With the advent of NES, the ethnicity that is used for funding is no longer the ethnicity that you have recorded in your PMS. It is now the ethnicity that is recorded in the MoH NHI data set.
This has caused some issues for practices and PHOs as the ethnicity on the Enrolment Form and the ethnicity on the NHI are different. Our current advice is that where ethnicity is recorded on the enrolment form but not the NHI then you should add the additional ethnicity. Where it is on NHI but not the enrolment form then we recommend that you check with the patient before making any changes to the NHI ethnicity.
However, it is still important that you correctly record the patient's ethnicity in your PMS. Recording a patient's ethnicity correctly can be harder than it looks. The following FAQs explain how to enter multiple ethnicities and how to enter a 'non-standard' ethnicity into your PMS.
1. Does it matter where I record ethnicity in the three possible fields in Medtech?
From a PHO perspective, it doesn't matter which of the three ethnicity fields you use to record a patient's ethnicity.
From a patient perspective, it may matter to them, so you need to be sensitive to that.
From a practice perspective, if you wish to run queries by ethnicity, it is easier if you put the priority ethnicity in the first ethnicity. Then you can just do one query on the first ethnicity.
There is a prioritisation standard that we are currently required to use for PHO funding and reporting. This specifies the order in which ethnicities are considered if a patient selects more than one ethnicity. The prioritisation order is:
- Maori (21)
- Samoan (31)
- Cook Island Maori (32)
- Tongan (33)
- Niuean (34)
- Tokelauan (35)
- Fijian (36)
- Other Pacific Island (37)
- Pacific Island not further defined (30)
- South-East Asian (41)
- Chinese (42)
- Indian (43)
- Other Asian (44)
- Asian not further defined (40)
- Middle Eastern (51)
- Latin American/Hispanic (52)
- African (53)
- Other (61)
- NZ European/Pakeha (11)
- Other European (12)
- European not further defined (10)
- Unknown (99)
This prioritisation order is used to determine the ethnicity of a patient for funding purposes from the 6 Level 5 ethnicities that are recorded in the NHI record.
2. What if we want to code people to a more detailed level than the NZ Statistics two-digit code (non-standard ethnicities)?
It is possible to code people to a more detailed level than the NZ Statistics two-digit code. However, there are two things we recommend you do:
Set up an 'Unload Reference'
It is a good idea to ensure that in the set-up of the non-standard ethnicity, you correctly fill in the Unload Ref to match the two-digit code that the person would be part of. For example, Australian Aboriginal should be set up with the Unload Ref of 37, which equates to 'Other Pacific Peoples'. See the example below. If you do this, whenever that person's information is unloaded (Imms, PHO export etc) it will be unloaded as 37 which is a valid two-digit ethnicity code!
Choose the NZ Statistics code
What code should I use to set up a non-standard ethnicity? We would strongly recommend that you try and identify the full NZ Stats code for the ethnicity in question. Using this example, the NZ Stats code for Australian Aboriginal is 37112, so that is the code you should use (see below for example). The reason for this is so that you can still easily extract people by group, using queries. For example, this person will be included if you run a query for 'anyone with ethnicity starting with 3' i.e. all Pacific people on your database.
3. How do the ethnicities from NHI work?
In the NHI system, there is the ability to record up to 6 different Level 5 ethnicities. All 6 of these ethnicities are considered for funding purposes and the highest priority ethnicity as per the list above will be the one used for PHO funding and clinical reports. In the NES file, there are also a further 3 Level 2 ethnicities that are sent - these level 2 ethnicities are the top 3 Level 2 ethnicities based on the same prioritisation list.
The Statistics NZ site has a detailed explanation of the ethnicity coding:
The files with the full lists of ethnicity coding are on the right-hand side of the screen and are downloadable.
Or if you just want to find a code then try using their code finder, select Ethnicity under 1. Select a classification and then type the ethnicity in 2. Search by and search by Keyword.