Health Services Research Centre, School of Government, Victoria University of Wellington, New Zealand.
Aust N Z J Public Health. 2010 Oct;34(5):451-7. doi: 10.1111/j.1753-6405.2010.00589.x.
To identify the characteristics of New Zealanders who utilised primary healthcare services prior to the implementation of the New Zealand Primary Healthcare Strategy (PHCS).
This paper uses data from the 1996/97 and 2002/03 waves of the nationally representative New Zealand Health Survey to examine the relationship between individual, household and community characteristics and the utilisation of healthcare services by New Zealanders. Multivariate regression models are used to examine the correlation between particular characteristics and whether an individual visited a GP in the previous 12 months, the number of visits made to a GP in the previous 12 months, whether they reported needing to see a GP in the previous 12 months, but failed to do so, and whether they visited a secondary practitioner in the previous 12 months.
Gender, age, and ethnicity are all found to be significantly related to healthcare utilisation, even when controlling for a fairly comprehensive set of characteristics. On the other hand, education, marital status, household composition, household income and community deprivation are found to be unrelated to healthcare utilisation. A strong relationship is found between employment status, health status and healthcare utilisation.
We do not find any evidence of a relationship between socioeconomic status and healthcare utilisation after controlling for other measures of need. This and other findings suggest that the government subsidies in place prior to the implementation of the 2001 Primary Healthcare Strategy helped to ensure that user charges did not limit service utilisation in New Zealand for groups with lower socioeconomic status.
确定在新西兰初级医疗保健战略（PHCS）实施之前使用初级医疗保健服务的新西兰人的特征。
本文使用了来自全国代表性的新西兰健康调查的 1996/97 年和 2002/03 年两个波次的数据，以检验个人、家庭和社区特征与新西兰人医疗服务使用之间的关系。采用多元回归模型检验特定特征与个体在过去 12 个月内是否看过全科医生、在过去 12 个月内看全科医生的次数、在过去 12 个月内是否报告需要看全科医生但未就诊、以及在过去 12 个月内是否看过二级从业者之间的相关性。
即使控制了一系列相当全面的特征，性别、年龄和族裔仍被发现与医疗保健的使用显著相关。另一方面，教育、婚姻状况、家庭构成、家庭收入和社区贫困程度与医疗保健的使用无关。就业状况、健康状况与医疗保健的使用之间存在很强的关系。
我们没有发现任何证据表明，在控制其他需求衡量标准后，社会经济地位与医疗保健的使用之间存在关系。这一发现和其他发现表明，在实施 2001 年初级医疗保健战略之前，政府的补贴有助于确保在新西兰，较低社会经济地位群体的用户收费不会限制服务的使用。
