Are Maori Under-served for Cardiac Interventions?

Aims: To examine hospitalisation rates for selected heart-disease-related diagnoses by age, gender, ethnicity and deprivation.

Methods: Four years' data on publicly-funded hospital discharges for: (i) heart failure and (ii) cardiac interventions were cross-classified by age group, gender, ethnicity (Maori/non-Maori) and deprivation (NZDep96). Population hospitalisation rates were calculated and displayed in multi-dimensional trellis graphs.

Results: The graphs show patterns of hospitalisation for chosen variables simultaneously. The expected increase in heart failure with age is found, as is an increase for the cardiac group up to ages 65-74 years. Clear gender differences were found. A further increase of heart failure with higher deprivation is evident throughout. For cardiac interventions, the relationship with deprivation is complex. Differences by ethnicity are disturbing. Hospitalisation rates for heart failure for Maori are typically more than double the non-Maori rates. In contrast, for the cardiac group Maori intervention rates are much lower.

Conclusions: Graphical analysis that displays age, gender, ethnicity and deprivation simultaneously provides great insight into hospitalisation rates. Ethnic differences are particularly concerning and raise important questions about how well Maori needs are being met and how equitable is access to cardiac interventions for Maori.