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.
Highlights
In 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 [1]
Adults without a subsidy card paid the full cost of primary health care themselves, which could vary, at the general practitioners (GPs)'s discretion, The Primary Health Care Strategy aims to achieve a new vision of primary care over five to ten years in which, "people will be part of local primary health care services that improve their health, keep them well, are easy to get to and co-ordinate their ongoing care" and which, "will focus on better health for a population and actively work to reduce health inequalities between different groups" [1]
Changes in Fees Paid by New Zealanders as a result of the Strategy we report on changes in fees brought about by the PHCS
Summary
In 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 [1]. 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. Adults without a subsidy card paid the full cost of primary health care themselves, which could vary, at the GP's discretion, The Primary Health Care Strategy aims to achieve a new vision of primary care over five to ten years in which, "people will be part of local primary health care services that improve their health, keep them well, are easy to get to and co-ordinate their ongoing care" and which, "will focus on better health for a population and actively work to reduce health inequalities between different groups" [1]
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