Resource implications of a national health target: The New Zealand experience of a Shorter Stays in Emergency Departments target

2014 ◽  
Vol 26 (6) ◽  
pp. 579-584 ◽  
Author(s):  
Peter Jones ◽  
Elizaveta Sopina ◽  
Toni Ashton
Keyword(s):  
New Zealand ◽  
National Health ◽  
Emergency Departments ◽  
Health Target

Advanced practice in ophthalmic nursing: A comparison of roles and the effects of policy on practice in the UK and New Zealand

2010 ◽  
Vol 18 (1) ◽  
pp. 7-18 ◽  
Author(s):  
Janet Marsden ◽  
Mary E. Shaw ◽  
Sue Raynel
Keyword(s):  
Health Policy ◽  
New Zealand ◽  
National Health ◽  
Mixed Method ◽  
Advanced Practice ◽  
National Health Policy ◽  
Minimal Effect ◽  
Questionnaire Data ◽  
Role Development ◽  
The Uk

This paper compares the results of studies of ophthalmic advanced practice in two similar but distinct health economies and integrates the effects of the setting, health policy and professional regulation on such roles. A mixed method questionnaire design was used, distributed at national ophthalmic nursing conferences in the UK and in New Zealand. Participants were nurses undertaking advanced practice who opted to return the questionnaire. Data were analysed separately, and are compared here, integrated with national health policy and role regulation to provide commentary on the findings. The findings suggest that health policy priorities stimulate the areas in which advanced practice roles in ophthalmic nursing emerge. The drivers of role development appear similar and include a lack of experienced doctors and an unmanageable rise in healthcare demand. Titles and remuneration are different in the two health economies, reflecting the organisation and regulation of nursing. In clinical terms, there are few differences between practice in the two settings and it appears that the distinct systems of regulation have minimal effect on role development. Ophthalmic nursing, as a reactive, needs based profession and in common with nursing in general, evolves in order that practice reflects what is needed by patients and services.

A view from abroad: a New Zealand perspective on the English NHS health reforms

2016 ◽  
Author(s):  
Robin Gauld
Keyword(s):  
Health Policy ◽  
New Zealand ◽  
Health System ◽  
Access To Care ◽  
Healthcare System ◽  
National Health ◽  
Universal Access ◽  
National Health System ◽  
High Income ◽  
Coalition Government

The English NHS is of significance among health policy observers around the globe for various reasons. The NHS is particularly noteworthy for the fact that, for many, it represents the high-income world’s best attempt to have built and maintained a ‘national’ health system with a focus on universal access to care that is free at point of service. The NHS has been in transition for several years. Many commentators have highlighted the role and influence of US market ideals in this transition, with various UK governments clearly pushing this agenda. However, is often useful to look to countries more closely comparable to England, such as New Zealand, for comparison with a view to improvement. This chapter takes such an approach in looking at the NHS from abroad. It draws upon the case of NZ which, in many ways, is very similar to England when it comes to health policy and the healthcare system. In doing so, it aims to provide a critique of the NHS reforms and demonstrate that there are alternatives to the policies and structures being pursued for the English NHS by the Coalition government.

scholarly journals Considerations of response bias and value in linking an existing longitudinal cohort study with national health record data

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Joanne Allen ◽  
Andy Towers ◽  
Fiona Alpass ◽  
Christine Stephens
Keyword(s):  
Cohort Study ◽  
New Zealand ◽  
National Health ◽  
Data Linkage ◽  
Longitudinal Survey ◽  
Health Record ◽  
Health Work ◽  
Longitudinal Cohort ◽  
Record Data ◽  
Retirement Study

ABSTRACTObjectiveLongitudinal cohort studies remain important sources of information in health and epidemiological research and represent a significant investment of resources. The maintenance of these cohorts over time and the representativeness of retained participants are important considerations for researchers. For those weighting the benefits of augmenting a longitudinal cohort study with data linkage to national health records, the potential for bias in consent and match rates and the utility of the newly obtained data are also key considerations. This study presents an analysis of bias associated with consent to participate and record matching in an established longitudinal cohort of older persons. We present the unique outcomes generated from this national health record data linkage project and the opportunities such variables present for longitudinal cohort studies.ApproachThe New Zealand Health, Work and Retirement study is a biennial survey of persons aged 55-85 which commenced in 2006. Over the past decade, additional cohorts have been recruited to the study, with n = 9003 older New Zealand residents participating to the year 2015. In 2013 the study began an approach to active survey participants for consent to link their longitudinal survey data to national health record data held by the New Zealand Health Information Service, including data related to hospital events, the New Zealand Cancer Registry, pharmaceutical data and mental health data. We compare self-reported longitudinal health trends associated with consent/declination to participate as well as for record match success and failure. Key outcomes derived from these national datasets for the purposes of the Health, Work and Retirement Study are described.ResultsConsent (62.5%) and declination (8.9%) to participate in the data linkage project are described in terms of the corresponding longitudinal self-reported health and socio-demographic trends for these groups. Successful and unsuccessful matches of participants to national health record data are also described. The calculation of outcomes from each of the linked datasets obtained and their potential utility in building upon existing longitudinal cohort data are also presented.ConclusionsNational health record data linkage presents a potentially valuable source of data to supplement and replicate findings related to health outcomes and expenditure derived from longitudinal cohort surveys. The challenges and successes of the New Zealand Health, Work and Retirement survey data linkage project touch upon considerations pertinent to evaluating the value of augmenting existing and ongoing longitudinal survey cohort for other researchers.

scholarly journals Variation in CT use for paediatric head injuries across different types of emergency departments in Australia and New Zealand

2020 ◽  
Vol 37 (11) ◽  
pp. 686-689
Author(s):  
Catherine L Wilson ◽  
Emma J Tavender ◽  
Natalie T Phillips ◽  
Stephen JC Hearps ◽  
Kelly Foster ◽  
...  
Keyword(s):  
New Zealand ◽  
Head Injury ◽  
North America ◽  
Emergency Departments ◽  
Head Injuries ◽  
Admission Rate ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Paediatric Head Injury ◽  
Tertiary Hospitals

ObjectivesCT of the brain (CTB) for paediatric head injury is used less frequently at tertiary paediatric emergency departments (EDs) in Australia and New Zealand than in North America. In preparation for release of a national head injury guideline and given the high variation in CTB use found in North America, we aimed to assess variation in CTB use for paediatric head injury across hospitals types.MethodsMulticentre retrospective review of presentations to tertiary, urban/suburban and regional/rural EDs in Australia and New Zealand in 2016. Children aged <16 years, with a primary ED diagnosis of head injury were included and data extracted from 100 eligible cases per site. Primary outcome was CTB use adjusted for severity (Glasgow Coma Scale) with 95% CIs; secondary outcomes included hospital length of stay and admission rate.ResultsThere were 3072 head injury presentations at 31 EDs: 9 tertiary (n=900), 11 urban/suburban (n=1072) and 11 regional/rural EDs (n=1100). The proportion of children with Glasgow Coma Score ≤13 was 1.3% in each type of hospital. Among all presentations, CTB was performed for 8.2% (95% CI 6.4 to 10.0) in tertiary hospitals, 6.6% (95% CI 5.1 to 8.1) in urban/suburban hospitals and 6.1% (95% CI 4.7 to 7.5) in regional/rural. Intragroup variation of CTB use ranged from 0% to 14%. The regional/rural hospitals admitted fewer patients (14.6%, 95% CI 12.6% to 16.9%, p<0.001) than tertiary and urban/suburban hospitals (28.1%, 95% CI 25.2% to 31.2%; 27.3%, 95% CI 24.7% to 30.1%).ConclusionsIn Australia and New Zealand, there was no difference in CTB use for paediatric patients with head injuries across tertiary, urban/suburban and regional/rural EDs with similar intragroup variation. This information can inform a binational head injury guideline.

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