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Home / New Zealand

Ratings expose variations in access to surgery

8 May, 2007 02:50 AM3 mins to read

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KEY POINTS:

A new standard has been introduced to measure how much access people in different parts of the country have to non-urgent surgery.

The aim is to discover where access to surgery is more limited and address the shortfall.

The Ministry of Health has introduced "standardised discharge ratios" which
break down elective surgery rates into district health board areas, and compare them to a national average.

A team of doctors and other medical specialists agreed on a list of 14 procedures which people should have equal access to, irrespective of where they lived.

These included hip replacements, knee replacements, hysterectomies, carpal tunnel procedures, hernia repairs and heart valve replacements.

The ratios compare a specific range of procedures within the public health sector only, and do not include urgent operations like an appendectomy or surgery for cancer.

The ministry's clinical adviser to the elective services programme, Ray Naden, said the ratios were designed to address inconsistent access to these operations across the country.

"If all DHBs were providing services at the same level, they would all be at 1," Dr Naden said.

"A rate higher than 1 indicates that the board is providing more than the average rate in New Zealand, and a rate lower than 1 indicates that the board is providing less than the average rate."

For example, Dr Nayden said, a district's ratio of 0.9 for orthopaedics meant people in that district received 90 per cent of the average national access for orthopaedic procedures.

Lists of ratios for each of the country's 21 health districts can be found online at www.nzhis.govt.nz/stats/surgical/tables.html.

Northland, for example, scored just 0.63 for prostactomies, but 1.44 for heart valve replacements and repairs.

Meanwhile, Canterbury had a ratio of 1.50 for prostactomies and 1.20 for heart valves, but just 0.63 for carpel tunnel procedures.

Dr Nayden said the health boards would use the information to spot areas where patients' needs weren't being met, and to decide how to spend their share of the $200 million in new funding for better access to elective surgery.

But the figures weren't the final word on how each board stacked up in comparison to the others, he said.

"A board which has a standardised discharge ratio of 0.8 for dental (surgery) may be providing very good preventive oral health services, therefore people in that district need less secondary elective dental surgery than people in other parts of the country."

So in some cases a ratio below 1 could be a sign of better than average service.

- NZPA

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