Abstract
To compare the quality of hospital care for New Zealand (NZ) Maori and NZ European adult patients, using the rate of unplanned readmission or death within 30 days of discharge as an indicator of quality.
Retrospective cohort study.
NZ public hospitals.
Data from 89 658 patients who were admitted for one of a defined set of surgical procedures at NZ public hospitals 20028 were obtained from the NZ Ministry of Health.
The odds of readmission for NZ Maori when compared with NZ European patients were calculated using logistic regression, incorporating variables for age, sex, comorbidity, index procedure, hospital volume and socioeconomic position.
NZ Maori had 16 higher odds of readmission or death when compared with NZ European patients (OR 1.16; 95 CI 1.081.24) after adjusting for all covariates. Readmission or death was also associated with being female (OR 1.09; 1.031.15), older age (OR 1.33; 1.191.48, for 79 years compared with 1839 years), higher comorbidity (OR 2.08; 1.892.31, for Charlson score 3 compared with 0) and higher hospital volume (OR 0.81; 0.760.86, for lowest volume compared with highest).
This study suggests ethnic disparities in the quality of hospital care in NZ using unplanned readmission rate as an indicator of quality. There are well-documented differences in health outcomes between Maori and NZ Europeans, and it is possible that differential treatment within the health system contributes to these health status inequalities.