Outcome measures for Maori with non-traumatic dental presentations: a retrospective observational study and Kaupapa Maori approach examining emergency department inequities.

AIM: To assess the equity of care of patients with non-traumatic dental presentations (NTDP) to Christchurch Emergency Department (ED) in Aotearoa New Zealand. METHODS: This retrospective observational study reviews NTDP to Christchurch ED over a 2-year period (2018-2020). ED and hospital outcomes were compared for Maori, Pacific peoples and NZ Europeans. Results are interpreted utilising Te Ao Maori principles and discussed referencing a Kaupapa Maori framework. RESULTS: There were a total of 2,034 NTDPs, with Maori (27.0%) and Pacific peoples (6.9%) being over-represented compared to local population estimates (9.4% and 3.2% respectively). Maori experienced shorter wait times (45 minutes, 95% CI 22-86) compared to NZ Europeans (56 minutes, 95% CI 24-97) and Pacific peoples (54 minutes, 95% CI 23-97). Maori had the highest age-standardised incidence of admission, but shorter hospital length of stay (0.9 days, IQR 0.4-2.3) compared to Pacific peoples (3.8 days, IQR 1.8-3.9) and NZ Europeans (2.0 days, IQR 1.0-3.7). CONCLUSION: This is the first paper to employ a Kaupapa Maori approach examining NTDP patients presenting to the ED. While outcome measures were largely positive, differences in demographic variables indicate upstream failures, specifically barriers to accessing primary oral healthcare and a paucity of Kaupapa Maori initiatives. Further action and accountability are required to provide high-quality, equitable care for Maori.