Provision of rheumatology services in New Zealand

To measure equity of access to rheumatology services and to assess the adequacy of the rheumatology workforce-compared with published recommended levels, United Kingdom levels, and previous New Zealand data; and to provide data to assist in workforce planning.

Data from of the central North Island of New Zealand were obtained during a review of rheumatology services in the Midland region. Complete national public-sector rheumatology workforce data were obtained in a separate survey.

This study demonstrates wide geographical variation in outpatient (more than three-fold variation) and inpatient (more than six-fold variation) service volumes per capita between the District Health Boards of the Midland region. Outpatient waiting lists were not higher in underserviced areas. Nationally, there were 251,211 people for each full time equivalent (FTE) rheumatologist, compared with the 1999 level of 235,593 population per FTE, and well behind the UK recommendation of 85,000 people per FTE. CONCLUSIONS This study has demonstrated marked variation in access to rheumatology services based on geographical location, as well as evidence of a worsening shortage of rheumatologists in New Zealand.