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Australia and New Zealand Health Policy

, 5:24

First Online: 06 November 2008Received: 11 June 2008Accepted: 06 November 2008DOI: 10.1186-1743-8462-5-24

Cite this article as: Cumming, J., Mays, N. & Gribben, B. Aust N Z Health Policy 2008 5: 24. doi:10.1186-1743-8462-5-24

Abstract

BackgroundIn 2001, the New Zealand government introduced its Primary Health Care Strategy PHCS, aimed at strengthening the role of primary health care, in order to improve health and to reduce inequalities in health. As part of the Strategy, new funding was provided to reduce the fees that patients pay when they use primary health care services in New Zealand, to improve access to services and to increase service use. In this article, we estimate the impact of the new funding on general practitioner and practice nurse visit fees paid by patients and on consultation rates. The analyses involved before-and-after monitoring of fees and consultation rates in a random sample of 99 general practices and covered the period from June 2001 pre-Strategy to mid-2005.

ResultsFees fell particularly in Access higher need, higher per capita funded practices over time for doctor and nurse visits. Fees increased over time for many in Interim lower need, lower per capita funded practices, but they fell for patients aged 65 years and over as new funding was provided for this age group. There were increases in consultation rates across almost all age, funding model Access or Interim, socio-demographic and ethnic groups. Increases were particularly high in Access practices.

ConclusionThe Strategy has resulted in lower fees for primary health care for many New Zealanders, and consultation rates have also increased over the past few years. However, fees have not fallen by as much as expected in government policy given the amount of extra public money spent since there are limited requirements for practices to reduce patients- fees in line with increases in public funding for primary care.

Electronic supplementary materialThe online version of this article doi:10.1186-1743-8462-5-24 contains supplementary material, which is available to authorized users.

Jacqueline Cumming, Nicholas Mays and Barry Gribben contributed equally to this work.

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Autor: Jacqueline Cumming - Nicholas Mays - Barry Gribben

Fuente: https://link.springer.com/







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