title: Real world initiation of newly funded empagliflozin and dulaglutide under special authority for patients with type 2 diabetes in New Zealand

authors: Chepulis, Lynne Merran

subjects: GLP1RA

abstract: Background: Type 2 diabetes (T2D) is sub-optimally managed for many in Aotearoa New Zealand, and disproportionately affects Māori and Pacific peoples. In February 2021, SGLT2i/GLP1RA agents were funded for use for the first time with prioritisation for Māori, Pacific and those with cardiovascular and/or renal disease or risk (CVRD). This study evaluates the impact of health system factors on initiation of SGLT2i/GLP1RA therapy. 

Methods: Primary care data was collected for patients with T2D aged 18–75 years from four primary care organisations (302 general practices) in the Auckland / Waikato region of New Zealand (Feb 2021 – July 2022). Initiation of SGLT2i/GLP1RA therapy was reviewed by patient (age, gender, ethnicity, CVRD status) and health system variables (funding, provider type, staffing, patient numbers, rurality, after-hours access). Logistic regression was used to estimate the odds ratio of a patient being dispensed SGLT2i/GLP1RA. 

Results: Of 57,743 patients with T2D, 22,331 were eligible for funded SGLT2i/GLP1RA access and 10,272 of those (46.0%) were prescribed. Initiation of therapy was highest in Māori (50.8%) and Pacific (48.8%) patients (vs. 36·2–40·7% of other ethnic groups; P < 0.001), but was comparable in those with and without CVRD (47·1% vs. 48·9%; P = 0.2). Prescribing was highest in practices with higher doctor/patient numbers, low-cost fees, Māori health providers and clinics without after-hours access.

Conclusion: Prioritised access for SGLT2i/GLP1RA appears to be associated with a reduced health equity gap for Māori and Pacific patients with T2D in NZ, but work is required to improve prescribing for patients with CVRD.

text: Real world initiation of newly funded empagliflozin and dulaglutide under special authority for patients with type 2 diabetes in New Zealand Background: Type 2 diabetes (T2D) is sub-optimally managed for many in Aotearoa New Zealand, and disproportionately affects Māori and Pacific peoples. In February 2021, SGLT2i/GLP1RA agents were funded for use for the first time with prioritisation for Māori, Pacific and those with cardiovascular and/or renal disease or risk (CVRD). This study evaluates the impact of health system factors on initiation of SGLT2i/GLP1RA therapy. 

Methods: Primary care data was collected for patients with T2D aged 18–75 years from four primary care organisations (302 general practices) in the Auckland / Waikato region of New Zealand (Feb 2021 – July 2022). Initiation of SGLT2i/GLP1RA therapy was reviewed by patient (age, gender, ethnicity, CVRD status) and health system variables (funding, provider type, staffing, patient numbers, rurality, after-hours access). Logistic regression was used to estimate the odds ratio of a patient being dispensed SGLT2i/GLP1RA. 

Results: Of 57,743 patients with T2D, 22,331 were eligible for funded SGLT2i/GLP1RA access and 10,272 of those (46.0%) were prescribed. Initiation of therapy was highest in Māori (50.8%) and Pacific (48.8%) patients (vs. 36·2–40·7% of other ethnic groups; P < 0.001), but was comparable in those with and without CVRD (47·1% vs. 48·9%; P = 0.2). Prescribing was highest in practices with higher doctor/patient numbers, low-cost fees, Māori health providers and clinics without after-hours access.

Conclusion: Prioritised access for SGLT2i/GLP1RA appears to be associated with a reduced health equity gap for Māori and Pacific patients with T2D in NZ, but work is required to improve prescribing for patients with CVRD.

year: 2025

title: Kaupapa Māori research- Some Kaupapa Māori principles

authors: Smith, Linda Tuhiwai

abstract: This paper was first presented at a conference of Māori academic staff at Massey University in 1996. It predates the publication of Decolonising Methodologies in 1998. You will note that since this paper was first presented our understandings and experiences in using Kaupapa Māori have deepened and we have significant capacity in Kaupapa Māori research. In 1996 there were many topics we could not imagine in depth as we had not completed the work to realise the potential of Kaupapa Māori. Also, our thinking was tentative and we were searching for the pathways to research that made sense in Māori ways. In looking back on the paper I can see my own naïve explorations into ideas that I thought were important. I have resisted the urge to rewrite this paper entirely as I think it stands as a good historical moment of where we were and where we are now. It needs to be read in the context of the 1990s.

text: Kaupapa Māori research- Some Kaupapa Māori principles This paper was first presented at a conference of Māori academic staff at Massey University in 1996. It predates the publication of Decolonising Methodologies in 1998. You will note that since this paper was first presented our understandings and experiences in using Kaupapa Māori have deepened and we have significant capacity in Kaupapa Māori research. In 1996 there were many topics we could not imagine in depth as we had not completed the work to realise the potential of Kaupapa Māori. Also, our thinking was tentative and we were searching for the pathways to research that made sense in Māori ways. In looking back on the paper I can see my own naïve explorations into ideas that I thought were important. I have resisted the urge to rewrite this paper entirely as I think it stands as a good historical moment of where we were and where we are now. It needs to be read in the context of the 1990s.

year: 2015

title: Measurement error and the effect of inequality on experienced versus reported crime

authors: Gibson, John

subjects: crime

abstract: This paper analyzes measurement errors in crime data to see how they impact econometric estimates, particularly of the key relationship between inequality and crime. Criminal victimization surveys of 140,000 respondents in 37 industrial, transition and developing countries are used. Comparing the crimes experienced by these respondents with those reported to the police, non-random and mean-reverting measurement errors are apparent. Some time-varying factors may also affect the propensity of victims to report crimes to the police, undermining the use of country-specific fixed effects as a means of dealing with measurement errors in official crime data. These measurement errors substantially attenuate both cross-sectional and panel estimates of the effect of inequality on crime.

text: Measurement error and the effect of inequality on experienced versus reported crime This paper analyzes measurement errors in crime data to see how they impact econometric estimates, particularly of the key relationship between inequality and crime. Criminal victimization surveys of 140,000 respondents in 37 industrial, transition and developing countries are used. Comparing the crimes experienced by these respondents with those reported to the police, non-random and mean-reverting measurement errors are apparent. Some time-varying factors may also affect the propensity of victims to report crimes to the police, undermining the use of country-specific fixed effects as a means of dealing with measurement errors in official crime data. These measurement errors substantially attenuate both cross-sectional and panel estimates of the effect of inequality on crime.

year: 2006-07