Julia is a final stage medical student at the University of Sydney and working with the NSW Health Mental Health Living Longer project to complete her MD dissertation. Prior to studying medicine, Julia graduated from the University of Toronto and worked as a neuroscientist studying concussion and mood disorders. Julia is very passionate about brain health and is an aspiring psychiatrist-scientist. Alongside her research pursuits, Julia is a yoga teacher and is highly involved in mental health advocacy work.
Title: Mental health consumers’ access to planned and emergency surgery in NSW
Author(s): Julia A. Hamer, Wendy Chen, Grant Sara
Introduction: Effective health systems provide timely access to planned surgery when needed. Different rates of surgery between groups may reflect differences in disease prevalence, primary health care, or access to specialist care. High rates of emergency surgery may reflect reduced access to planned care. Our aim was to describe rates of planned and emergency surgery for NSW mental health service users.
Methods: Using the NSW Mental Health Living Longer linked dataset, we calculated surgery procedure rates in NSW public and private hospitals in 2018-19. We compared rates for mental health service users to other NSW residents using incidence rate ratios adjusted for age, sex, disadvantage and rurality. We examined planned and emergency procedures separately, and compared different procedure types.
Results and findings: We identified 2.1 million in-scope surgical procedures and approximately 256,000 mental health service users. 83% of procedures were planned. Compared to the matched NSW population, mental health service users had nearly one fifth more planned surgical procedures (aIRR 1.18, 95% CI 1.17-1.19) and more than three times as many emergency surgical procedures (aIRR 3.42, 95% CI 3:38 -3:46). Subgroup analyses will be presented on specific procedure types, AIHW access-sensitive procedures and different subgroups of mental health consumers.
Discussion: People who use mental health services have a slightly increased rate of planned surgical procedures and a more than three-fold increase in emergency surgical procedures. These findings are not accounted for by social disadvantage. They may reflect greater prevalence of acute and chronic medical conditions requiring surgery, or barriers in access to primary care or planned surgery when and where it is needed. Access to planned surgical care may be an overlooked factor contributing to unequal health outcomes in people living with a mental illness.