Causes of excess hospitalisations among Pacific peoples in New Zealand: implications for primary care

Abstract

INTRODUCTION: Pacific people suffer disproportionately poorer health and reduced life expectancy at birth compared to the total New Zealand population. AIM: To assess causes of excess morbidity in the Pacific population, and identify lesser known or previously unknown causes which require further investigation. METHODS: We obtained public hospital discharge data from July 2000 to December 2002. The population data were from the 2001 Census. Standardised discharge ratios were calculated to compare Pacific peoples with the total New Zealand population. RESULTS: Pacific peoples were six times more likely to have a diagnosis of cardiomyopathy and gout, and four to five times of rheumatic fever, gastric ulcer, systemic lupus erythematosus (SLE), and diabetes. Respiratory diseases, skin abscesses, heart failure, cataracts, cerebral infarction and chronic renal failure were also significant causes of excess morbidity. Unexpected causes of excess morbidity included candidiasis, excess vomiting in pregnancy (hyperemesis gravidarum) and pterygium. DISCUSSION: The magnitude of established causes of excess morbidity among Pacific peoples were similar to our findings. Other causes of excess morbidity are less widely known, or are identified here for the first time. These are systemic lupus erythematosus, hyperemesis gravidarum, cardiomyopathy, gastric ulcer, candidiasis and pterygium. The findings draw attention to specific causes of excess morbidity in Pacific communities where effective interventions are available in primary care, and where further research may identify preventive or curative interventions. KEYWORDS: Pacific peoples; primary care; hyperemesis gravidarum; morbidity; hospitalizations