The New Zealand medical journal
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Biography Historical Article Classical Article
Death due to a stingray barb piercing the heart: a New Zealand case from 1939. An unusual bathing fatality.
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Comparative Study
New Zealand health professionals do not agree about what defines appropriate attendance at an emergency department.
Emergency Departments (EDs) worldwide are facing a crisis from overcrowding--a common perception exists that inappropriate use of the ED is the major contributing factor. This study aims to examine the concept of 'inappropriate' ED attendances in relation to the Emergency Department at New Zealand's Christchurch Hospital. It specifically seeks to determine whether there is a consensus opinion among healthcare providers regarding a definition of 'inappropriate'. ⋯ While there are some areas of general agreement, there is no clear consensus between the professionals surveyed regarding the concept of 'appropriateness.' This has implications for any interventions aimed at addressing ED 'overcrowding' that assume the presence of a consensus understanding of this concept.
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Pressure to fund Herceptin (trastuzumab) for use in early-stage breast cancer is a welcome development for those patients who may benefit. However such a decision would have major implications since the health gains made by trastuzumab come at a very high cost (when compared to health gains achieved by other drugs currently funded on PHARMAC's schedule). The budget for trastuzumab (estimated to be NZ30m dollars/annum but this is currently being negotiated) will be funded from district health board (DHB) budgets, which will impact other patients unless DHB budgets are appropriately increased. In comparative terms, this proposed expenditure is almost the same as what is currently being spent on all other oncology agents together, and is similar to the total cost of hospital services in New Zealand regions such as Wairarapa and Marlborough.