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Rural-urban differences in wait-time to general surgical outpatient care.
1Department of Surgery, Taranaki Base Hospital, New Plymouth, New Zealand.
Summary
Rural patients in Taranaki, New Zealand, experience significantly longer surgical wait times compared to urban patients. This disparity is greatest for those in the R1 rural category and for Māori and early settler populations, highlighting a need for targeted interventions.
Area of Science:
- Health Services Research
- Surgical Access Equity
- Rural Health Disparities
Background:
- The Ministry of Health aims to reduce health inequalities, particularly geographic and ethnic disparities in healthcare access.
- This study investigates the impact of rurality on surgical care provision in Taranaki, New Zealand, to inform interventions.
- Understanding these disparities is crucial for equitable healthcare delivery.
Purpose of the Study:
- To determine if rurality in Taranaki, New Zealand, affects the provision of general surgical care.
- To quantify differences in wait times for surgical appointments based on geographic location and ethnicity.
- To support the development of interventions to minimize inequities in surgical care access.
Main Methods:
- A 24-month retrospective analysis of 2878 general surgery referrals in Taranaki, New Zealand.
- Rurality was classified using the Statistical Standard for Geographic Areas 2018 (SSGA18) and Geographic Classification for Health (GCH).
- Wait time (referral to first specialist appointment) was analyzed using a 2-tailed Student's t-test, examining the impact of rurality and ethnicity.
Main Results:
- Patients in rural categories (GCH) experienced longer mean wait times (90 days) compared to urban counterparts (81.5 days).
- The R1 rural classification showed significantly longer wait times (95.3 days) versus urban (81.5 days, P=0.0017).
- Rural Māori and settler patients faced the longest wait times (101.2 days) compared to urban European Pakeha (white New Zealanders, P=0.035). Similar trends were observed using SSGA18 classifications.
Conclusions:
- Rural patients, particularly those in the R1 category and Māori and early settlers, face significantly longer wait times for surgical care.
- These findings underscore a pronounced inequity in surgical care access based on geography and ethnicity in Taranaki.
- Interventions such as rural specialist clinics, improved hospital transport, and virtual triaging are recommended to address these disparities.
Keywords:
Médecine ruraleRural general surgerychirurgie générale en milieu ruralinégalités dans la prestation de soins chirurgicaux en milieu ruralprestation de soins chirurgicaux en milieu ruralrural medicinerural surgical care provisionrural surgical care provision inequitiestemps d’attentewait-times
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