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| Journal of the New Zealand Medical Association,
28-January-2005, Vol 118 No 1208
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This Issue in the Journal
Occupational class has been used extensively to monitor
trends in socioeconomic mortality gradients. Using linked census and mortality
data for New Zealand, Blakely and Fawcett find many likely biases that may
impact on the measurement of occupational class differences in mortality. They
conclude that whilst using occupational class to monitor socioeconomic trends
over time in mortality in New Zealand is possible, it must be done very
cautiously.
Heart failure
hospitalisations and deaths in New Zealand: patterns by deprivation and
ethnicity
T Riddell The focus of this research was to examine the association
between socioeconomic deprivation and heart failure deaths and hospitalisations
for Maori and non-Maori New Zealanders. This study found that deprivation was
associated with an increased chance of death and hospitalisation from heart
failure in New Zealand. However, within all socioeconomic strata, this risk was
higher for Maori than non-Maori. Further studies are needed to explain the
influence of other determinants such as lifecourse and lifestyle exposures,
neighbourhood characteristics, access to medical care, and racism.
Antithrombotic therapy in
atrial fibrillation: an assessment of compliance with guidelines
A Nair, W Hazell, T Sutton, S Pillai Atrial fibrillation is the most common arrhythmia and
accounts for 15% of all strokes. This has resulted in the recommendation for
commencement of prophylactic medications for prevention of strokes. The study
showed a significant underuse of these medications (especially warfarin) in
atrial fibrillation at our institution.
Avoiding and fixing medical
errors in general practice: prevention strategies reported in the Linnaeus
Collaboration’s Primary Care International Study of Medical
Errors
M Tilyard, S Dovey, K Hall This international study reports strategies used by general
practitioners in six countries to prevent medical errors seen in their everyday
clinical practices. The default strategy in all countries, including New
Zealand, reflected the unhelpful “name, shame, blame” medical
culture. Other useful strategies were proposed and some had been implemented.
These findings suggest that “insider” knowledge of the health system
may be an important tool that health system planners should use to make
healthcare safer for patients.
Quality use of medicines
activities in New Zealand hospitals from 2000 to 2002
J Tordoff, P Norris, J Kennedy, D Reith A recent study indicated a range of activities to promote
the appropriate use of medicines were undertaken in New Zealand public hospitals
in 2000 to 2002: Drug Utilisation Reviews and campaigns were undertaken;
formularies, bulletins and drug expenditure data were distributed. Tertiary and
secondary hospitals, where more clinical and specialist pharmacist staff-time
was allocated, reported greater activity. Results suggest that staff resources
may need consideration for activity to increase, and there may be resistance to
central (rather than local) development of treatment guidelines.
New Zealand Rural General
Practitioners 1999 Survey Part 4: analysis of specific sub-groups
R Janes, D Cormack, A Dowell This paper compares and contrasts sub-groups of rural
general practitioners in New Zealand by age, rurality, training, country of
graduation, and island location (North Island or South Island). It confirms the
trend of younger doctors choosing to work part-time, in group practices, and to
not own their practice. As older (predominantly male) rural general
practitioners retire, finding their replacements may prove difficult, as it will
require a greater number of these part-time younger (and increasingly female)
doctors.
Accident and fatality
characteristics in a population of mountain climbers in
New Zealand
E Monasterio This is the first reported, systematic study that follows a
group (49) of experienced climbers for 4 years. The purpose of the study was to
determine the injury and death rate in this group. The results show that there
was a significant rate of serious injury (involving 47% of climbers) and death
(8.2%) related to climbing misadventure, and recommends urgent further
investigation into the relationship between mountaineering, accidents, and fatal
accidents.
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