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BMJ 2012; 344 doi: (Published 29 February 2012) Cite this as: BMJ 2012;344:e1395

Social inequality drives up admissions for infectious diseases in New Zealand

New Zealand has experienced a surge in hospital admissions for infectious diseases, driven by high rates among indigenous New Zealanders and people with a Pacific island heritage, according to a study of hospital admissions data.

Between 1989 and 2008, admissions for infectious diseases rose by 51% (from 1242/100 000 population to 1880/100 000), while admissions for non-infectious diseases rose by just 7.3% (4823/100 000 to 5175/100 000). Pneumonias and infections of skin, soft tissues, and the gastrointestinal tract dominated the picture, accounting for more than half of all acute admissions for infections during the study.

The gap between minority and majority ethnic groups widened over time. By 2008, people who described themselves as Maori or Pacific peoples were twice as likely as those describing themselves as “European or other” to be admitted with an infectious disease. The gap between rich and poor also widened, with admission rates rising fastest among the poorest social groups, regardless of ethnicity.

These data challenge the received wisdom that developed countries can sideline infectious disease policy and shift resources towards chronic diseases instead, says a linked comment (doi:10.1016/S0140-6736(12)60151-2). Social inequality is closely linked to infectious disease through overcrowding and poor access to health services. Both deserve closer scrutiny in New Zealand and elsewhere.

Pharmacists can help primary care doctors cut prescribing errors

Primary care researchers from the UK have developed and tested a protocol led by pharmacists that helps doctors avoid prescribing mistakes. In a cluster randomised trial, practices using the protocol had a dedicated pharmacist who identified risky prescribing from electronic records and met with staff to provide feedback, education, and support over 12 weeks. The pharmacist developed and implemented strategies to encourage safer prescribing of specific drugs. Control practices were given computerised feedback reports of any risky prescribing identified by baseline searches.

Doctors …

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