An abdominal aortic aneurysm (AAA) screening programme to improve health outcomes for Māori Dr Da le Bra mle y, Chie f E xe c utive Dr Pe te r Sa ndifo rd, Clinic a l Dire c to r He a lth Ga in
The problem He a lth ine q ua litie s b e twe e n Māori and non - Māori New Zealanders are large, pervasive, and pe rsist a c ro ss the life spa n a nd o ve r time 7 to 9 ye a r g a p in life e xpe c ta nc y b e twe e n Māori • a nd no n- Māori New Zealanders • Māori develop and die fro m a b do mina l a o rtic a ne urysms (AAA) 8 ye a rs yo ung e r tha n Ne w Ze a la nd E uro pe a ns • Only 40% of AAA detected in Māori are repaired by e le c tive surg e ry (61% in E uro pe a ns)
Overall aim • Help Māori in o ur re g io n to live lo ng e r a nd e njo y a b e tte r q ua lity o f life Sa ve Māori lives by • re duc ing mo rta lity fro m AAA
De ve lo p a nd te st Ne w Ze a la nd’ s first Māori -spe c ific Ab do mina l Ao rtic Ane urysm (AAA) sc re e ning pro g ra mme in pa rtne rship with ma na whe nua
Programme development c h: Re se ar • E pide mio lo g ic inve stig a tio n q ua ntifying fo r the first time the b urde n o f dise a se in NZ due to AAA a nd de mo nstra ting e no rmo us e thnic ine q ua litie s in AAA inc ide nc e a nd mo rta lity in Ne w Ze a la nd Ne w polic y de ve lopme nt: • Bo a rd a ppro va l to sc re e n a ll Māori in Auckland and Wa ite ma ta DHBs a nd a dditio n o f a n inno va tive me tho d o f he a rt a rrhythmia (a tria l fib rilla tio n) sc re e ning
AAA screening programme Simple solution: • A fre e o nc e -in-a -life time ultra so und sc a n o f the a b do me n to de te c t AAA unde rta ke n b y a Māori ultra so und te c hnic ia n e ative c onc e pts: Cr • Applie d a Māori ka upa pa a ppro a c h using the He Piking a Wa io ra I mple me nta tio n F ra me wo rk
Innovative business model Applie d rig o ro us he a lth ne e ds a na lysis me tho ds • with a spe c ific fo c us o n re duc ing e thnic he a lth ine q ua litie s Use d c o st-e ffe c tive ne ss mo de ling a da pting a • Ca mb ridg e Unive rsity mo de l in c o lla b o ra tio n with Ota g o Unive rsity
AAA screening results A simple ultra so und sc a n is a n a c c e pta b le sc re e ning test for Māori with high participation ra te s Pre va le nc e
Results • 183% r e tur n on inve stme nt Additio na l b e ne fits c a n b e re a lise d b y o ffe ring • smo king c e ssa tio n a dvic e a nd c a rdio va sc ula r dise a se risk a sse ssme nt a t time o f sc re e ning
What we have learnt Public services can be made to work for Māori a nd c a n a c hie ve o utsta nding o utc o me s a t a n a ffo rda b le c o st Health inequalities are not inevitable for Māori and c a n b e re duc e d thro ug h a ppro pria te ly de sig ne d a nd c o nduc te d inte rve ntio ns E xtra o rdina rily hig h pa rtic ipa tio n ra te a c hie ve d in this pilo t o ffe rs a mo de l fo r o the r sc re e ning pro g ra mme s a nd fo r wide r so c ia l se rvic e s g e ne ra lly
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