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Exposure to primary medical care in New Zealand

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Authors:
Summary:

This observational study used a representative survey of visits to general practitioners to estimate exposure to primary medical care amongst different population groups. The highest annual exposure to primary medical care was observed amongst the elderly (aged > 65 years) and then adults aged 18 to 64 years. Ethnically European New Zealanders had higher annual exposure to primary medical care in comparison to those of Mäori, Pacific, and Asian ethnicity after controlling for age, gender, NZDep2001, rural/urban, and organisation type. There was no effect of deprivation (NZDep2001 quintiles) on exposure to primary medical care after controlling for other factors. The authors note that populations groups with high healthcare needs should be expected to have greater exposure to primary medical care, but that this does not appear to be the case for New Zealanders of Mäori, Pacific, and Asian ethnicity, or for those living in deprived areas.

Comment:
It is a major concern that given the high health need, Mäori do not have relatively high exposure to primary medical care. The flow-on effects will be significant as a visit to the GP is often the first step in the care pathway including prevention (screening or immunizations), primary health care (diagnosis and management of illness) and referral to secondary and tertiary services (hospital and specialist care). One major barrier is cost and the recent subsidies for adults aged 18 to 45 enrolled at PHO’s may address the inequalities somewhat. Other barriers require similar attention.
Reference: J NZMA 2007; 120(1256)
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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