Otago rural hospitals study: what do utilisation rates tell us about the performance of New Zealand rural hospitals?

AIM

To provide a description of the role and function of Otago Province's three main rural hospitals, utilising analysis of hospital discharge data for the period July 2001 to June 2002.

METHODS

Calculation of hospitalisation rates based on analysis of information contained in the National Minimum Dataset (Hospital Events); Census data from Statistics New Zealand; and local knowledge of hospital utilisation by geographical district.

RESULTS

A comparison between the rural Otago population and New Zealand (as a whole) show age-standardised hospitalisation rates of 19,847 vs 19,930 per 100,000, and a mean length of hospital stay of 4.5 days vs 6.8 days respectively. Patients aged over 75 years account for 49% of the work of rural Otago hospitals calculated by total bed days; 9% of patients account for 28% of the total discharges.

CONCLUSIONS

Results show that Otago's rural hospitals (when compared to the New Zealand average) provide an efficient and appropriate service for their communities when judged by hospitalisation rates, mean length of stay, and patient groups cared for. There are serious difficulties encountered in using the National Minimum Dataset to analyse the workload of a rural hospital. An agreed methodology to overcome these difficulties is needed as they have significant implications for service planning and resource allocation for rural hospitals in New Zealand.