether adult patients presenting with a seizure to the emergency department (ED) of Wellington Hospital and Hutt Hospital, in the Wellington region, were equally likely to be referred for neurology input.
  
  
  METHODS
  A retrospective review was conducted of 250 consecutive patients presenting with a seizure to the ED of each hospital. Patient electronic records were examined to determine the proportion of patients discussed with the inpatient neurology team and referred to neurology outpatient clinic.
  
  
  RESULTS
  Fifty-two per cent of the patients presenting to Wellington Hospital ED with a seizure were referred to neurology, compared to 13.4% of those presenting to Hutt Hospital ED. The proportion of 'first seizure' patients referred to neurology was 63.1% for Wellington Hospital and 9.8% for Hutt Hospital. The difference in referral rates was primarily attributable to the difference in inpatient referrals. Māori were over-represented in the patients presenting to ED with a seizure, compared to their population composition.
  
  
  CONCLUSIONS
  This study demonstrated unequal referral practices and therefore provision of neurology care for adult seizure patients across the Wellington region, for patients with established epilepsy and those with a first seizure. There were a disproportionately high number of Māori accessing acute seizure care.
authors.affiliation: Neurology, Wellington Hospital. purwa.joshi@ccdhb.org.nz.
authors.forename: Purwa
authors.initials: P
authors.lastname: Joshi
authors.forename: Eloise
authors.initials: E
authors.lastname: Watson
authors.forename: Ian
authors.initials: I
authors.lastname: Rosemergy
authors.forename: Sisira
authors.initials: S
authors.lastname: Jayathissa
mesh_terms: D000293:Adolescent; D000328:Adult; D019468:Disease Management; D057286:Electronic Health Records; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D012017:Referral and Consultation; D012189:Retrospective Studies; D012640:Seizures / Q000453:epidemiology / Q000628:therapy*