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Benchmarking home parenteral nutrition in Scotland and New Zealand: disparities revealed.

AIM
Home parenteral nutrition (HPN) remains the treatment of choice for severe intestinal failure. These patients are few in number but consume significant resource in funding and personnel. Patients receiving HPN in Scotland and New Zealand (NZ) are both tracked through HPN registers which enable clinical audit for identifying important variations in practice. Scotland and NZ have similar demographics, healthcare systems, and populations (Scotland 5.1 million, NZ 4.1 million).


METHODS
The HPN registers for Scotland and New Zealand for 2005 were examined for patients who received HPN during 2005 together with the diagnostic category identified (ICD-10) that resulted in provision of HPN.


RESULTS
The diagnostic categories for the 2005 HPN patients were similar in both countries but rates of provision were much higher in Scotland (71 patients vs 14 patients).


CONCLUSIONS
Despite similar demographics, healthcare systems, and population size, HPN is utilised to a significantly lesser extent in NZ. The reasons for this are not clear. However, it is possible that there is a lack of recognition of the need for HPN and/or under provision of HPN, which may lead to poorer treatment outcomes.