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- Ethnic variation in access to publicly funded care for unintentional injuries in older adults in Aotearoa New Zealand: a retrospective study
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Original research
Ethnic variation in access to publicly funded care for unintentional injuries in older adults in Aotearoa New Zealand: a retrospective study
- http://orcid.org/0000-0002-5709-367XAlana Cavadino1,
- Braden Te Ao2,
- Ngaire Kerse3,
- http://orcid.org/0000-0002-2537-4688Bridget Kool1,
- John Parsons4,
- http://orcid.org/0000-0001-6792-6607Joanna Hikaka3,5
- 1Epidemiology & Biostatistics, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
- 2The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
- 3General Practice and Primary Health Care, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
- 4Exercise Sciences, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
- 5Te Kupenga Hauora Māori, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand
- Correspondence to Dr Joanna Hikaka, General Practice and Primary Health Care, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New Zealand; j.hikaka{at}auckland.ac.nz
Abstract
Background Māori (the Indigenous people of Aotearoa New Zealand (NZ)) are more likely to experience injury than non-Māori, but less likely to have effective access to publicly funded injury care services. It is unknown if this pattern extends into older age. This retrospective study analysed Accident Compensation Corporation (ACC; national no-fault injury compensation scheme) claims data to investigate ethnic variation in unintentional injury claims and related costs for older adults (≥50 years).
Methods Injury claims data for older adults residing in two regions of NZ between January 2014 and December 2018 were reviewed. Age-standardised claims rates (per person year) standardised rate ratios were calculated and compared between Māori and non-Māori. ACC claim costs (medical treatment; earning-related compensation) were estimated, with total and average costs per claim compared between the two groups.
Results There were 149 275 ACC claims (18 369 Māori; 130 906 non-Māori) among 64 238 individuals (9284 Māori; 54 954 non-Māori). The age-standardised rate of ACC claims for unintentional injury was 46% higher among non-Māori (95% CI 44% to 48%) than Māori. The ACC spend for non-Māori was NZ$155 277 962 compared with NZ$30 446 673 for Māori. Māori had a significantly higher average cost per claim (NZ$1658 vs NZ$1186, p<0.001).
Conclusions Results of this study highlight differences in the manner in which different groups of older adults access injury compensation in NZ, indicating the need to invest in injury prevention initiatives that target older Māori, as well as initiatives supporting improved ACC access for older Māori.
- Older People
- Health Disparities
- Costs
Data availability statement
Data are available upon reasonable request. No data are available. Due to the current ethical approval for the study, data are not publicly available to share.
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- Older People
- Health Disparities
- Costs
Data availability statement
Data are available upon reasonable request. No data are available. Due to the current ethical approval for the study, data are not publicly available to share.
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Footnotes
X @johikaka
Contributors AC, BTA: methodology, formal analysis, interpretation, writing - original draft, review and editing. JP, NK and BK: conceptualisation, methodology, interpretation, writing - review and editing. JH: conceptualisation, methodology, interpretation, writing - original draft, review and editing, project administration, funding acquisition. All authors had access to the raw data, contributed to drafting the paper, and reviewed and approved the final version. AC is responsible for the overall content as guarantor.
Funding This research is funded by Health Research Council of NZ, ACC, and the National Science Challenge Ageing Well (HRC:20/1379). Funders had no role or influence over the study design, collection, analysis and interpretation or reporting of the data.
Competing interests None declared.
Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.
Provenance and peer review Not commissioned; externally peer reviewed.
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