Your browser doesn't support javascript.
loading
Rural-urban variation in the utilisation of publicly funded healthcare services: an age-stratified population-level observational study.
Nixon, Garry; Davie, Gabrielle; Whitehead, Jesse; Miller, Rory; de Graaf, Brandon; Liepins, Talis; Lawrenson, Ross; Crengle, Sue.
Afiliación
  • Nixon G; Professor Rural Health, Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand.
  • Davie G; Associate Professor and Biostatistician, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
  • Whitehead J; Health Geographer, Te Ngira: Institute for Population Research, University of Waikato, Hamilton, New Zealand.
  • Miller R; Senior Lecturer and Rural Generalist, Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand.
  • de Graaf B; Data analyst, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
  • Liepins T; Health Economist, Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand.
  • Lawrenson R; Professor Population Health, Waikato Medical Research Centre, University of Waikato, Hamilton, New Zealand.
  • Crengle S; Professor of Maori Health, Public Health Physician and GP, Ngai Tahu Maori Health Research Unit, University of Otago, Dunedin, New Zealand.
N Z Med J ; 137(1590): 33-47, 2024 Feb 23.
Article en En | MEDLINE | ID: mdl-38386854
ABSTRACT

AIM:

To compare age-stratified public health service utilisation in Aotearoa New Zealand across the rural-urban spectrum.

METHODS:

Routinely collected hospitalisation, allied health, emergency department and specialist outpatient data (2014-2018), along with Census denominators, were used to calculate utilisation rates for residents in the two urban and three rural categories in the Geographic Classification for Health.

RESULTS:

Relative to their urban peers, rural Maori and rural non-Maori had lower all-cause, cardiovascular, mental health and ambulatory sensitive (ASH) hospitalisation rates. The age-standardised ASH rate ratios (major cities as the reference, 95% CIs) across the three rural categories were for Maori 0.79 (0.78, 0.80), 0.83 (0.82, 0.85) and 0.80 (0.77, 0.83), and for non-Maori 0.87 (0.86, 0.88), 0.80 (0.78, 0.81) and 0.50 (0.47, 0.53). Residents of the most remote communities had the lowest rates of specialist outpatient and emergency department attendance, an effect that was accentuated for Maori. Allied health service utilisation by those in rural areas was higher than that seen in the major cities.

CONCLUSIONS:

The large rural-urban variation in health service utilisation demonstrated here is previously unrecognised and in contrast to comparable international data. New Zealand's most remote communities have the lowest rates of health service utilisation despite high amenable mortality rates. This raises questions about geographic equity in health service design and delivery and warrants further in-depth research.
Asunto(s)
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aceptación de la Atención de Salud / Servicios Urbanos de Salud / Servicios de Salud Rural Límite: Humans País/Región como asunto: Oceania Idioma: En Revista: N Z Med J Año: 2024 Tipo del documento: Article País de afiliación: Nueva Zelanda Pais de publicación: Nueva Zelanda
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Aceptación de la Atención de Salud / Servicios Urbanos de Salud / Servicios de Salud Rural Límite: Humans País/Región como asunto: Oceania Idioma: En Revista: N Z Med J Año: 2024 Tipo del documento: Article País de afiliación: Nueva Zelanda Pais de publicación: Nueva Zelanda