Media release

From: New Zealand Medical Association (NZMA)

Disparities in post-operative mortality between Māori and non-Indigenous ethnic groups in New Zealand

Summary

In this study, we looked at nearly 4 million surgical procedures that took place within hospitals around New Zealand between 2005 and 2017. We found that Māori patients (in particular) are more likely to die within 30 days of a procedure compared to European patients. This is probably because of unfair differences in access to the best care when it is needed the most. We believe that we need to pay more attention in the future to how well Māori are accessing surgical care, including “pre-operative” care.

Key Points

• We studied nearly 3.9 million surgical procedures conducted between 2005 and 2017 in New Zealand, looking for evidence of disparities in post-operative mortality between Māori and other non-Indigenous ethnic groups.
• We found substantial evidence of ethnic disparities in post-operative mortality across procedures, with the clearest disparities occurring between Indigenous Māori and the majority European population.
• Māori have higher rates of 30- and 90-day post-operative mortality across most broad procedure categories, with this disparity strongest for elective/waiting list procedures.
• These disparities are likely driven by structural factors, including institutional racism, acting through a combination of healthcare system, process and clinical team factors.
• As a starting point, we recommend that ethnicity/Indigeneity-stratified monitoring and reporting of access to elective/waiting list procedures, as well as access to pre-operative care, is incorporated into surgical care at a systems level, as part of ongoing quality assurance processes.