Paine Sarah-Jane, Li Chao, Wright Karen, Harris Ricci, Loring Belinda, Reid Papaarangi
Te Kupenga Hauora Māori, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand.
Te Rōpū Rangahau Hauora a Eru Pōmare, University of Otago, Wellington, New Zealand.
N Z Med J. 2022 Jan 20;136(1568):23-45. doi: 10.26635/6965.5874.
This study estimates of the cost of Indigenous child health inequities in New Zealand.
Standard quantitative epidemiological and cost of illness methodologies were used within a Kaupapa Māori framework. Data for 2003-2014 on children under 15 years were obtained from government datasets. Rates of potentially avoidable hospitalisations and mortality, as well as excess or under-utilisation were calculated. Publicly funded health sector costs, costs to families and costs of premature mortality were used to estimate the costs (or savings) of inequities.
Māori children had lower utilisation rates than non-Māori for primary healthcare, outpatient care, medicines, laboratory investigations and care after an accident/injury. Māori children had greater rates of avoidable hospitalisation (RR=1.36, 95% CI 1.35-1.37) and death (RR 1.98, 95% CI 1.84-2.13). Inequalities between Māori and non-Māori children cost in excess of $170 million NZD each year. This includes an annual net savings for the government health sector of $4 million NZD, with an annual cost to society of around $175 million NZD.
The under-serving of Māori children in the health sector saves the government health system money, yet imposes a huge cost on Māori families and society. In addition to avoiding considerable human suffering, reducing child health inequities would result in significant economic benefits.
本研究估算了新西兰原住民儿童健康不平等问题的成本。
在毛利人健康框架内采用标准的定量流行病学和疾病成本方法。2003 - 2014年15岁以下儿童的数据来自政府数据集。计算了潜在可避免的住院率和死亡率,以及过度或未充分利用的比率。使用公共资助的卫生部门成本、家庭成本和过早死亡成本来估算不平等问题的成本(或节省的成本)。
在初级医疗保健、门诊护理、药品、实验室检查以及事故/受伤后的护理方面,毛利儿童的利用率低于非毛利儿童。毛利儿童的可避免住院率(相对风险=1.36,95%置信区间1.35 - 1.37)和死亡率(相对风险1.98,95%置信区间1.84 - 2.13)更高。毛利儿童与非毛利儿童之间的不平等每年造成超过1.7亿新西兰元的成本。这包括政府卫生部门每年净节省400万新西兰元,而社会每年的成本约为1.75亿新西兰元。
卫生部门对毛利儿童服务不足为政府卫生系统节省了资金,但给毛利家庭和社会带来了巨大成本。除了避免巨大的人类痛苦外,减少儿童健康不平等将带来显著的经济效益。