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Issue

Vol 129 No 1442: 23 September 2016

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Issue Summary

SUMMARY

Equity of publicly-funded hip and knee joint replacement surgery in New Zealand: Results from a national observational study

Helen Harcombe, Gabrielle Davie, Sarah Derrett, Haxby Abbott, David Gwynne-Jones

The provision of publicly-funded hip and knee total joint replacement (TJR) procedures varies between District Health Boards (DHBs) and national rates have not increased since 2007, new University of Otago research has found. The Dunedin School of Medicine study, which appears in the latest edition of the New Zealand Medical Journal, examined rates of elective TJR procedures between 2006 and 2013. Study principal investigator Dr Helen Harcombe says that geographically-based inequities emerged from the research.Even taking into account age and ethnicity, rates of TJR procedures varied between DHBs, with DHBs covering larger populations tending to have lower rates than smaller ones Dr Harcombe says. The study also showed that while there has been an increase in the number of TJR procedures carried out in the public system between 2007 and 2013, rates are barely keeping pace with a growing population. The number of publicly-funded TJR procedures increased by six percent over this period, but New Zealands growing population meant the surgery rate per head of population (aged over 20 years) actually decreased by 0.6 percent.

SUMMARY

How effective is our current Orthopaedic Prioritisation Tool for scoring patients for arthroplasty surgery?

Neal Singleton, Lewis Agius, Sudhindra Rao

The aim of this study was to compare those patients being accepted onto the waiting list for total hip or knee replacement in Hawke's Bay with those being declined surgery using the Oxford score which is a validated questionnaire for assessing patient function. Patients are currently prioritised for surgery using a non-validated tool which scores patients according to their symptoms and likely benefit from surgery. We found that there was no difference between those patients being accepted for surgery and those being declined surgery. In other words, patients were equally disabled. Patients being seen in Hawke's Bay Hospital for consideration of arthroplasty surgery are severely disabled and yet nearly half are declined surgery. This paper has highlighted the issue of unmet need for arthroplasty surgery which is becoming an increasing issue with New Zealands ageing population.

SUMMARY

Low FODMAP diet efficacy in IBS patients—what is the evidence and what else do we need to know?

Tim Kortlever, Clarice Hebblethwaite, Julie Leeper, Leigh O'Brien, Chris Mulder, Richard B Gearry

Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder characterised by intermittent abdominal pain with altered bowel habit. Low FODMAP diet has been shown to reduce gastrointestinal symptoms in people with IBS. Low FODMAP diet should be taught by an experienced dietitian.

SUMMARY

Epidemiology of intussusception in New Zealand pre-rotavirus vaccination

Bronwyn Rosie, Stuart R Dalziel, Elizabeth Wilson, Emma J Best

Intussusception is a rare form of gut obstruction seen in infants typically aged between six to nine months. It rarely can occur in the first week after a baby receives his/her first or second rotavirus vaccination. Since 2014 rotavirus vaccination has been given in New Zealand to all babies at age six weeks, three months and five months\u00ad this is expected to prevent thousands of hospitalisations with rotavirus diarrhoea. We set out to describe intussusception rates in New Zealand babies to compare with other parts of the world, and understanding background rates of intussusception is an important way to monitor rotavirus vaccination safety.

SUMMARY

Rebalancing health service use for older people: simulating policy-relevant scenarios under demographic ageing

Roy Lay-Yee, Janet Pearson, Peter Davis, Martin von Randow, Ngaire Kerse, Laurie Brown

The ageing of society has major implications for providing health services. We use a simulation model of a representative sample of older New Zealand people to study their use of health services. Our model shows that, in the near future, there will be a moderate increase in long-term illness and health service use. When we simulate a reduction in long-term illness, the effect is a moderate reduction in overall health service use. When we simulate an increase in people visiting the practice nurse at least once a year, the effect is a substantial reduction in use of other health services particularly public hospital admissions.

SUMMARY

Access to orthopaedic spinal specialists in the Canterbury public health system: quantifying the unmet need

Tom Inglis, Rowan Schouten, Kristian Dalzell, Jeremy Evison, Grahame Inglis

This study quantifies the unmet need for both Spinal Orthopaedic Specialist assessment and if warranted, surgical management of elective spine conditions within the Canterbury public health system. It highlights the degree of rationing within the public health system and its failure to adequately provide for the Canterbury Public.

ALL ARTICLES
SUMMARY

Equity of publicly-funded hip and knee joint replacement surgery in New Zealand: Results from a national observational study

Helen Harcombe, Gabrielle Davie, Sarah Derrett, Haxby Abbott, David Gwynne-Jones

Obituary William Brown, M.D., M.A., of Dunedin

Exercise-induced rhabdomyolysis

Joseph Hutton, Daniel Wellington, Steven Miller

How effective is our current Orthopaedic Prioritisation Tool for scoring patients for arthroplasty surgery?

Neal Singleton, Lewis Agius, Sudhindra Rao

Access to joint replacement: have we got it right?

Gary Hooper

Low FODMAP diet efficacy in IBS patients—what is the evidence and what else do we need to know?

Tim Kortlever, Clarice Hebblethwaite, Julie Leeper, Leigh O'Brien, Chris Mulder, Richard B Gearry

Epidemiology of intussusception in New Zealand pre-rotavirus vaccination

Bronwyn Rosie, Stuart R Dalziel, Elizabeth Wilson, Emma J Best

Homeopathy when self-regulation fails

Lance Gravatt

Rebalancing health service use for older people: simulating policy-relevant scenarios under demographic ageing

Roy Lay-Yee, Janet Pearson, Peter Davis, Martin von Randow, Ngaire Kerse, Laurie Brown

Access to orthopaedic spinal specialists in the Canterbury public health system: quantifying the unmet need

Tom Inglis, Rowan Schouten, Kristian Dalzell, Jeremy Evison, Grahame Inglis

Gingival lipoma

Makoto Adachi, Shinichiro Sumitomo

SUMMARY

Equity of publicly-funded hip and knee joint replacement surgery in New Zealand: Results from a national observational study

Helen Harcombe, Gabrielle Davie, Sarah Derrett, Haxby Abbott, David Gwynne-Jones

The provision of publicly-funded hip and knee total joint replacement (TJR) procedures varies between District Health Boards (DHBs) and national rates have not increased since 2007, new University of Otago research has found. The Dunedin School of Medicine study, which appears in the latest edition of the New Zealand Medical Journal, examined rates of elective TJR procedures between 2006 and 2013. Study principal investigator Dr Helen Harcombe says that geographically-based inequities emerged from the research.Even taking into account age and ethnicity, rates of TJR procedures varied between DHBs, with DHBs covering larger populations tending to have lower rates than smaller ones Dr Harcombe says. The study also showed that while there has been an increase in the number of TJR procedures carried out in the public system between 2007 and 2013, rates are barely keeping pace with a growing population. The number of publicly-funded TJR procedures increased by six percent over this period, but New Zealands growing population meant the surgery rate per head of population (aged over 20 years) actually decreased by 0.6 percent.

SUMMARY

How effective is our current Orthopaedic Prioritisation Tool for scoring patients for arthroplasty surgery?

Neal Singleton, Lewis Agius, Sudhindra Rao

The aim of this study was to compare those patients being accepted onto the waiting list for total hip or knee replacement in Hawke's Bay with those being declined surgery using the Oxford score which is a validated questionnaire for assessing patient function. Patients are currently prioritised for surgery using a non-validated tool which scores patients according to their symptoms and likely benefit from surgery. We found that there was no difference between those patients being accepted for surgery and those being declined surgery. In other words, patients were equally disabled. Patients being seen in Hawke's Bay Hospital for consideration of arthroplasty surgery are severely disabled and yet nearly half are declined surgery. This paper has highlighted the issue of unmet need for arthroplasty surgery which is becoming an increasing issue with New Zealands ageing population.

SUMMARY

Low FODMAP diet efficacy in IBS patients—what is the evidence and what else do we need to know?

Tim Kortlever, Clarice Hebblethwaite, Julie Leeper, Leigh O'Brien, Chris Mulder, Richard B Gearry

Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder characterised by intermittent abdominal pain with altered bowel habit. Low FODMAP diet has been shown to reduce gastrointestinal symptoms in people with IBS. Low FODMAP diet should be taught by an experienced dietitian.

SUMMARY

Epidemiology of intussusception in New Zealand pre-rotavirus vaccination

Bronwyn Rosie, Stuart R Dalziel, Elizabeth Wilson, Emma J Best

Intussusception is a rare form of gut obstruction seen in infants typically aged between six to nine months. It rarely can occur in the first week after a baby receives his/her first or second rotavirus vaccination. Since 2014 rotavirus vaccination has been given in New Zealand to all babies at age six weeks, three months and five months\u00ad this is expected to prevent thousands of hospitalisations with rotavirus diarrhoea. We set out to describe intussusception rates in New Zealand babies to compare with other parts of the world, and understanding background rates of intussusception is an important way to monitor rotavirus vaccination safety.

SUMMARY

Rebalancing health service use for older people: simulating policy-relevant scenarios under demographic ageing

Roy Lay-Yee, Janet Pearson, Peter Davis, Martin von Randow, Ngaire Kerse, Laurie Brown

The ageing of society has major implications for providing health services. We use a simulation model of a representative sample of older New Zealand people to study their use of health services. Our model shows that, in the near future, there will be a moderate increase in long-term illness and health service use. When we simulate a reduction in long-term illness, the effect is a moderate reduction in overall health service use. When we simulate an increase in people visiting the practice nurse at least once a year, the effect is a substantial reduction in use of other health services particularly public hospital admissions.

SUMMARY

Access to orthopaedic spinal specialists in the Canterbury public health system: quantifying the unmet need

Tom Inglis, Rowan Schouten, Kristian Dalzell, Jeremy Evison, Grahame Inglis

This study quantifies the unmet need for both Spinal Orthopaedic Specialist assessment and if warranted, surgical management of elective spine conditions within the Canterbury public health system. It highlights the degree of rationing within the public health system and its failure to adequately provide for the Canterbury Public.

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