Consequences of barriers to primary health care for children in Aotearoa New Zealand

被引:8
作者
Jeffreys, Mona [1 ,5 ]
Smiler, Kirsten [2 ]
Pledger, Megan [1 ]
Kennedy, Jonathan [4 ]
Cumming, Jacqueline [1 ]
Loschmann, Lis Ellison [3 ]
机构
[1] Victoria Univ Wellington, Hlth Serv Res Ctr, Te Hikuwai Rangahau Hauora, Te Herenga Waka, Wellington, New Zealand
[2] Victoria Univ Wellington, Sch Hlth, Te Herenga Waka, Wellington, New Zealand
[3] Flax Analyt, Wellington, New Zealand
[4] Univ Otago, Dept Primary Hlth Care & Gen Practice, Wellington, New Zealand
[5] Hlth Serv Res Ctr, Te Hikuwai Rangahau Hauora, Old Govt Bldg, 55 Lambton Quay, Wellington 6011, New Zealand
关键词
Health services accessibility; Primary health care; Ambulatory care; Health equity; Hospitalisations; Aotearoa New Zealand; GROWING-UP; WAITANGI;
D O I
10.1016/j.ssmph.2022.101044
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Inequities in the provision of accessible primary health care contribute to poor health outcomes and health inequity. This study evaluated inequities in the prevalence and consequences of barriers that children face in seeing a general practitioner (GP) in Aotearoa New Zealand. We analysed data on 5,947 children from the Growing Up in New Zealand longitudinal study cohort on barriers to seeing a GP in the previous year, reported by mothers when their children were aged 24 months and 54 months (in 2011/12 and 2013/14 respectively); and maternal-reported hospitalisations in the year prior to age 54 months. We used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CIs) for consequences of these barriers. Overall, 4.7% (n = 279) of children experienced barriers to seeing a GP in the year to 24 months and 5.5% (n = 325) in the year to 54 months. At each age, and for each specific barrier studied, barriers were more prevalent among Ma over bar ori (the indigenous people of Aotearoa New Zealand), and among Pacific, compared to New Zealand European, children. Children facing barriers in the year to age 24 months were twice as likely to be hospitalised in the year to 54 months (OR 2.18, 95%CI: 1.38 to 3.44). When this relationship was analysed by ethnicity, the association was strongest for Ma over bar ori (OR: 2.92, 95%CI: 1.60 to 5.30), less strong for Pacific (OR 2.01, 95%CI: 0.92 to 4.37) and not present for New Zealand European (OR 1.27, 95%CI 0.39 to 4.12) families. Barriers that children face to seeing a GP have social and cost implications for families and the health system. Changes to the health system, and future health policy, must align with the New Zealand government's obligations under Te Tiriti o [The Treaty of] Waitangi, to ensure that health equity becomes a reality for Ma over bar ori.
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页数:11
相关论文
共 46 条
[1]  
[Anonymous], STAT NZ
[2]  
[Anonymous], 2020, STAT NZ
[3]  
[Anonymous], 2014, Improving Maori Access to Diabetes Health Care: Literature Review
[4]  
Barker Carol, 2016, N Z Med J, V129, P15
[5]  
Boulton A., 2020, Te Arotahi Paper Series
[6]  
Came H, 2020, HEALTH HUM RIGHTS, V22, P209
[7]  
Came H, 2019, NEW ZEAL MED J, V132, P61
[8]   Lessons for achieving health equity comparing Aotearoa/New Zealand and the United States [J].
Chin, Marshall H. ;
King, Paula T. ;
Jones, Rhys G. ;
Jones, Bryn ;
Ameratunga, Shanthi N. ;
Muramatsu, Naoko ;
Derrett, Sarah .
HEALTH POLICY, 2018, 122 (08) :837-853
[9]  
Cormack D., 2010, Ethnicity, national identity, and New Zealanders: Considerations for monitoring Maori health and ethnic inequalities
[10]   Factors associated with multiple barriers to access to primary care: an international analysis [J].
Corscadden, L. ;
Levesque, J. F. ;
Lewis, V. ;
Strumpf, E. ;
Breton, M. ;
Russell, G. .
INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH, 2018, 17