IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v93y2009i1p1-10.html
   My bibliography  Save this article

Primary health care in New Zealand: Who has access?

Author

Listed:
  • Jatrana, Santosh
  • Crampton, Peter

Abstract

Objective We examined the demographic, socioeconomic, health behaviour and health determinants of financial barriers to access to general practitioner services, prescription drugs and dental care in New Zealand (NZ).Methods Data from SoFIE-health, which is an add-on to the Statistics New Zealand-led Survey of Family, Income and Employment (SoFIE), were analyzed using logistic regression.Results Of the total of 18,320 respondents, 2845 (15.5%), 4175 (22.8%), and 1165 (6.4%), reported that they had deferred seeing their doctor/s, dentist and buying a prescription, respectively, at least once during the preceding 12 months, because they could not afford the cost of a visit or prescription. Younger age, female sex, low or middle income tertile, living in a least deprived area, having more individual deprivation characteristics (5+), current smokers, reporting high and very high levels of psychological distress and more than two co-morbid diseases were all independently associated with increased odds of deferring doctors' visits, collecting medications and dental visits.Conclusions Financial barriers to needed primary care exist for a substantial subgroup of people in New Zealand. A key policy lever is lowering cost barriers to make primary health care in general and dental care in particular more accessible.

Suggested Citation

  • Jatrana, Santosh & Crampton, Peter, 2009. "Primary health care in New Zealand: Who has access?," Health Policy, Elsevier, vol. 93(1), pages 1-10, November.
  • Handle: RePEc:eee:hepoli:v:93:y:2009:i:1:p:1-10
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168-8510(09)00135-3
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Green, Carla A & Pope, Clyde R, 1999. "Gender, psychosocial factors and the use of medical services: a longitudinal analysis," Social Science & Medicine, Elsevier, vol. 48(10), pages 1363-1372, May.
    2. Parslow, Ruth & Jorm, Anthony & Christensen, Helen & Jacomb, Patricia & Rodgers, Bryan, 2004. "Gender differences in factors affecting use of health services: an analysis of a community study of middle-aged and older Australians," Social Science & Medicine, Elsevier, vol. 59(10), pages 2121-2129, November.
    3. Schoen, Cathy & Doty, Michelle M., 2004. "Inequities in access to medical care in five countries: findings from the 2001 Commonwealth Fund International Health Policy Survey," Health Policy, Elsevier, vol. 67(3), pages 309-322, March.
    4. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
    5. Diamant, A.L. & Hays, R.D. & Morales, L.S. & Ford, W. & Calmes, D. & Asch, S. & Duan, N. & Fielder, E. & Kim, S. & Fielding, J. & Sumner, G. & Shapiro, M.F. & Hayes-Bautista, D. & Gelberg, L., 2004. "Delays and Unmet Need for Health Care among Adult Primary Care Patients in a Restructured Urban Public Health System," American Journal of Public Health, American Public Health Association, vol. 94(5), pages 783-789.
    6. Phongsavan, Philayrath & Chey, Tien & Bauman, Adrian & Brooks, Robert & Silove, Derrick, 2006. "Social capital, socio-economic status and psychological distress among Australian adults," Social Science & Medicine, Elsevier, vol. 63(10), pages 2546-2561, November.
    7. Keeler, Emmett B. & Rolph, John E., 1988. "The demand for episodes of treatment in the health insurance experiment," Journal of Health Economics, Elsevier, vol. 7(4), pages 337-367, December.
    8. Himmelstein, D.U. & Woolhandler, S., 1995. "Care denied: US residents who are unable to obtain needed medical services," American Journal of Public Health, American Public Health Association, vol. 85(3), pages 341-344.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Felipa de Mello-Sampayo, 2022. "On the timing and probability of Presurgical Teledermatology: how it becomes the dominant strategy," Health Care Management Science, Springer, vol. 25(3), pages 389-405, September.
    2. Robin Gauld & Simon Horsburgh, 2016. "Does a host country capture knowledge of migrant doctors and how might it? A study of UK doctors in New Zealand," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 61(1), pages 1-8, January.
    3. Penno, Erin & Gauld, Robin, 2017. "The role, costs and value for money of external consultancies in the health sector: A study of New Zealand’s District Health Boards," Health Policy, Elsevier, vol. 121(4), pages 458-467.
    4. Jatrana, Santosh & Crampton, Peter, 2021. "Do financial barriers to access to primary health care increase the risk of poor health? Longitudinal evidence from New Zealand," Social Science & Medicine, Elsevier, vol. 288(C).
    5. Thomson, Michael, 2019. "Who had access to doctors before and after new universal capitated subsidies in New Zealand?," Health Policy, Elsevier, vol. 123(8), pages 756-764.
    6. Robin Gauld & Simon Horsburgh, 2016. "Does a host country capture knowledge of migrant doctors and how might it? A study of UK doctors in New Zealand," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 61(1), pages 1-8, January.
    7. Michael G Baker & Jason Gurney & Jane Oliver & Nicole J Moreland & Deborah A Williamson & Nevil Pierse & Nigel Wilson & Tony R Merriman & Teuila Percival & Colleen Murray & Catherine Jackson & Richard, 2019. "Risk Factors for Acute Rheumatic Fever: Literature Review and Protocol for a Case-Control Study in New Zealand," IJERPH, MDPI, vol. 16(22), pages 1-39, November.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Allin, Sara & Grignon, Michel & Le Grand, Julian, 2010. "Subjective unmet need and utilization of health care services in Canada: What are the equity implications?," Social Science & Medicine, Elsevier, vol. 70(3), pages 465-472, February.
    2. Jens Detollenaere & Lise Hanssens & Veerle Vyncke & Jan De Maeseneer & Sara Willems, 2017. "Do We Reap What We Sow? Exploring the Association between the Strength of European Primary Healthcare Systems and Inequity in Unmet Need," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-13, January.
    3. Koopmans, Gerrit T. & Lamers, Leida M., 2007. "Gender and health care utilization: The role of mental distress and help-seeking propensity," Social Science & Medicine, Elsevier, vol. 64(6), pages 1216-1230, March.
    4. Mohammad Hajizadeh & Luke Brian Connelly & James Robert Gerard Butler, 2014. "Health Policy and Equity of Health Care Financing in Australia: 1973–2010," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 60(2), pages 298-322, June.
    5. Jatrana, Santosh & Crampton, Peter, 2009. "Affiliation with a primary care provider in New Zealand: Who is, who isn't," Health Policy, Elsevier, vol. 91(3), pages 286-296, August.
    6. Ford, Julian D. & Trestman, Robert L. & Tennen, Howard & Allen, Scott, 2005. "Relationship of anxiety, depression and alcohol use disorders to persistent high utilization and potentially problematic under-utilization of primary medical care," Social Science & Medicine, Elsevier, vol. 61(7), pages 1618-1625, October.
    7. Eric French & Elaine Kelly & Richard Cookson & Carol Propper & Miqdad Asaria & Rosalind Raine, 2016. "Socio‐Economic Inequalities in Health Care in England," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 371-403, September.
    8. Hai Zhong, 2011. "Effect of patient reimbursement method on health‐care utilization: evidence from China," Health Economics, John Wiley & Sons, Ltd., vol. 20(11), pages 1312-1329, November.
    9. Kankaanranta, Terhi & Nummi, Tapio & Vainiomaki, Jari & Halila, Hannu & Hyppola, Harri & Isokoski, Mauri & Kujala, Santero & Kumpusalo, Esko & Mattila, Kari & Virjo, Irma & Vanska, Jukka & Rissanen, P, 2007. "The role of job satisfaction, job dissatisfaction and demographic factors on physicians' intentions to switch work sector from public to private," Health Policy, Elsevier, vol. 83(1), pages 50-64, September.
    10. Hoeck, Sarah & François, Guido & Van der Heyden, Johan & Geerts, Joanna & Van Hal, Guido, 2011. "Healthcare utilisation among the Belgian elderly in relation to their socio-economic status," Health Policy, Elsevier, vol. 99(2), pages 174-182, February.
    11. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    12. Ni, Xinwen, 2019. "Voting for Health Insurance Policy: the U.S. versus Europe," IRTG 1792 Discussion Papers 2019-012, Humboldt University of Berlin, International Research Training Group 1792 "High Dimensional Nonstationary Time Series".
    13. Clarke, Philip & Van Ourti, Tom, 2010. "Calculating the concentration index when income is grouped," Journal of Health Economics, Elsevier, vol. 29(1), pages 151-157, January.
    14. Kai Yeung & Anirban Basu & Ryan N. Hansen & Sean D. Sullivan, 2016. "Price Elasticities of Pharmaceuticals in a Value-Based-Formulary Setting," NBER Working Papers 22308, National Bureau of Economic Research, Inc.
    15. Erik Schokkaert & Jonas Steel & Carine Van de Voorde, 2017. "Out-of-Pocket Payments and Subjective Unmet Need of Healthcare," Applied Health Economics and Health Policy, Springer, vol. 15(5), pages 545-555, October.
    16. Stefan Boes & Michael Gerfin, 2016. "Does Full Insurance Increase the Demand for Health Care?," Health Economics, John Wiley & Sons, Ltd., vol. 25(11), pages 1483-1496, November.
    17. Majo, Maria Cristina & van Soest, Arthur, 2012. "Income and health care utilization among the 50+ in Europe and the US," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 28(4), pages 3-22.
    18. M. Antonini & R. C. van Kleef & J. Henriquez & F. Paolucci, 2023. "Can risk rating increase the ability of voluntary deductibles to reduce moral hazard?," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 48(1), pages 130-156, January.
    19. Amanda Cook, 2020. "Do the uninsured demand less care? Evidence from Maryland’s hospitals," International Journal of Health Economics and Management, Springer, vol. 20(3), pages 251-276, September.
    20. Fiona Cocker & Angela Martin & Jenn Scott & Alison Venn & Kristy Sanderson, 2013. "Psychological Distress, Related Work Attendance, and Productivity Loss in Small-to-Medium Enterprise Owner/Managers," IJERPH, MDPI, vol. 10(10), pages 1-21, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:93:y:2009:i:1:p:1-10. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.