Home > Review Articles > Geographic, ethnic and socioeconomic factors influencing access to implantable cardioverter defibrillators (ICDs) in New Zealand

Geographic, ethnic and socioeconomic factors influencing access to implantable cardioverter defibrillators (ICDs) in New Zealand

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From Māori Health Review Issue 39
Authors:
  • Wilson D et al
Summary:

All new implanted cardioverter defibrillator (ICD) recipients in 2010 were assessed according to home DHB, ethnicity and socioeconomic status using the NZDep index. A total of 352 new ICDs were implanted nationwide during 2010, yielding an overall implantation rate of 80.6/million. There was substantial variance in implant rates across the 20 DHBs with the highest implant rate observed in Tairawhiti at 192.3/million, and the lowest at 22/million in the Nelson region. Implant rate also varied significantly by ethnicity, with Māori ethnicity at an implant rate of 114/million, European patients at 83/million, Pacific Island patients at 47/million and Asian patients at an implant rate of 32/million. Socioeconomic decile had no significant effect upon number of implants.

Comment:
I’ve included this paper to highlight the fact that ‘not all things are equal’. So when the authors suggest that people living in Tairawhiti and Māori have higher implant rates than others, I’d argue that there is greater need for implants in these two populations. In fact, Māori are twice as likely to die from CVD than NZ Europeans, and therefore Māori should be receiving ICDs at twice the rates of NZ Europeans. Instead, the rates are only 1.4 times higher; therefore Māori are missing out!
Reference: Heart Lung Circ. 2012 May 15. [Epub ahead of print]
Abstract
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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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