Trends in general practice in the Waikato, 1979-80/1991-92, II: Social variations in service use and clinical activity.

AIMS

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.