Better Sooner More Convenient Primary Care - New Zealand Doctor

Appendix One: Health Equity Assessment Tool -
Integrated Family Health Centres
1. What health issue is the programme addressing?
Access to better sooner more convenient primary health services.
Quality of service/care pathways through primary – community - secondary health
services.
2. What inequalities exist in this health area?
Despite year on year increases in PHO enrolments occurring at faster rate for Māori,
enrolment in primary care remains lower than for non Māori.
Māori enrolment in primary care is lowest in the Grey District.
Māori enrolled in primary care access GP/nurse appointments at a lower rate than
non Māori.
Māori are under enrolled and have lower utilization rates in some primary care
programs (eg. care plus, CVD annual reviews, immunisation) but not all (cancer
navigation services, diabetes annual review, youth sexual health, primary mental health,
green prescription).
Māori have poorer health outcomes in the majority of health outcomes monitored.
3. Who is the most advantaged and how?
Data would indicate that non Māori are the most advantaged, with higher enrolments and
higher access rates than Māori, they receive the benefits associated with primary
practice enrolment including:
VLCA fees
lower after hours fees
recall for screening, annual reviews and immunisations
access to programs including, smoking cessation, green prescriptions, brief intervention
counselling and self management education programs.
4. How did the inequality occur? (What are the mechanisms, by which this inequality was
created, is maintained or increased?)
The inequality was created, and is maintained through a variety of mechanisms including:
long term impact of colonization and the resulting education and economic disparities
lower enrolments in primary care
mainstream service effectiveness
Business case appendices V12 AC 25Feb2010 Page 2