Comprehensiveness of Primary Care Services in New Zealand

Abstract

OBJECTIVES: There is a lack of research on the assessment of the comprehensiveness of primary care services in New Zealand. Together with the current government’s “Better, Sooner, More Convenient” primary care policy which is about providing more services in the primary care level, there is a need to examine how comprehensive are NZ’s primary care services, as well as finding out what are the factors that influence comprehensive services. METHOD: This study used the GP and the patient experience surveys from the NZ Quality and Costs of Primary Care (QUALICOPC) study and extracted the relevant parts regarding comprehensiveness of services to examine the range of services provided by general practitioners (GPs) and the perception of patients on comprehensive services. Principle component analysis, factor analysis and regression analysis were employed to explore the data and answer our research questions. A comprehensiveness score was constructed to compare how well GPs with different characteristics performed in providing comprehensive services, as well as comparing how strong patients with different characteristics perceived their service experience as comprehensive. RESULTS: Nearly all GPs provided treatment and follow up services and health education to their patients. However, GPs did not perform so well in the provision of services regarding health promotion and non-technical medical advice. The principle component analysis revealed that there were 12 components of comprehensiveness in the GP data and 7 components in the patient data. Male GPs tended to provide a higher degree of comprehensiveness while female patients tended to have a stronger perception on comprehensive services. Older GPs tended to provide more treatment and follow up services and lesser preventive care to patients than younger GPs. GPs who shared accommodation, and practiced in rural areas achieved higher overall comprehensiveness than others. CONCLUSION: This study provides valuable information on the comprehensiveness of primary care services in NZ, in particular, the services provided by GPs. It identifies the gaps in general practice for primary care services and increases our understanding on the characteristics of comprehensive services.