Pacific Patterns in Primary Health Care: A comparison of Pacific and all patient visits to doctors: The National Primary Medical Care Survey (NatMedCa): 2001/02. Report 7

Abstract

This study compares the experience of Pacific patients with that of the total population (including Pacific). The data was contributed by community general practices and A&M clinics. The report uses the data on 2,293 visits by Pacific patients (4% of all visits) with full encounter recordings for 536 visits. Sixty percent of Pacific patients saw a private GP, and 26.5% were seen at community-governed practices. Three hundred and twenty visits (13.9% on all Pacific visits) were at Māori provider general practices. Half of the encounters with Pacific patients took place in Auckland, where Pacific patients made up 13.9% of total visits recorded. Half of the consultations were for those aged under 25 (compared to a quarter of the total sample). Overall, the attendance records were similar to the total sample, but there were higher rates for those under five, women over 55 and men over 65. Two thirds of Pacific patients had a benefit card compared with half the total sample. Nearly half lived in NZDep 2001 decile 10 areas. Practitioners assessed 22.4% as not fluent in English, compared with 4.1% of the total population. Although attachment to the practice that patients attended was similar to the total sample, GPs reported less rapport than average with Pacific patients. Few presentations were judged life-threatening (1.1%) and 73.5% were judged as intermediate or self-limiting. The average number of reasons for attending (1.3) was similar to that for the total sample. The number of problems recorded by GPs (1.4) was slightly less than the total sample (1.7). Nearly one third problems presented were respiratory conditions (compared with one fifth in the total sample). Pacific patients were less likely (17.8%) to have tests and investigations ordered than the total sample (24.9%). Drugs were prescribed during consultation more frequently (71.2% vs 66.2%) than in the total sample, and the number of prescriptions was higher per visit and per problem. Pacific patients (52.3%) were slightly less likely to be referred for treatment than in the total sample (57.3%). Pacific patients received fewer non-prescription treatments and treatment items than the total sample. Non-drug management was recorded for 47.5% of consultations, compared with 62.1% for the total sample. The most common item was health advice, more frequently for females. The average length of visit for those attending private GPs was shorter than for the other types of practice (community-governed practices and Māori GPs), and fewer tests and investigations were ordered. More treatment items were offered to patients. There were some differences in treatment between Pacific and total populations at A&M Clinics. Pacific patients were less likely to receive a test or investigation in “normal working hours” visits, but there was no difference in “out of office” hours. They were less likely to receive a prescription or non-drug treatment in either of the sessions but had higher rates of follow-up than patients from the total sample.