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Post-operative mortality in New Zealand

New Zealand’s Perioperative Mortality Review Committee (POMRC) recently reported that, between 2009-2013, Māori New Zealanders were 62% more likely to die within 30 days following an elective or waiting list procedure (adjusted odds ratio [OR]: 1.62, 95% CI 1.33-1.97) – even after adjusting for age, gender, deprivation and physical status (‘ASA’ score). 

There is an urgent need to describe in detail the extent to which disparities in postoperative mortality exist between Māori and non-Māori, particularly for surgical procedures that are major causes of postoperative mortality and/or morbidity.  This research also needs to measure the extent to which any observed disparities are explained by patient-level factors, surgical quality-of-care factors and health system level factors (as outlined above). The factors that drive postoperative mortality among Māori may be different to the factors that drive postoperative mortality for non-Māori; also, the magnitude of the impact of common factors (such as comorbidity) may differ between Māori and non-Māori.  It is crucial that we understand where these differences lie, in order to best-inform our actions to address them.

Our research in this area focusses on a) comparing the risk of post-operative mortality between Māori and non-Māori New Zealanders across multiple surgical specialties, and b) identifying the key drivers of observed disparities.  To achieve this, we have received project funding from the Health Research Council of New Zealand as part of the 2018 round (HRC reference #: 18/037).