Citation

Wyeth E, Lambert M, Samaranayaka A, Harcombe H, Davie GS, Derrett S. N. Zeal. Med. J. 2019; 132(1499): 23-35.

Affiliation

Professor, Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin.

Copyright

(Copyright © 2019, New Zealand Medical Association)

DOI

unavailable

PMID

31352471

Abstract

AIM: Māori, the indigenous population of New Zealand, experience a disproportionate burden of injury compared to non-Māori. Injury burden can be exacerbated by subsequent injuries (injuries that occur after, but not necessarily because of, an earlier or 'sentinel' injury). Despite obligations under New Zealand's Treaty of Waitangi, it appears no published studies have investigated subsequent injuries among Māori. This study aims to describe subsequent injuries experienced by Māori and reported to New Zealand's no-fault injury Accident Compensation Corporation (ACC), and determine: the number and timing of subsequent injury (SI) claims reported to ACC in 24 months following a sentinel injury; the proportions experiencing ≥1 SI; and the nature of SIs.

METHODS: The Subsequent Injury Study analysed interview, ACC and hospital discharge data. SIs were classified as injury events involving an ACC claim within 24 months of a sentinel injury.

RESULTS: Of 566 participants, 349 (62%) experienced ≥1 SI in the 24 months post-sentinel injury. Those with moderate/high alcohol use, or cognitive difficulties, before the sentinel injury were more likely to experience SIs. Fewer SIs occurred between 0-3 months after a sentinel injury compared to later periods. Spine dislocations/sprains/strains were the most common SI type.

CONCLUSIONS: Despite their descriptive nature, our findings point to both the complexity of SI and the need for a greater research, ACC and health service focus on SI if the burden of injury for Māori is to be truly addressed. That 62% of Māori who had already experienced a profound sentinel injury went on to experience ≥1 SIs reported to ACC within a 24-month period suggests that the burden is considerable, and that preventive opportunities are being missed. Additional analyses are now underway to investigate factors predicting SI, while accounting for potential confounders, in order to assist in the development of SI prevention initiatives for Māori at multiple points in the complex post-injury pathway.

Language: en