Vol 135 No 1551: 11 March 2022

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Issue Summary

Editorial

SUMMARY

Genomic discrimination in New Zealand health and life insurance. AGenDA: Against Genomic Discrimination in Aotearoa | OPEN ACCESS

Andrew N Shelling, Louise S Bicknell, Stefan S Bohlander, Murray P Cox, Sara K Filoche, Harry G Fraser, Kimberley Gamet, Paul Lacaze, Rinki Murphy, Russell G Snell, Andrew Sporle, Ben Te Aika, Rachel V Purcell, Jane M Tiller

Genomic testing is the use of genetic and other types of molecular testing, and is increasingly used as part of routine healthcare to determine a patient’s risk for some conditions, including certain cancers. But insurers can use genomic test results to refuse cover or increase premiums. This is called genomic discrimination, the use of someone’s genomic information to treat them differently. New Zealand is out of step with the rest of the world in its consumer protection against genomic discrimination.

Article

SUMMARY

The economic and health burden of infective endocarditis in Northland, New Zealand

Johanna M Birrell, Thomas Evans, Raewyn Fisher, Alan Davis, Lucille Wilkinson

Infective endocarditis is an infection of the heart valves, which can cause serious complications such as stroke and heart failure. This study found a high rate of severe infective endocarditis in Northland, particularly in the elderly Maori population. A large proportion of cases were caused by dental bacteria, which is a pattern usually seen in lower-income countries. Investment in community water fluoridation, oral health education and access to affordable dental care is recommended in Northland and is likely to be cost-effective.

Article

SUMMARY

Variability of CPR training requirements among New Zealand health professionals | OPEN ACCESS

Daniel Harvey, Jonathon Webber, Daniel W O’Brien.

This study looked at the cardiopulmonary resuscitation (CPR) training requirements among the 17 types of registered health care professionals (e.g., Nurses, dentists, physiotherapists) and 20 different specialities of doctors (e.g., Surgeons, anaesthetists, GPs) within New Zealand. Considerable variability was found, with some professions having comprehensive training policies while others had none. The authors believe that CPR training at a level appropriate to the clinical setting should be compulsory for all health professionals, with a requirement to refresh this on a regular basis. They suggest that better patient outcomes could be achieved with regular training and that patients, the public, and whānau would expect health professionals to be competent in performing CPR and managing a medical emergency, however, more research is needed to prove this.

Article

SUMMARY

Structural disadvantage for priority populations: the spatial inequity of COVID-19 vaccination services in Aotearoa | OPEN ACCESS

Jesse Whitehead, Polly Atatoa Carr, Nina Scott, Ross Lawrenson

New Zealand’s rollout of the Covid-19 vaccine has failed Māori and at-risk communities by relying on current health services, regardless of their already inequitable distribution. Vaccination services could have been proactively planned to target priority populations, but the rollout relied on current health services regardless of their already recognised inequitable distribution and delivery. Māori and Pacific people, over 65-year-olds, and rural residents had the worst access to vaccination services. Access varied for DHB regions, and those with the best overall access to vaccination services had the most equitable uptake. On the other hand, DHBs providing the lowest levels of service accessibility had the largest inequities in vaccination rates.

Article

SUMMARY

Stroke reperfusion treatment trends in New Zealand: 2019 & 2020

Natsuko Fushida-Hardy, Anne Kim, Andrew Leighs, Stephanie G Thompson, Alicia Tyson, P Alan Barber, Annemarei Ranta.

Stroke reperfusion therapy is the only effective treatment to reverse stroke symptoms before brain damage occurs. Stroke reperfusion therapy rates in NZ have continuously risen over the past 5 years and this is attributed to important service improvement initiatives at DHBs and supported by MoH through this period. There are areas requiring ongoing work such as onset to treatment times especially for regional patients. We have uncovered a signal that Māori may experience longer in-hospital treatment delays than NZ Europeans and that women experience a lower intervention rate than men. These are preliminary findings and require more exploration, but if confirmed signal significant inequity that needs to be addressed.

Article

SUMMARY

A five-year retrospective observational study of dental presentations to Waikato Hospital’s emergency department

Jamie Mckenzie, Ming Yap, Rebecca Phemister, Thasvir Singh

At Waikato Hospital, males, NZ European, and patients of high deprivation most commonly presented to ED for dental related presentation, which were primarily non-traumatic in origin. Many patients did not require hospital care, and were managed by ED and discharged. Few patients re-presented to ED for further care. Dental presentations to ED are potentially preventable, and may be related to barriers such as cost, access or health knowledge, or an increased need. Further research is required on strategies to reduce ED presentations for dental conditions.

Article

SUMMARY

A Critical Tiriti Analysis of the Pae Ora (Healthy Futures) Bill

Ngaire Rae, Heather Came, Maria Baker, Tim McCreanor

Article

SUMMARY

Measuring health consumers’ engagement at the governance level: development and validation of the Middlemore Consumer Engagement Questionnaire

Karol J Czuba, Christin Coomarasamy, Richard J Siegert, Renee Greaves, Lucy Wong, Te Hao Apaapa-Timu, Lynne M Maher

Consumer Engagement (CE) is globally recognised as central to improving the quality of health care services. The NZ healthcare reforms have identified that consumers will be increasingly engaged in contributing to the design of their local services through to national strategies and plans. A recent systematic review of questionnaires to measure CE at governance level found that most of the identified tools lacked scientific rigour, were not proven to be reliable, and were not easy to read or understand. The Middlemore Consumer Engagement Questionnaire (MCE-Q) is a validated tool to measure how health consumer representatives at a governance level feel about being enabled and supported to contribute to improving healthcare systems.

Editorial