C F Tukuitonga1, A B Bindman. 1. Pacific Health Research Centre, Division of Maori and Pacific Health, Faculty of Medical and Health Sciences, University of Auckland. c.tukuitonga@auckland.ac.nz
Abstract
AIMS: To examine ethnic and gender variations in the use of coronary artery revascularisation procedures in New Zealand and to determine whether the introduction of priority scores affected intervention trends. METHODS: Analysis of the National Minimum Database for coronary artery bypass graft (CABG) and percutaneous transluminal coronary angioplasty (PTCA) intervention rates for New Zealand Pacific, Maori and other men and women aged 40 years and over during the decade 1990-1999. RESULTS: Coronary artery revascularisation rates were lower in women than in men in all ethnic groups and in Pacific and Maori men compared with other New Zealand men. Compared to all men, the mean age-standardised CABG and PTCA intervention rate ratios in all women were 0.34 and 0.36. Compared to other New Zealand men, the mean age-standardised CABG and PTCA intervention rate ratios were 0.64 and 0.25 in Pacific and 0.40 and 0.29 in Maori men respectively. Compared to other New Zealand women, the rate ratios for CABG and PTCA were 0.73 and 0.21 in Pacific and 0.74 and 0.43 in Maori women respectively. Introducing priority scores was neither associated with reduced cardiac procedures nor significantly reduced variation in procedures across all ethnic groups. CONCLUSIONS: Although Pacific and Maori peoples had higher rates of coronary artery disease morbidity and mortality, revascularisation rates were lower in both groups. Strategies beyond the use of priority scores are needed to address ethnic and gender disparities in coronary artery revascularisation procedures in New Zealand.
AIMS: To examine ethnic and gender variations in the use of coronary artery revascularisation procedures in New Zealand and to determine whether the introduction of priority scores affected intervention trends. METHODS: Analysis of the National Minimum Database for coronary artery bypass graft (CABG) and percutaneous transluminal coronary angioplasty (PTCA) intervention rates for New Zealand Pacific, Maori and other men and women aged 40 years and over during the decade 1990-1999. RESULTS: Coronary artery revascularisation rates were lower in women than in men in all ethnic groups and in Pacific and Maori men compared with other New Zealand men. Compared to all men, the mean age-standardised CABG and PTCA intervention rate ratios in all women were 0.34 and 0.36. Compared to other New Zealand men, the mean age-standardised CABG and PTCA intervention rate ratios were 0.64 and 0.25 in Pacific and 0.40 and 0.29 in Maori men respectively. Compared to other New Zealand women, the rate ratios for CABG and PTCA were 0.73 and 0.21 in Pacific and 0.74 and 0.43 in Maori women respectively. Introducing priority scores was neither associated with reduced cardiac procedures nor significantly reduced variation in procedures across all ethnic groups. CONCLUSIONS: Although Pacific and Maori peoples had higher rates of coronary artery disease morbidity and mortality, revascularisation rates were lower in both groups. Strategies beyond the use of priority scores are needed to address ethnic and gender disparities in coronary artery revascularisation procedures in New Zealand.