Aotearoa New Zealand cochlear implant programmes equity audit: addressing disparities and equity for Māori with severe and profound hearing loss.

AIM

We examined equity in the provision of cochlear implant services for New Zealand Māori compared with other New Zealanders.

METHODS

The client databases of both Aotearoa New Zealand cochlear implant programmes were searched and an anonymised dataset was provided to the audit team. Ethics committee approval was not required. Ethnicity was categorised as Māori or non-Māori.

RESULTS

There is no significant difference between Māori and non-Māori with respect to acceptance for surgery rates and time from acceptance to surgery. Māori children and adults have a higher rate of proceeding to surgery than non-Māori ethnic groups. Average days to surgery for adult clients reduced over the period studied. Time to surgery was low for both child ethnic groups. When a measure of prioritisation (clinical priority access criteria [CPAC]) was incorporated into the evaluation, we found that Māori clients waited slightly, but not significantly less time per unit of CPAC scored.

CONCLUSION

We were able to demonstrate that once Māori clients accessed the cochlear implant programmes, they were implanted at a similar rate as non-Māori, and adult clients experienced equivalent waiting times even when adjusted for CPAC score. These favourable results suggest that our internal systems and pathways are promoting equity.