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Primary health care in New Zealand: Who has access?

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  • Jatrana, Santosh
  • Crampton, Peter

Abstract

Objective We examined the demographic, socioeconomic, health behaviour and health determinants of financial barriers to access to general practitioner services, prescription drugs and dental care in New Zealand (NZ).Methods Data from SoFIE-health, which is an add-on to the Statistics New Zealand-led Survey of Family, Income and Employment (SoFIE), were analyzed using logistic regression.Results Of the total of 18,320 respondents, 2845 (15.5%), 4175 (22.8%), and 1165 (6.4%), reported that they had deferred seeing their doctor/s, dentist and buying a prescription, respectively, at least once during the preceding 12 months, because they could not afford the cost of a visit or prescription. Younger age, female sex, low or middle income tertile, living in a least deprived area, having more individual deprivation characteristics (5+), current smokers, reporting high and very high levels of psychological distress and more than two co-morbid diseases were all independently associated with increased odds of deferring doctors' visits, collecting medications and dental visits.Conclusions Financial barriers to needed primary care exist for a substantial subgroup of people in New Zealand. A key policy lever is lowering cost barriers to make primary health care in general and dental care in particular more accessible.

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  • Jatrana, Santosh & Crampton, Peter, 2009. "Primary health care in New Zealand: Who has access?," Health Policy, Elsevier, vol. 93(1), pages 1-10, November.
    • Handle: RePEc:eee:hepoli:v:93:y:2009:i:1:p:1-10
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    1. Green, Carla A & Pope, Clyde R, 1999. "Gender, psychosocial factors and the use of medical services: a longitudinal analysis," Social Science & Medicine, Elsevier, vol. 48(10), pages 1363-1372, May.
    2. Parslow, Ruth & Jorm, Anthony & Christensen, Helen & Jacomb, Patricia & Rodgers, Bryan, 2004. "Gender differences in factors affecting use of health services: an analysis of a community study of middle-aged and older Australians," Social Science & Medicine, Elsevier, vol. 59(10), pages 2121-2129, November.
    3. Schoen, Cathy & Doty, Michelle M., 2004. "Inequities in access to medical care in five countries: findings from the 2001 Commonwealth Fund International Health Policy Survey," Health Policy, Elsevier, vol. 67(3), pages 309-322, March.
    4. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
    5. Diamant, A.L. & Hays, R.D. & Morales, L.S. & Ford, W. & Calmes, D. & Asch, S. & Duan, N. & Fielder, E. & Kim, S. & Fielding, J. & Sumner, G. & Shapiro, M.F. & Hayes-Bautista, D. & Gelberg, L., 2004. "Delays and Unmet Need for Health Care among Adult Primary Care Patients in a Restructured Urban Public Health System," American Journal of Public Health, American Public Health Association, vol. 94(5), pages 783-789.
    6. Phongsavan, Philayrath & Chey, Tien & Bauman, Adrian & Brooks, Robert & Silove, Derrick, 2006. "Social capital, socio-economic status and psychological distress among Australian adults," Social Science & Medicine, Elsevier, vol. 63(10), pages 2546-2561, November.
    7. Keeler, Emmett B. & Rolph, John E., 1988. "The demand for episodes of treatment in the health insurance experiment," Journal of Health Economics, Elsevier, vol. 7(4), pages 337-367, December.
    8. Himmelstein, D.U. & Woolhandler, S., 1995. "Care denied: US residents who are unable to obtain needed medical services," American Journal of Public Health, American Public Health Association, vol. 85(3), pages 341-344.
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    3. Robin Gauld & Simon Horsburgh, 2016. "Does a host country capture knowledge of migrant doctors and how might it? A study of UK doctors in New Zealand," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 61(1), pages 1-8, January.
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    7. Jatrana, Santosh & Crampton, Peter, 2021. "Do financial barriers to access to primary health care increase the risk of poor health? Longitudinal evidence from New Zealand," Social Science & Medicine, Elsevier, vol. 288(C).

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