The report uses the data on visits by Māori and non-Māori patients at community-based general practices. Information was logged on 6,384 visits by Māori with a more detailed sub-sample of 1,447 visits. Māori consultations at A&M Clinics were included.
- Māori accounted for twelve percent of visits to GPs, a smaller percentage than they represent in the overall New Zealand population. Patients were also younger than non-Māori. For example, 30.7% of visits by Māori were by the under 14 age group (compared to 21.4% of non- Māori visits) and nearly half were under 25 years of age. The percentage of Māori patients (58.9%) in Māori providers was substantially higher than in private GPs (11.8%) and community governed non-profits (19.4%) respectively.
- Māori patients were more likely to hold a community services card than non-Māori. Over 60% lived in the three most deprived deciles of NZ Deprivation 2001 areas. About 90% regarded the practice where their data was collected as their normal practice. Doctors reported a lower level of rapport with Māori patients than with non-Māori patients, and the mean length of consultations (13.7 minutes) was lower than that for non-Māori patients (15.1 minutes).
- Māori patients (43.3%) were more likely to be assessed as needing attention as soon as possible or today than were non-Māori (31.3%). The number of reasons for visit nominated by the patients were slightly lower for Māori, but the mean number of issues managed by the doctor during a visit were similar for both population groups. Reasons for a visit for Māori were more likely to be for a short term problem than for non-Māori.
- Tests and investigations were less likely to be ordered in consultations with Māori (21.0%) than non-Māori (25.4%). Visits for Māori (69.6%) were slightly more likely to result in a prescription than for non-Māori (65.9%) and the average number of items prescribed was higher.
- The study compared the nature of Māori consultations in private GPs, community-governed providers and GPs in Māori providers. The mean duration of visits was longer in community-governed practices. The average number of prescriptions per 100 visits was slightly lower in community governed practices, but the number of other treatments appeared higher.
The authors note that Māori have differences in their experience with general practice. These are more marked when the different burdens of disease are considered.
Disclaimer: The views expressed in this occasional paper are the personal views of the authors and should not be taken to represent the views or policy of the Ministry of Health or the Government. Although all reasonable steps have been taken to ensure the accuracy of the information, no responsibility is accepted for the reliance by any person on any information contained in this occasional paper, nor for any error in or omission from the occasional paper.
Purpose
The aim of the National Primary Medical Care Survey (NatMedCa) is to describe primary medical care in New Zealand, including the characteristics of providers and the practices they work in, the patients they see, the problems they manage and the investigation and treatment that they offer. The study included private general practices, community-governed (CG) providers, Māori providers, Accident and Medical (A&M) clinics and Emergency Departments.
This report presents findings describing the experiences of Māori patients during their visits to doctors.
Methodology
The study was a nationally representative, multi-stage probability sample of private general practices, stratified by place and practice type. Each GP was asked to provide data on themselves and on their practice, and to report on a 25% sample of patients in each of two week-long periods separated by an interval of six months. In addition, and over the same time period, all CG primary health care practices in New Zealand were also invited to participate, as was a 50% random sample of all A&M clinics distributed over the country (and four representative hospital Emergency Departments not reported here).
All practitioners within these participating practices and clinics were in turn asked to participate. Similar data collection methods were used as for the private GPs, except that A&M patient visit data were collected for one week from each clinic with clinics spread over the year. A number of Māori providers were recruited into the survey, but these providers were included through recruitment processes for CG and private GPs and not through a recruitment process specifically for Māori providers. The findings for Māori providers cannot, therefore, be considered to be representative of all Māori providers across the country.