Primary Care Doctor And Nurse Utilisation Rates For Billed Consultations Across The Comprehensive Care Primary Health Organisation

Jennifer N Baldwin,Nick Garrett,Peter J Larmer, Craig Murray, Rachael Evans, Rosey Buchan,Stephen Neville

NEW ZEALAND MEDICAL JOURNAL(2019)

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摘要
AIM: To examine socio-demographic trends in doctor and nurse utilisation rates for invoiced consultations across Comprehensive Care Primary Health Organisation (PHO).METHOD: De-identified enrolled patient information and Service Utilisation Reporting data for invoiced consultations were extracted from all general practices for January 2013-December 2016. Utilisation rates were calculated using the number of enrolled patients as the denominator.RESULTS: Data for 3,657,873 invoiced consultations across 66 general practices were analysed, including 2,941,624 doctor and 716,249 nurse consultations. Average utilisation rates were 3.1 visits per patient year for doctors and 0.7 visits for nurses, with considerable variability between practices. Utilisation rates were higher for females (3.3 visits for doctors; 0.8 for nurses), older adults (5.0-6.9; 1.3-1.6 visits) and patients residing in the most socially deprived quintile (3.3; 1.6 visits). European patients had the highest doctor utilisation rates (3.2 visits), while Maori and Pacific patients had the highest nurse utilisation rates (1.1 and 1.3 visits, respectively).CONCLUSION: Females, older adults and people residing in socially deprived areas utilise primary care more frequently according to invoiced consultation data. Analysis of all other consultations, including immunisations, Accident Corporation Claims and non-billed services is needed to more accurately capture utilisation rates, particularly for nurses, to better inform national decision-making, workforce planning and funding assumptions.
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