JANUARY

NEW ZEALAND
including such information as screening rates for chronic diseases. Data on individual doctors’ performance,
however, are not routinely made available. As noted above, PHOs and GPs receive performance payments
for achieving various targets.
DHBs and individual GP clinics and networks run various chronic disease management programs. There are
national registries for some diseases, including diabetes, cardiovascular disease, and cancers. Since 2014, public
hospitals have been required to conduct a nationally standardized survey of a random sample of patients and
to submit data to the Health Quality and Safety Commission, which publicizes the findings.
Certification by the Ministry of Health is mandatory for hospitals, nursing homes, and assisted-living facilities,
which must meet published and defined health and disability standards. All practicing health professionals must
be certified annually by the relevant registration authority (e.g., for doctors, the Medical Council of New
Zealand), which has ongoing responsibility for ensuring professional standards and providing accreditation.
Registration authorities supervise individual professionals where appropriate.
The Health Quality and Safety Commission is intended to increase the focus on quality and coordinate the
varied approaches to quality improvement across DHBs, such as those aimed at improving the patient journey,
ensuring safer medication management, reducing rates of health care–associated infection, and standardizing
national incident reporting. Other initiatives include the ongoing development of the Atlas of Healthcare
Variation (an online tool aimed at highlighting variations in the provision and use of services by geographic
area); a series of standard quality and safety indicators for DHBs based on routinely collected data; a program
for consumer involvement in service design; and advice for DHBs on how to prepare annual “Quality Accounts,”
required since 2012–2013. Much like a financial account, Quality Accounts report on how the DHB has
approached quality improvement, including descriptions of key initiatives and their results. In 2013, the
commission launched a national patient safety campaign, Open for Better Care, focused on reducing the
negative consequences associated with falls, surgery, health care–associated infections, and medications.
The National Health Board is also working on quality improvement in DHBs, with particular emphasis on
management systems, clinical services, and patient pathways. “Clinical governance” has been implemented
in most DHBs, meaning that management and health professionals are assuming joint accountability for quality,
patient safety, and financial performance.
What is being done to reduce disparities?
Disparities in health are a central concern in New Zealand, as Maori and people of Pacific Island origin have
shorter life expectancies than other New Zealanders (by seven and six years, respectively), and reducing
disparities is a policy priority (Ministry of Health, 2013). Maori and Pacific people are also known to experience
greater difficulty in gaining access to health services, and data describing disparities are routinely collected and
publicly reported.
Through much of the 2000s, a multisector policy approach saw investments in housing, education, and health,
as DHBs and primary health organizations were required to develop strategies for reducing disparities. Many
PHOs were created especially to serve Maori or Pacific populations.
The post-2008 government has focused on specific initiatives such as Whanau Ora, a policy designed to
integrate health and social services for disadvantaged Maori. The aim has been to develop coordinated,
multiagency approaches to service provision and foster joint responsibility for outcomes.
What is being done to promote delivery system integration and
care coordination?
Larger Integrated Family Health Centers (IFHCs) are developed in line with the “Better, Sooner, More
Convenient” government policy, which aims to improve access to integrated care provided by DHBs and PHOs
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The Commonwealth Fund