What supports are needed by New Zealand primary care to improve equity and quality?
Gay Keating 1 , Richard Jaine 21 Te Rōpū Rangahau Hauora A Eru Pōmare, University of Otago, Wellington, New Zealand
2 Department of Public Health, University of Otago, Wellington, New Zealand
3 Correspondence to: Gay Keating Te Rōpū Rangahau Hauora A Eru Pōmare, University of Otago, Wellington, PO Box 7343, Wellington South, Wellington 6242, New Zealand gay.keating@otago.ac.nz
Journal of Primary Health Care 8(4) 312-315 https://doi.org/10.1071/HC16020
Published: 5 September 2016
Journal Compilation © Royal New Zealand College of General Practitioners 2016.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
While some primary care practices have found ways to deliver quality care more equitably to their Māori and Pacific patients, others have struggled to get started or be successful. Quality Symposium attendees shared their views on barriers and success factors, both within the practice and beyond. When practices have collaborated and used their own ethnic-specific data in quality improvement techniques, they have improved Māori and Pacific health and equity. Attendees asked for greater practical support and guidance from the profession and sector. They report a funding gap for services needed by their patients to enable primary care to deliver equitable services for Māori and Pacific people.
KEYWORDS: Equity; quality and safety; health services; Māori health services; Pacific communities; Indigenous health; primary health care
References
[1] Health Quality and Safety Commission. Equity Explorer. Atlas of Healthcare Variation; 2016. [cited 2016 June 20]. Available from: http://www.hqsc.govt.nz/our-programmes/health-quality-evaluation/projects/atlas-of-healthcare-variation/equity-explorer/.[2] Ministry of Health. Equity of health care for Maori: a framework. Wellington: Ministry of Health; 2014.
[3] Southwick M, Kenealy T, Ryan D. Primary care for pacific people: a Pacific and health systems approach. Wellington: Pacific Perspectives; 2012.
[4] Finding Answers. Finding answers: disparities research for change. [cited 2016 June 1]. Available from: www.solvingdisparities.org
[5] Chin MH, Clarke AR, Nocon RS, et al. A roadmap and best practices for organizations to reduce racial and ethnic disparities in health care. J Gen Intern Med. 2012; 27 992–1000.
| A roadmap and best practices for organizations to reduce racial and ethnic disparities in health care.Crossref | GoogleScholarGoogle Scholar | 22798211PubMed |
[6] The Royal New Zealand College of General Practitioners. Aiming for excellence: RNZCGP standard for New Zealand general practice. Wellington: The Royal New Zealand College of General Practitioners; 2011.
[7] Lynn J, Baily M, Bottrell M. The ethics of using quality improvement methods in health care. Ann Intern Med. 2007; 146 666–73.
| The ethics of using quality improvement methods in health care.Crossref | GoogleScholarGoogle Scholar | 17438310PubMed |
[8] Keating GM. Ethnic equity in the management of child asthma: developing and testing a primary care quality improvement tool. Master of Public Health Thesis, University of Otago. July 2015. Available from: http://hdl.handle.net/10523/5765
[9] Taylor SL, Fremont A, Jain AK, et al. Racial and ethnic disparities in care: the perspectives of cardiovascular surgeons. Ann Thorac Surg. 2006; 81 531–6.
| Racial and ethnic disparities in care: the perspectives of cardiovascular surgeons.Crossref | GoogleScholarGoogle Scholar | 16427845PubMed |
[10] Lurie N, Fremont A, Jain AK, et al. Racial and ethnic disparities in care: the perspectives of cardiologists. Circulation 2005; 111 1264–9.
| Racial and ethnic disparities in care: the perspectives of cardiologists.Crossref | GoogleScholarGoogle Scholar | 15769767PubMed |
[11] The Kaiser Family Foundation. National survey of physicians part I : doctors on disparities in medical care. Menlo Park: The Kaiser Family Foundation; 2002.
[12] The Royal New Zealand College of General Practitioners. Foundation Standard and Interpretation Guide. Version 3.0, July 2015. Wellington: The Royal New Zealand College of General Practitioners; 2015.
[13] Ministry of Health. Summary of the BreastScreen Aotearoa Mortality Evaluation 1999–2011. Wellington: Ministry of Health; 2015.
[14] Kenealy TW, Eggleton KS, Robinson EM, Sheridan NF. Systematic care to reduce ethnic disparities in diabetes care. Diabetes Res Clin Pract. 2010; 89 256–61.
| Systematic care to reduce ethnic disparities in diabetes care.Crossref | GoogleScholarGoogle Scholar | 20570383PubMed |
[15] Riley C, Crawford R. Reducing health disparities for low decile children and families : a nurse-led response. J Prim Health Care. 2010; 2 243–8.
| 21069120PubMed |
[16] Krebs JD, Parry-Strong A, Gamble E, et al. A structured, group-based diabetes self-management education (DSME) programme for people, families and whanau with type 2 diabetes (T2DM) in New Zealand: an observational study. Prim Care Diabetes. 2013; 7 151–8.
| A structured, group-based diabetes self-management education (DSME) programme for people, families and whanau with type 2 diabetes (T2DM) in New Zealand: an observational study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3svosV2htQ%3D%3D&md5=b29d310959401b103f2e5dfb34307518CAS | 23517821PubMed |
[17] bestpractice. bestpractice Childhood asthma module produces results. 2010. [cited 2012 May 13]. Available from: www.bestpractice.net.nz/news_art_childhoodAsthma_nov2010.php
[18] Tanuvasa AF, Neale J. Evaluation of Pacific cancer care navigation patient facilitation and support service. Eval J Australas. 2015; 15 30–6.
[19] Ministry of Health. Annual update of key results 2013/2014. New Zealand Health Survey. Wellington: Ministry of Health; 2014.
