Affiliation with a primary care provider in New Zealand: Who is, who isn’t

Jatrana, Santosh, and Crampton, Peter (2009) Affiliation with a primary care provider in New Zealand: Who is, who isn’t. Health Policy, 91 (3). pp. 286-296.

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Aims: New Zealand has a mixed public–private funded primary care system. In the last decade, considerable effort has gone into reducing the financial barriers to primary care, with some targeting of greater public funding of practices in more deprived areas. In this paper we explore the association of socio-demographic factors with affiliation with a primary care provider (PCP), and specifically examine the association with deprivation. Affiliation refers to having a doctor, nurse or medical centre one could go to if need arises.

Methods: We used data from the third wave (2004–2005) of an ongoing 8-year panel study of 22,000 adults that includes a health add-on. This paper utilises demographic, socio-economic and health behaviour characteristics of those who reported affiliation with a PCP at wave 3. Affiliation itself was measured with the question: “do you have a doctor, nurse or medical centre you usually go to, if you need to see a doctor?” Logistic regression is used to determine the independent association of a range of socio-demographic factors with affiliation with a PCP.

Results: Of the total of 18,320 respondents, 1530 (8.3%) reported no affiliation with a PCP. The odds of affiliation was significantly lower for males compared to females (OR 0.45, 95% CI: 0.39–0.50), never married compared to currently married (OR 0.48, 95% CI: 0.41–0.57), Asians compared to New Zealand Europeans (OR 0.47, 95% CI: 0.38–0.57), current smokers compared to never smokers (OR 0.79, 95% CI: 0.68–0.91) and those with post-school education compared to no education (OR 0.65, 95% CI: 0.55–0.76) and higher for older adults aged 65 years and over compared to young adults aged 15–24 years old (OR 5.14, 95% CI: 3.59–7.36), those reporting poor self-assessed health compared to those reporting good health (OR 1.45, 95% CI: 1.06–1.98), and those reporting one or more co-morbid conditions compared to no co-morbid conditions (OR 2.02, 95% CI: 1.78–2.29). However, there was no significant difference in affiliation with a PCP between those living in the most deprived areas and the least deprived areas.

Conclusions: Affiliation to a PCP is a measure of potential access to primary care. Overall, our data provide some support for the hypothesis that people with high health needs have high rates of affiliation with a PCP (e.g., elderly, women, Māori and those in poor health). The results also suggest that current health policies in New Zealand, with their emphasis on a strong primary health care system, are ensuring that people with greater health care needs are affiliated with a PCP.

Item ID: 71023
Item Type: Article (Research - C1)
ISSN: 1872-6054
Keywords: Regular health care provider, Primary health care, New Zealand
Copyright Information: © 2009 Elsevier Ireland Ltd.
Date Deposited: 16 Dec 2021 07:47
FoR Codes: 42 HEALTH SCIENCES > 4203 Health services and systems > 420319 Primary health care @ 100%
SEO Codes: 28 EXPANDING KNOWLEDGE > 2801 Expanding knowledge > 280112 Expanding knowledge in the health sciences @ 20%
20 HEALTH > 2002 Evaluation of health and support services > 200204 Health inequalities @ 80%
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