2013 VOL. 37 NO. 2 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 189
© 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia
doi: 10.1111/1753-6405.12041
Accuracy of National Health Index
numbers for Pacific people in NZ
Teresa Lepa, Pauline Norris
School of Pharmacy, University of Otago, New Zealand
Simon Horsburgh
Preventive and Social Medicine, University of Otago, New Zealand
Finau Taungapeau
Pacific Trust Otago, New Zealand
National Health Index (NHI) numbers are used in New Zealand
(NZ) to identify patients and link their medical records. The NHI
dataset contains ethnicity and other demographic data on each
patient and so NHIs are important for measuring disparities in
health status, in treatment utilisation and outcomes between ethnic
groups, and monitoring attempts to reduce disparities. However,
previous studies have found inaccuracies in ethnicity data in the
NHI dataset
1-3
that could introduce significant errors into estimates
of healthcare need.
4
In the 2006 Census, Pacific people made up 6.9% of the NZ
population. This proportion will increase significantly in the future,
and Pacific people experience much higher levels of ill-health
than other New Zealanders.
5
There are a range of reasons why the
NHI system might not capture accurate data about Pacific people,
such as healthcare staff’s lack of understanding of Pacific naming
conventions. Our study aimed to investigate the accuracy of ethnicity
data in the NHI dataset for Pacific people in Dunedin.
Most previous studies of the accuracy of ethnicity data have
compared administrative records. In an earlier study, we developed
a novel methodology of working with communities to collect
personal details, and asking the Ministry of Health to check
recorded ethnicities against the ones provided by the community
members.
6
In this study, we worked with the Pacific Trust Otago and
attended events organised by the Trust. The purpose of the study
was explained to people attending the events, and they were asked
to participate. We asked them to provide date of birth, gender, full
name, any other names they might be recorded as, address, length of
residence in NZ and ethnicity. We used both paper and an electronic
form for data collection. Participants were also given the option of
being contacted if their ethnicity was incorrectly recorded in the
NHI database. Participants with incomplete information on the
paper-based questionnaire were contacted by telephone to provide
the missing information. Data was sent to the Ministry of Health
in an attempt to locate NHI numbers for participants and find their
ethnicity/ies. We compared these ethnicities with those given by
participants. For each group, the data was analysed (using Microsoft
Excel) based on linked and matched data with age and length of
residence in NZ.
The 120 participants were from a range of Pacific ethnicities and
had a mean age of 38 (standard deviation of 18). A NHI number
was found for 118 of the participants. Only 93 of the 118 (79%)
Letters