New Zealand: Where Are We Going?
New Zealand is a small remote country with 4.4 million increasingly ethnically diverse inhabitants. There is a well-entrenched tradition of publicly funded social services including healthcare, education and welfare. Public expectations of the capabilities of the welfare state have become tempered in recent years by the legacy of the free-market reforms which began in the late 1980s and by the almost-stagnant economy which has yet to recover from the 2008 global recession. Per capita GDP at purchasing power parity is just over half that of the US. Health expenditure  is around 75 % of that in Australia, Canada and most of western Europe but only a third of US health expenditure. Publicly funded healthcare occupies a dominant position in health care with 81 % of expenditure being Government-funded . Intensive care medicine (as it is known in New Zealand) is almost completely confined to the 25 ICUs in public hospitals . Most of these are multi-disciplinary ICUs—only one is a speciality ICU (cardiovascular) and there is only one paediatric ICU. There are small intensive care units confined to post-surgical (mostly cardiac) patients in three private hospitals.
KeywordsEurope Pneumonia Meningitis Catecholamine Theophylline
- 1.International Monetary Fund. World economic outlook database. Washington DC: International Monetary Fund. 2010. http://www.imf.org/external/pubs/ft/weo/2010/02/weodata/index.aspx. Accessed 16 Nov 2010.
- 2.The New Zealand Health and Disability System: Organisations and Responsibilities. Briefing to the Minister of Health. Wellington: Ministry of Health. 2008. http://www.moh.govt.nz/moh.nsf/pagesmh/8704/$File/nz-health-disability-system-briefing2008.doc. Accessed 16 Nov 2010.
- 3.Drennan K, Hart GK, Hicks P. Intensive care resources and activity: Australia and New Zealand 2006/2007. Melbourne: ANZICS. 2008. http://www.anzics.com.au/. Accessed 23 Nov 2010.
- 4.Verdon-Roe A, Gilbert J. The world of wings and things. New York: Arno Press; 1979.Google Scholar
- 8.Trubuhovich RV. From respiratory support to critical care: my early days in intensive care medicine. Crit Care Resusc. 2007;9(2):123–6.Google Scholar
- 16.Streat S. Improving the effectiveness of our practices. In: Flaatten H, Moreno R, Putensen C, Rhodes A, editors. Organisation and management of intensive care. Berlin: Medizinisch Wissenschaftliche Verlagsgesellschaft; 2010.Google Scholar
- 22.Angus DC, Kelley MA, Schmitz RJ, White A, Popovich J Jr; Committee on Manpower for Pulmonary and Critical Care Societies (COMPACCS). Caring for the critically ill patient. Current and projected workforce requirements for care of the critically ill and patients with pulmonary disease: can we meet the requirements of an aging population? JAMA. 2000;284(21):2762–70.Google Scholar