Ethnic variation in access to publicly funded care for unintentional injuries in older adults in Aotearoa New Zealand: a retrospective study.

Background: Māori (the Indigenous people of Aotearoa New Zealand (NZ)) are more likely to experience injury than non-Māori, but less likely to have effective access to publicly funded injury care services. It is unknown if this pattern extends into older age. This retrospective study analysed Accident Compensation Corporation (ACC; national no-fault injury compensation scheme) claims data to investigate ethnic variation in unintentional injury claims and related costs for older adults (≥50 years).

Methods: Injury claims data for older adults residing in two regions of NZ between January 2014 and December 2018 were reviewed. Age-standardised claims rates (per person year) standardised rate ratios were calculated and compared between Māori and non-Māori. ACC claim costs (medical treatment; earning-related compensation) were estimated, with total and average costs per claim compared between the two groups.

Results: There were 149 275 ACC claims (18 369 Māori; 130 906 non-Māori) among 64 238 individuals (9284 Māori; 54 954 non-Māori). The age-standardised rate of ACC claims for unintentional injury was 46% higher among non-Māori (95% CI 44% to 48%) than Māori. The ACC spend for non-Māori was NZ$155 277 962 compared with NZ$30 446 673 for Māori. Māori had a significantly higher average cost per claim (NZ$1658 vs NZ$1186, p<0.001).

Conclusions: Results of this study highlight differences in the manner in which different groups of older adults access injury compensation in NZ, indicating the need to invest in injury prevention initiatives that target older Māori, as well as initiatives supporting improved ACC access for older Māori.