Exposure to primary medical care in New Zealand: number and duration of general practitioner visits

AIMS: To estimate (among different population groups and different practice types) average duration of visit to a general practitioner, average number of visits, and average population exposure to primary medical care in New Zealand. METHODS: Observational study using a representative survey of visits to general practitioners in New Zealand. Average exposure to primary medical care for a particular class of patient (e.g. by age group) was calculated as the average of the product of number of visits over the past 12 months and duration of visit for the current visit. Comparisons were made across different demographic groups of patients and different practice types. RESULTS: Annual exposure to primary medical care was highest amongst the elderly (65+ years), followed by adults (18-64 years). Adjusting for age, gender, NZDep2001, rural/urban, and organisation type, average annual exposure to primary medical care was higher in the European ethnic group than in the Maori, Pacific, and Asian ethnic groups. Exposure to primary medical care did not differ significantly across NZDep2001 quintiles after controlling for other co-variates. CONCLUSIONS: Annual exposure to primary medical care is both a direct measure of utilisation of primary medical care and also an indicator of access. Primary medical care exposure measurement can be used to monitor equity of service provision across different population groups: groups with high identified health care needs should have relatively high exposure to primary medical care. The most obvious breach of this principle is for Maori and Pacific users of primary medical care and for those living in deprived areas. Similarly, the low overall exposure to primary medical care for the Asian ethnic group is concerning and warrants further exploration.