Summary
The 2001/02 National Primary Medical Care Survey (NatMedCa) was undertaken to describe consultations between primary health care providers and their patients. The research was led by Professor Peter Davis with a team from the Centre for Health Services Research and Policy, University of Auckland in collaboration with the University of Otago. The survey was funded by the Health Research Council, with practical support from the academic Departments of General Practice and from the Royal New Zealand College of General Practitioners.
The reports provide in-depth information on the content of consultations between practitioners and patients. The survey collected information from private General Practitioners; GPs and nurses in community governed non-profits and in practices in Māori led providers; doctors and nurses in accident and emergency clinics and a sample of primary care activity that takes place in Emergency Departments (EDs). From this data set a wide range of analyses were possible.
Each of the reports has material on relevant literature, the methodology of the study, patients’ normal relationship to the practice, characteristics of the consultation (such as the time of day, source of payment and urgency), the problems patients brought to the consultation, tests and investigations, referrals and admissions, drug prescribed and other treatments determined by the health care provider.
A representative sample of providers was drawn for the study and included general practitioners in private practice, in community governed non-profits (GPs and nurses) and a smaller sample of Maori providers (GPs and nurses). The representative sample of practitioners was drawn from across the country. In the selected general practices data was collected for two complete weeks six months apart. Basic data was kept on every visit that week, and detailed information was recorded on every fourth patient. Over 42,000 interactions were recorded with full data kept for 9,682 consultations. In the sample of 12 Accident and Medical Clinics data was only kept for one week. Over 6,000 consultations were recorded with full data on 1,430 consultations.
The complex sampling process allows comparison between visits in different types of provider organisations, for example private GPs and GPs in community governed non-profits. It also allows for comparisons of consultations with different population groups, for example by age or ethnicity.
The Ministry commissioned nine reports based on this data. Five of these described the experience of doctors in different types of provider originations, including those in accident and medical clinic. One report addresses the experience of primary health care nurses and another describes activities in Emergency Departments (ED). Two reports focus on the experience of Maori and of Pacific patients in different provider organisations.
The Reports
Four reports were released by the Ministry of Health in August 2004, they were: :
- Report 1: Family Doctors: Methodology and description of the activity of private GPs
- Report 2: Primary Health Care in Community-governed Non-Profits: The work of doctors and nurses
- Report 3: Māori Providers: Primary health care delivered by doctors and nurses
- Report 4: A Comparison of Primary Health Care Provided by Rural and Non-Rural General Practices
Five further reports were released in April 2005. These were:
- Report 5: The Work of Doctors in Accident and Medical Clinics
- Report 6: A Comparison of Māori and Non-Māori Patient Visits to Doctors
- Report 7: Pacific Patterns in Primary Health Care: A comparison of Pacific and all patient visits to doctors
- Report 8: A Description of the Activity of Selected Hospital Emergency Departments in New Zealand
- Report 9: Nurses and Their Work in Primary Health Care
Since this survey, the Government has made and is making a significant investment in primary health care to reduce this financial barrier, improve all New Zealanders' health and address health disparities, through the Primary Health Care Strategy.