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Primary Health Care in New Zealand: Benefits, Drawbacks & Lessons for Global Health

Explore the demographics, funding models, services, and challenges of New Zealand's primary health care system, with insights on benefits and drawbacks for patient care. Discover valuable lessons applicable to healthcare systems worldwide.

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Primary Health Care in New Zealand: Benefits, Drawbacks & Lessons for Global Health

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  1. New Zealand WONCA Asia-Pacific Regional Meeting, <name of location>, <date> Felicity Goodyear-Smith Department of General Practice & Primary Health Care University of Auckland, New Zealand

  2. Demographics of New Zealand’s population Population4.4 million Distribution>80% urban Ethnicity68% European, 15% Māori, 9% Asian, 7% Pacific peoples, 1% Other (2006 Census) Unemployment rate 6.2% (Mar 2013) etc

  3. Overall health system design Strong expectation of state funding (social democratic tradition) Public / private mix Public hospitals free, universal access Private insurance available - offers choice of specialist & hospital care eg elective surgery Primary care variably subsidized – GP services mixture of state & out of pocket Medicines & investigations heavily subsidized No fault liability – Accident Compensation Corporation

  4. How primary care is delivered in New Zealand • Primary Health Organisations (PHOs): Multidisciplinary PHC team - GPs, nurses, pharmacists, allied health • Capitated government funding: • Based on numbers & characteristics of enrolled patients • Pays for: • Care & treatment when ill • Help stay healthy • Outreach, reduce inequalities

  5. Access to primary health care in New Zealand Government + fee for service paid by patientFree: Immunisations, Antenatal, 0-5 years consultations, (most), Practice nurse consultations (often), X-ray, Laboratory,Funded projects directed at specific populations (eg Chronic care management, Services to Improve Access)Mixed funding: General consultations (FFS), ACC (may be surcharge), pharmaceuticals: part charges, physiotherapy (may surcharge)

  6. What are the benefits? • Most of population enrolled with GP clinic • Childhood immunisations • Continuity of provider • Screening • Influenza vaccine • Health checks • CVD risk assessments • Chronic disease management • Ministry of Health. 2008. A Portrait of Health: Key results of the 2006/07 New Zealand Health Survey. Wellington

  7. What are the drawbacks? Co-payments – Barrier for someInequity – Extra funding for socially deprived populations not individualsAccess within 24 hours – at least once annually 20% not able to see GP within 24 hours Complexity of funding – Complicated, frequent changesPoor primary–secondary integration – Unable to follow patients in hospital

  8. Impact on patient care Cost barriers – Means some do not access GP, uncollected prescriptionsIn general, family & patient-centred comprehensive careContinuity of careBoth individual & population-based

  9. Impact on patient care Cost barriers – Means some do not access GP, uncollected prescriptionsIn general, family & patient-centred comprehensive careContinuity of careBoth individual & population-based

  10. Growing health care burden in New Zealand

  11. Ability of health system to respond to challenge

  12. Lessons for other countries

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