Progress on the Better Public Services rheumatic fever target

In 2012 we started working towards the five-year Better Public Services (BPS) target to reduce rheumatic fever by two-thirds to 1.4 cases per 100,000 people by June 2017.

The table below shows the baseline DHB and national rheumatic fever rates calculated using the average number of cases from 2009/10 to 2011/12. The table also shows the annual reductions needed to meet the BPS target.

  2009/10-2011/12 2012/13 2013/14 2014/15 2015 /16 2016/17
DHB Baseline year (3-year average rate) Remain at baseline level 10% reduction from baseline 40% reduction from baseline 55% reduction from baseline 2/3 reduction from baseline
Northland 10.5 10.5 9.4 6.3 4.7 3.5
Waitemata 2.2 2.2 2.0 1.3 1.0 0.7
Auckland 3.3 3.3 3.0 2.0 1.5 1.1
Counties Manukau 13.6 13.6 12.2 8.2 6.1 4.5
Waikato 3.5 3.5 3.2 2.1 1.6 1.2
Lakes 7.8 7.8 7.0 4.7 3.5 2.6
Bay of Plenty 3.8 3.8 3.4 2.3 1.7 1.3
Hauora Tairāwhiti 8.5 8.5 7.7 5.1 3.8 2.8
Taranaki 0.9 0.9 0.8 0.5 0.4 0.3
Hawke's Bay 4.4 4.4 4.0 2.7 2.0 1.5
MidCentral 1.8 1.8 1.6 1.1 0.8 0.6
Whanganui 3.2 3.2 2.9 1.9 1.4 1.1
Capital & Coast 3.1 3.1 2.8 1.9 1.4 1.0
Hutt Valley 4.9 4.9 4.4 2.9 2.2 1.6
Wairarapa 0.0 0.0 0.0 0.0 0.0 0.0
Southern region 0.5 0.5 0.4 0.3 0.2 0.2
New Zealand 4.0 4.0 3.6 2.4 1.8 1.4

Note – the DHB target rates have been updated using 2014 Statistics New Zealand population projections and may differ slightly from those previously published.

How are we doing with the target?

In the 2016 calendar year the national incidence of rheumatic fever was 3.0 cases per 100,000 people – a total of 137 people were admitted to hospital for the first time with rheumatic fever. This represents a statistically significant 23% decrease in first episode hospitalisations from the baseline (2009/10–2011/12) rate of 4.0 per 100,000.

First episode rheumatic fever hospitalisations, annual rate per 100,000, New Zealand, 2002–2016

While rates since 2013 have generally trended downwards, close to the goal, there was an upward spike in 2016.

Source: National Minimum Dataset

The graph above shows the rate of people admitted to hospital with rheumatic fever for the first time from 2002 to 2016.

First episode rheumatic fever hospitalisations, annual rate per 100,000, Māori and Pacific people, 2011–2016

While rates for Māori have trended down roughly matching the goal, the downward trend for Pacific people reversed in 2015.

Source: National Minimum Dataset
Note that the graph shown on this page differs from that shown previously as it only includes financial year data

The graph above shows the rate of Māori and Pacific people admitted to hospital with rheumatic fever for the first time.

The latest data represent a 48% statistically significant decrease in first episode rheumatic fever hospitalisations for Māori since baseline (2009/10–2011/12).  There has also been a 12% increase from baseline for Pacific – this increase is not statistically significant.

The following table shows the numbers and rates of people being admitted to hospital with rheumatic fever for the first time in 2016 by age group. It shows that the majority of cases occur in children less than 14 years old.

Age group Number Rate (per 100,000)
0–14 years 85 9.3
15–44 years 48 2.6
45+ years 4 0.2

Source: National Minimum Dataset.

The table below details the latest available rheumatic fever rates and case numbers by DHB regions for 2016.

District health board Number Rate per 100,000
Northland 4 2.4
Waitemata 18 3.1
Auckland 26 5.4
Counties Manukau 42 7.9
Waikato 4 1.0
Lakes 6 5.8
Bay of Plenty 9 4.0
Hauora Tairāwhiti <4
Taranaki <4
Hawke's Bay 4 2.5
MidCentral 4 2.3
Whanganui 0 0
Capital & Coast 7 2.3
Hutt Valley 4 2.8
Wairarapa 0 0
Nelson Marlborough <4
West Coast 0 0
Canterbury 4 0.7
South Canterbury 0 0
Southern <4

Source: National Minimum Dataset

Note: Rates have not been calculated where there were fewer than four cases. This is because the small numbers will result in unreliable estimates of rates.

Downloads

You can download the data tables for first episode rheumatic fever hospitalisations. Rates and numbers are available for the New Zealand population, by ethnic group and for district health board. The workbook also includes the data definition that is used to calculate first episode rheumatic fever hospitalisations.

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