title: Comparison of Australian and New Zealand referral rates for hyperbaric oxygen in oro-facial osteoradionecrosis: evidence-based, funding constraint or clinician whim?
abstract: OBJECTIVE
  To compare Australian and New Zealand (NZ) rates of referral to hyperbaric units for patients with, or at risk of developing mandibular or maxillary osteoradionecrosis (ORN) due to a history of radiotherapy for oro-pharyngeal cancer.
  
  
  METHODS
  Relevant patient treatment data from all hyperbaric units in Australia and NZ were collated and analysed.
  
  
  RESULTS
  The rate of referral to hyperbaric units in Australia for treatment or prophylaxis of patients with, or at risk of oro-facial ORN, was 1.7 times the rate of referral in NZ. Within Australia, there was a greater than three-fold interstate variation.
  
  
  CONCLUSIONS
  There is a significant referral rate difference both within Australia and between Australia and NZ for hyperbaric oxygen therapy for oro-facial ORN. Possible reasons for this difference include access to funding, logistical difficulties, clinician preference for an alternative treatment and clinician attitudes to hyperbaric oxygen.
authors.affiliation: Slark Hyperbaric Unit, Waitemata District Health Board, PO Box 32051, Devonport, Auckland, New Zealand, Phone: +64-(0)21-125-5687, E-mail: Christopher.Sames@waitematadhb.govt.nz.
authors.forename: Christopher
authors.initials: C
authors.lastname: Sames
authors.affiliation: University of Auckland, Auckland, New Zealand.
authors.forename: Desmond F
authors.initials: DF
authors.lastname: Gorman
authors.affiliation: Clinical Director of Health Gain, Waitemata and Auckland District Health Boards, Auckland, New Zealand.
authors.forename: Peter
authors.initials: P
authors.lastname: Sandiford
authors.affiliation: Senior Epidemiologist and Asian Health Advisor, Waitemata and Auckland District Health Boards, Auckland, New Zealand.
authors.forename: Lifeng
authors.initials: L
authors.lastname: Zhou
mesh_terms: D001291:Attitude of Health Personnel; D001315:Australia; D002391:Catchment Area, Health / Q000706:statistics & numerical data; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000706:statistics & numerical data*; D008336:Mandibular Diseases / Q000517:prevention & control / Q000628:therapy*; D008439:Maxillary Diseases / Q000517:prevention & control / Q000628:therapy*; D009520:New Zealand; D010025:Osteoradionecrosis / Q000517:prevention & control / Q000628:therapy*; D012017:Referral and Consultation / Q000706:statistics & numerical data*
keywords: Hyperbaric oxygen therapy; evidence; osteoradionecrosis; survey