Inequities in provision of seizure care across the Wellington Region

Making Education Easy

Authors:

Joshi P et al.

October 20, 2015

Summary:

These researchers conducted a retrospective review of 250 consecutive adult patients (aged ≥16 years) presenting to Wellington Hospital and Hutt Hospital Emergency Departments (EDs) with the primary diagnosis of a seizure between 11 February 2013 and 30 December 2013. Patient electronic records were examined to determine the proportion of patients discussed with the inpatient neurology team and referred to the neurology outpatient clinic. A significantly higher proportion of the patients presenting to Wellington Hospital ED with a seizure were referred to neurology, compared with those presenting to Hutt Hospital ED (52% vs 13.6%; p<0.0001). Similarly, the proportion of ‘first seizure’ patients referred to neurology was 63.2% for Wellington Hospital versus 9.8% for Hutt Hospital (p<0.0001). The difference in referral rates was primarily attributable to the difference in inpatient referrals. Māori were over-represented in the patients presenting to ED with a seizure, compared to their population composition: 16% of the seizure patients presenting to Wellington Hospital were Māori, compared to the population composition of 11.1%; 22% of the seizure patients presenting to Hutt Hospital were Māori, compared to the population composition of 17.8%.

Comment:

I’ve included this paper as this is the first study I’m aware of that has looked at epilepsy and Māori. These findings and the fact that risk factors for epilepsy are higher for Māori than non-Māori (such as brain injury) would suggest that epilepsy is a major health issue for Māori. The impacts on work, school, driving and quality of life deserve further investigation.

Reference: N Z Med J. 2015;128(1417):30-5

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.

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