Access to Primary Care and Hospital Admissions
In New Zealand a number of studies have documented strong links between
deprivation and the use of hospital services, but little attempt has
been made to assess temporal changes in this relationship. Moreover,
despite a voluminous literature on factors affecting geographical variations
in hospital admission rates, little attention has been paid to the extent
to which rates of admission are higher or lower than expected in different
geographical contexts after taking account of variations in population
composition. The former might be expected if increased deprivation had
led to an increased disease burden and especially if this had been compounded
by problems of access to primary care. Such findings are consistent
with other studies which indicate continuing problems of access to primary
care, on the part of the poor and that reduced access is likely to lead
to an increased frequency of admissions. However, the exact nature of
the links between the availability and quality of GP services and increased
hospital admissions are complex and remain unclear.
This project has three objectives. First it aims to examine the relationship between deprivation and hospital admissions (including average length of stay and rates of re-admission) in Canterbury for the period 1998 to 2004. Work will focus upon whether the increasingly strong relationship between deprivation and admission rates that was found in previous work during the period 1990 to 1997 has intensified or lessened. Secondly, it seeks to undertake a small-area analysis of variations in rates of increase in the level of admissions. The research will identify census area units (CAUs) in both Christchurch and other parts of the Canterbury District Health Board that have rates of hospital admissions, for specific types of ill health, that are higher than expected, after having accounted for key risk factors, in particular age/sex, ethnicity and material deprivation. Third, it examines the effects of access to general practitioners, both financial and geographic, upon hospital admission rates.
Staff involved
- Assoc. Prof. Ross Barnett
- Dr Jamie Pearce
- Professor Graham Moon