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Emergency department length of stay for Māori and European patients in New Zealand

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Authors:
Summary:

A demographic audit of a provincial New Zealand emergency department (ED) revealed a significantly shorter ED length of stay (LOS) among Māori versus European patients (mean LOS, 266.8 mins vs 315.9 mins, respectively), despite Māori having poorer health outcomes overall. The study researchers therefore sought to determine drivers of LOS in this ED. They reviewed 80,714 electronic medical records of ED patients from 1 December 2012 to 1 December 2014. In a stepwise regression procedure that accounted for patient factors of age, gender and deprivation score, ethnicity had no statistically significant effect on LOS. Māori were, on average, younger, less likely to receive bloodwork and radiographs, less likely to go to the ED observation area, less likely to have a GP, and more likely to be discharged and to self-discharge; all of these factors decreased their length of stay.

Comment:
I’ve included this paper to highlight the incidental findings – that Māori attending this ED were less likely to receive investigations or have a GP, and more likely to be discharged or self-discharged. It would be interesting to know if guidelines were followed appropriately.
Reference: West J Emerg Med. 2016;17(4):438-48
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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