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

Author

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  • Jatrana, Santosh
  • Crampton, Peter

Abstract

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, Maori 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.

Suggested Citation

  • Jatrana, Santosh & Crampton, Peter, 2009. "Affiliation with a primary care provider in New Zealand: Who is, who isn't," Health Policy, Elsevier, vol. 91(3), pages 286-296, August.
    • Handle: RePEc:eee:hepoli:v:91:y:2009:i:3:p:286-296
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    References listed on IDEAS

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    1. Hayward, R.A. & Bernard, A.M. & Freeman, H.E. & Corey, C.R., 1991. "Regular source of ambulatory care and access to health services," American Journal of Public Health, American Public Health Association, vol. 81(4), pages 434-438.
    2. Starfield, Barbara & Shi, Leiyu, 2002. "Policy relevant determinants of health: an international perspective," Health Policy, Elsevier, vol. 60(3), pages 201-218, June.
    3. Katharina Hauck & Nigel Rice, 2004. "A longitudinal analysis of mental health mobility in Britain," Health Economics, John Wiley & Sons, Ltd., vol. 13(10), pages 981-1001, October.
    4. Kandrack, Mary-Anne & Grant, Karen R. & Segall, Alexander, 1991. "Gender differences in health related behaviour: Some unanswered questions," Social Science & Medicine, Elsevier, vol. 32(5), pages 579-590, January.
    5. Shi, L. & Starfield, B., 2001. "The effect of primary care physician supply and income inequality on mortality among Blacks and Whites in US metropolitan areas," American Journal of Public Health, American Public Health Association, vol. 91(8), pages 1246-1250.
    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. repec:bla:ausecr:v:37:y:2004:i:3:p:343-349 is not listed on IDEAS
    8. 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.
    9. Starfield, B., 1996. "Public health and primary care: a framework for proposed linkages," American Journal of Public Health, American Public Health Association, vol. 86(10), pages 1365-1369.
    10. Grumbach, K. & Keane, D. & Bindman, A., 1993. "Primary care and public emergency department overcrowding," American Journal of Public Health, American Public Health Association, vol. 83(3), pages 372-378.
    11. Popay, Jennie & Bartley, Mel & Owen, Charlie, 1993. "Gender inequalities in health: Social position, affective disorders and minor physical morbidity," Social Science & Medicine, Elsevier, vol. 36(1), pages 21-32, January.
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    1. McRae, Ian & Yen, Laurann & Gillespie, James & Douglas, Kirsty, 2011. "Patient affiliation with GPs in Australia—Who is and who is not and does it matter?," Health Policy, Elsevier, vol. 103(1), pages 16-23.
    2. 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).
    3. Thomson, Michael, 2019. "Who had access to doctors before and after new universal capitated subsidies in New Zealand?," Health Policy, Elsevier, vol. 123(8), pages 756-764.

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