Financial barriers to primary health care in Aotearoa New Zealand.

Autor:	Jeffreys M; Te Hikuwai Rangahau Hauora | Health Services Research Centre, Te Herenga Waka-Victoria University of Wellington, Wellington, New Zealand.; Flax Analytics Ltd, Wellington, New Zealand., Ellison-Loschmann L; Flax Analytics Ltd, Wellington, New Zealand., Irurzun-Lopez M; Te Hikuwai Rangahau Hauora | Health Services Research Centre, Te Herenga Waka-Victoria University of Wellington, Wellington, New Zealand., Cumming J; Te Hikuwai Rangahau Hauora | Health Services Research Centre, Te Herenga Waka-Victoria University of Wellington, Wellington, New Zealand., McKenzie F; Te Hikuwai Rangahau Hauora | Health Services Research Centre, Te Herenga Waka-Victoria University of Wellington, Wellington, New Zealand.; Flax Analytics Ltd, Wellington, New Zealand.
Jazyk:	angličtina
Zdroj:	Family practice [Fam Pract] 2024 Dec 02; Vol. 41 (6), pp. 995-1001.
DOI:	10.1093/fampra/cmad096
Abstrakt:	Background: In Aotearoa New Zealand, co-payments to see a general practitioner (GP, family doctor) or collect a prescription are payable by virtually all adults. Objective: To examine the extent to which these user co-payments are a barrier to accessing health care, focussing on inequities for indigenous Māori. Methods: Pooled data from sequential waves (years) of the New Zealand Health Survey, 2011/12 to 2018/19 were analysed. Outcomes were self-reported cost barriers to seeing a GP or collecting a prescription in the previous year. Logistic regression was used to estimate odds ratios (ORs) of barriers to care for Māori compared with non-Māori, sequentially adjusting for additional explanatory variables. Results: Pooled data included 107,231 people, 22,292 (21%) were Māori. Across all years, 22% of Māori (13% non-Māori) experienced a cost barrier to seeing a GP, and 14% of Māori (5% non-Māori) reported a cost barrier to collecting a prescription. The age- and wave-adjusted OR comparing Māori/non-Māori was 1.71 (95% confidence interval [CI]: 1.61, 1.81) for the cost barrier to primary care and 2.97 (95% CI: 2.75, 3.20) for the cost barrier to collecting prescriptions. Sociodemographics accounted for about half the inequity for both outcomes; in a fully adjusted model, age, sex, low income, and poorer underlying health were determinants of both outcomes, and deprivation was additionally associated with the cost barrier to collecting a prescription but not to seeing a GP. Conclusions: Māori experience considerable inequity in access to primary health care; evidence supports an urgent need for change to system funding to eliminate financial barriers to care. (© The Author(s) 2023. Published by Oxford University Press.)
Databáze:	MEDLINE
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