Davis P, Lay-Yee R, Finn E, Gribben B
Centre for Health Services Research and Policy, University of Auckland.
N Z Med J. 1998 Nov 13;111(1077):419-21.
To document trends in ethnic group and occupational class differences in the use of general practitioner services and in patterns of clinical activity for the Hamilton Health District of the Waikato over the period 1979-80 to 1991-92.
The data are drawn from a baseline and a follow-up survey of general practice in the Waikato region representing a one per cent sample of all in-surgery, in-hours, week-day encounters at two points in time. The data were recorded by participating general practitioners in four collection weeks spaced over the period of a year. In total, 9468 and 10,235 patient encounter forms were completed respectively.
Over a period in which service availability and rates of medical contact grew, there was a relatively greater increase in utilisation among Maori and lower socioeconomic groups: between the two surveys the ratio of Maori to non-Maori rates increased from 0.8 to 1.0 and the ratio of visits for lower to higher socioeconomic groups grew from a differential of 2.5 to one of 3.1. More serious conditions apart, these changes seemed to occur uniformly regardless of the severity, amenability or susceptibility of the condition presented to the general practitioner. Changes in ethnic group and occupational class patterns of service activity almost exactly mirrored these trends.
A notable relative increase in rates of contact for primary medical care among Maori and lower socioeconomic groups seems to have accompanied the growth in the 1980s of the availability of general practitioner services in this region of New Zealand.
记录1979 - 1980年至1991 - 1992年期间，怀卡托地区汉密尔顿健康区在全科医生服务使用及临床活动模式方面的种族群体和职业阶层差异趋势。
数据取自怀卡托地区全科医疗的基线调查和随访调查，代表了两个时间点所有工作日工作时间内手术室内就诊情况的1%样本。数据由参与调查的全科医生在一年中分布的四个收集周内记录。总共分别完成了9468份和10235份患者就诊表格。
在服务可及性和医疗接触率上升的时期，毛利人和社会经济地位较低群体的利用率增长相对更大：在两次调查之间，毛利人与非毛利人使用率的比率从0.8升至1.0，社会经济地位较低与较高群体就诊率的差异从2.5扩大至3.1。除了病情更严重的情况外，无论向全科医生呈现的病情严重程度、可治疗性或易感性如何，这些变化似乎都是一致发生的。种族群体和职业阶层的服务活动模式变化几乎完全反映了这些趋势。
在20世纪80年代新西兰该地区全科医生服务可及性增加的同时，毛利人和社会经济地位较低群体的初级医疗护理接触率相对显著上升。
