The New Zealand medical journal
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Comparative Study
Audit of acute referrals to the Department of Dermatology at Waikato Hospital: comparison with national access criteria for first specialist appointment.
This audit was designed to compare current referral practice with the Ministry of Health elective services National Access Criteria for first Specialist Assessment (ACA) guidelines, to identify specific problems, and (if possible) to improve the use of acute dermatology services. ⋯ Inappropriate referrals are time-consuming and reduce our capacity for seeing community patients on the waiting list. To improve referral triage, we recommend that a referral letter that clearly specifies the information that should be provided. The majority of acute referrals did not comply with the ACA guidelines. We recommend applying the ACA guidelines to internal acute dermatology referrals (as well as those from GPs) to reduce unnecessary inpatient reviews, and to provide a better urgent service for those persons who truly require it.
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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. ⋯ 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.