Malcolm Laurence, Barnett Ross
Aotearoa Health, Christchurch.
J Prim Health Care. 2009 Dec;1(4):297-301.
To compare enrolment data for ethnicity and deprivation and other classifications in Partnership Health Primary Health Organisation (PHO) general practices with the National Health Index (NHI) data set and hospital discharge data and to analyse use of special access funding.
NHI-linked practice data were obtained through Partnership Health and sent directly to New Zealand Health Information Service (NZHIS). The database was linked with the hospital discharge data for the two years ending June 2007, with the NHIs encrypted. Data were analysed for a range of variables and relationships especially related to ethnicity.
Data was obtained from atotal of 345 247 patients in 103 practices. Practices varied widely in their data completion including ethnicity, the latter being unavailable in 7.2% of patients. Ethnicity recording in Partnership Health practice was substantially more complete than national NHI records. Maori in the hospital records was 6.1% compared with 7.0% in the Partnership Health records relating to discharged patients (p < .001). Practice use of special access funding varied widely and was unrelated to need.
Despite substantial practice database development, findings point to the need for further collaborative and innovative strategies to improve data recording. Issues needing to be addressed nationally include regular updating and correction of the national NHI set from PHO records. PHO data could, with improvements, become the basis for District Health Board databases. The findings support the current national review of the use of special access funding which appears to be seriously inequitable and inefficient.
比较合作健康初级卫生组织（PHO）全科医疗中种族、贫困及其他分类的登记数据与国家健康指数（NHI）数据集及医院出院数据，并分析特殊访问资金的使用情况。
通过合作健康获取与NHI相关的医疗数据，并直接发送给新西兰健康信息服务局（NZHIS）。该数据库与截至2007年6月的两年期医院出院数据相链接，NHI数据进行了加密处理。对一系列变量及关系进行了分析，尤其涉及种族相关内容。
从103家医疗机构的总共345247名患者处获取了数据。各医疗机构在数据完整性方面差异很大，包括种族数据，7.2%的患者没有种族信息。合作健康医疗机构的种族记录比国家NHI记录要完整得多。医院记录中的毛利人占6.1%，而合作健康记录中出院患者的毛利人占7.0%（p <.001）。医疗机构对特殊访问资金的使用差异很大，且与需求无关。
尽管医疗机构数据库有了很大发展，但研究结果表明仍需进一步采取合作性和创新性策略来改善数据记录。全国范围内需要解决的问题包括根据PHO记录定期更新和校正国家NHI数据集。PHO数据若能改进，可成为地区卫生局数据库的基础。研究结果支持当前对特殊访问资金使用情况的全国性审查，该审查显示其存在严重的不公平和低效率问题。
