Jamie-Lee Rahiri1, Zanazir Alexander1, Matire Harwood2, Jonathan Koea3, Andrew G Hill1. 1. Department of Surgery, The University of Auckland, Middlemore Hospital, Auckland, New Zealand. 2. Te Kupenga Hauora Māori, The University of Auckland, Auckland, New Zealand. 3. Department of Surgery, Waitemata District Health Board, North Shore Hospital, Auckland, New Zealand.
Abstract
BACKGROUND: Health equity for Indigenous peoples in the context of surgery has recently become topical amongst surgeons in Australasia. Health inequities are amongst the most consistent and compelling disparities between Māori and New Zealand Europeans (NZE) in New Zealand (NZ). We aimed to investigate where ethnic disparities in surgical care may occur and highlight some of the potential contributing factors, over all surgical specialties, between Māori and NZE adults in NZ. METHODS: A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A series of electronic searches were performed in Medline, Embase, PubMed and CINAHL. RESULTS: Ten studies met the inclusion criteria. All studies employed a range of indicators for surgical care including receipt of surgery following diagnosis, delays to treatment and post-operative morbidity and mortality. Disparities in the receipt of surgical treatment for several cancers were observed for Māori and remained after adjustment for socioeconomic variables and extent of disease. Māori were more likely to experience delays in treatment and referral to other medical specialties involved in their care. CONCLUSION: Despite the significant variation in the types of diseases, procedures and indicators of surgical care of the included studies, consistent findings are that disparities in different aspects of surgical care exist between Māori and NZE in NZ. This review highlights the need to better quantify the important issue of health equity for Māori in surgery given the lack of studies over the majority of surgical specialties.
BACKGROUND: Health equity for Indigenous peoples in the context of surgery has recently become topical amongst surgeons in Australasia. Health inequities are amongst the most consistent and compelling disparities between Māori and New Zealand Europeans (NZE) in New Zealand (NZ). We aimed to investigate where ethnic disparities in surgical care may occur and highlight some of the potential contributing factors, over all surgical specialties, between Māori and NZE adults in NZ. METHODS: A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A series of electronic searches were performed in Medline, Embase, PubMed and CINAHL. RESULTS: Ten studies met the inclusion criteria. All studies employed a range of indicators for surgical care including receipt of surgery following diagnosis, delays to treatment and post-operative morbidity and mortality. Disparities in the receipt of surgical treatment for several cancers were observed for Māori and remained after adjustment for socioeconomic variables and extent of disease. Māori were more likely to experience delays in treatment and referral to other medical specialties involved in their care. CONCLUSION: Despite the significant variation in the types of diseases, procedures and indicators of surgical care of the included studies, consistent findings are that disparities in different aspects of surgical care exist between Māori and NZE in NZ. This review highlights the need to better quantify the important issue of health equity for Māori in surgery given the lack of studies over the majority of surgical specialties.
Authors: Jason A McVicar; Alana Poon; Nadine R Caron; M Dylan Bould; Jason W Nickerson; Nora Ahmad; Donna May Kimmaliardjuk; Chelsey Sheffield; Caitlin Champion; Daniel I McIsaac Journal: CMAJ Date: 2021-05-17 Impact factor: 8.262
Authors: Jason A McVicar; Alana Poon; Nadine R Caron; M Dylan Bould; Jason W Nickerson; Nora Ahmad; Donna May Kimmaliardjuk; Chelsey Sheffield; Caitlin Champion; Daniel I McIsaac Journal: CMAJ Date: 2021-08-23 Impact factor: 8.262