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How is enrolment with a general practice associated with subsequent use of the emergency department in Aotearoa New Zealand? A cohort study.
- Source :
- Journal of Primary Health Care; Jun2024, Vol. 16 Issue 2, p135-142, 8p
- Publication Year :
- 2024
-
Abstract
- Introduction. Around 5% of the people in Aotearoa New Zealand (NZ) are not enrolled with a general practice. Aim. This study aimed to explore the utilisation of general practice by enrolment status and subsequent use of an emergency department. Methods. We compared a cohort of respondents from New Zealand Health Surveys (2013/14-2018/19) on self-reported general practice utilisation and their substitutes, according to their enrolment status (enrolled and not enrolled). They were then followed up to examine their subsequent use of an emergency department. Time to an emergency department presentation was modelled with proportional hazards regression models with enrolment status as the explanatory variable. Confounding variables used were sex, age group, prioritised ethnicity, the New Zealand Deprivation Index and self-rated health. Results. Those not enrolled were more likely to be young, male, Asian, more socioeconomically deprived and with better health status than those enrolled. Generally, those not enrolled utilised general practice services less. Those not enrolled who had used an emergency department were more likely to have used it as a substitute for general practice (40% vs 26%). Modelling showed that those not enrolled took longer to access an emergency department. Adjusting for confounding variables did not change that interpretation. Discussion. Those not enrolled were younger and healthier and may have a perception that enrolment isn't necessary. As a group, they were more likely to be socioeconomically deprived and to use an emergency department, which is free at a public hospital in NZ, as a substitute for primary care which suggests that cost may influence their choices. [ABSTRACT FROM AUTHOR]
- Subjects :
- HEALTH services accessibility
SELF-evaluation
FAMILY medicine
HEALTH status indicators
RESEARCH funding
QUESTIONNAIRES
SEX distribution
SOCIOECONOMIC factors
HOSPITAL emergency services
AGE distribution
DESCRIPTIVE statistics
RELATIVE medical risk
LONGITUDINAL method
MEDICAL appointments
COMPARATIVE studies
PATIENTS' attitudes
PROPORTIONAL hazards models
SOCIAL isolation
Subjects
Details
- Language :
- English
- ISSN :
- 11726164
- Volume :
- 16
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Journal of Primary Health Care
- Publication Type :
- Academic Journal
- Accession number :
- 178202007
- Full Text :
- https://doi.org/10.1071/HC24023