Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Health Systems, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
BMJ Open. 2018 Jun 19;8(6):e020763. doi: 10.1136/bmjopen-2017-020763.
There is significant international interest in the economic impacts of persistent inequities in morbidity and mortality. However, very few studies have quantified the costs associated with unfair and preventable ethnic/racial inequities in health. The proposed study will investigate inequities in health between the indigenous Māori and non-Māori adult population in New Zealand (15 years and older) and estimate the economic costs associated with these differences.
The study will use national collections data that is held by government agencies in New Zealand including hospitalisations, mortality, outpatient consultations, laboratory and pharmaceutical claims, and accident compensation claims. Epidemiological methods will be used to calculate prevalences for Māori and non-Māori, by age-group, gender and socioeconomic deprivation (New Zealand Deprivation Index) where possible. Rates of 'potentially avoidable' hospitalisations and mortality as well as 'excess or under' utilisation of healthcare will be calculated as the difference between the actual rate and that expected if Māori were to have the same rates as non-Māori. A prevalence-based cost-of-illness approach will be used to estimate health inequities and the costs associated with treatment, as well as other financial and non-financial costs (such as years of life lost) over the person's lifetime.
This analysis has been approved by the University of Auckland Human Participants Research Committee (Ref: 018621). Dissemination of findings will occur via published peer-reviewed articles, presentations to academic, policy and community-based stakeholder groups and via social media.
发病率和死亡率持续存在的不公平现象所带来的经济影响引起了国际社会的广泛关注。然而,很少有研究对与健康方面不公平和可预防的族裔/种族不平等相关的成本进行量化。本研究将调查新西兰(15 岁及以上)本土毛利人和非毛利成年人之间的健康不平等问题,并估计这些差异所带来的经济成本。
本研究将使用新西兰政府机构持有的全国性数据,包括住院、死亡率、门诊咨询、实验室和药品索赔以及事故赔偿索赔。将使用流行病学方法计算毛利人和非毛利人按年龄组、性别和社会经济贫困程度(新西兰贫困指数)的患病率,如果可能的话。“可避免的”住院率和死亡率以及医疗保健的“过度或不足”使用率将通过实际比率与毛利人达到与非毛利人相同比率时的预期比率之间的差异来计算。将采用基于患病率的疾病成本法来估计健康不平等以及与治疗相关的成本,以及与终生治疗相关的其他经济和非经济成本(例如失去的生命年)。
该分析已获得奥克兰大学人类参与者研究委员会的批准(参考:018621)。研究结果将通过已发表的同行评议文章、向学术、政策和社区利益相关者团体以及通过社交媒体进行传播。