Understanding disparities in post-operative mortality for Indigenous patients.

Area of Science:

• Health Services Research
• Indigenous Health
• Surgical Outcomes

Background:

• Post-operative mortality disparities exist between Indigenous Māori and non-Indigenous New Zealanders.
• A national audit of 4 million procedures (2005-2017) highlighted these significant inequities.
• Understanding the drivers of these disparities is crucial for global Indigenous populations.

Purpose of the Study:

• To analyze the multi-level drivers contributing to post-operative mortality disparities in Indigenous peoples.
• To present a framework for understanding and addressing inequities in surgical outcomes.
• To inform interventions aimed at improving post-operative care for Indigenous populations.

Main Methods:

• Analysis of a national audit of 4,000,000 surgical procedures (2005-2017).
• Conceptualization of drivers in layered categories: structural, care system, care process, care team, and patient factors.
• Development of a framework to understand and address identified inequities.

Main Results:

• Considerable disparities in post-operative mortality were identified between Indigenous Māori and non-Indigenous New Zealanders.
• Drivers of disparities operate across multiple levels, from systemic to individual factors.
• A layered framework illustrates the interconnectedness of factors influencing surgical outcomes.

Conclusions:

• Addressing post-operative mortality inequities requires a comprehensive understanding of multi-level drivers.
• The proposed framework can guide targeted interventions to reduce disparities for Indigenous peoples.
• Urgent action and intervention are needed to achieve equitable surgical outcomes for Indigenous populations worldwide.