Primary healthcare utilisation among adults with mood and anxiety disorders: an analysis of the New Zealand Health Survey
Helen Lockett 1 2 , Jennifer Lai 3 , Charito Tuason 3 , Angela Jury 3 , David Fergusson 41 The Wise Group, Hamilton, New Zealand
2 Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
3 Te Pou o te Whakaaro Nui, Auckland, New Zealand
4 Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
Correspondence to: Helen Lockett, The Wise Group, 293 Grey Street, PO Box 307, Hamilton 3240, New Zealand. Email: Helen.Lockett@wisegroup.co.nz
Journal of Primary Health Care 10(1) 68-75 https://doi.org/10.1071/HC17077
Published: 29 March 2018
Journal Compilation © Royal New Zealand College of General Practitioners 2018.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: In New Zealand, as in other OECD countries, there is a high and growing prevalence of mental health problems, particularly anxiety and depression. These conditions are associated with a range of physical illnesses, and as a result this population have high and often complex needs for healthcare services, particularly through primary care.
AIM: To use data from the New Zealand Health Survey (NZHS) to examine the associations between internalising disorders (including anxiety, depression and bipolar disorder) and measures related to the utilisation of primary healthcare services.
METHODS: The study was based on responses from 13,719 adults who took part in the 2015–16 NZHS. Logistic regression analyses adjusted for sociodemographic variables were undertaken to examine the effect of having an internalising disorder on each measure related to primary healthcare utilisation. The strength of associations was indicated by odds ratios (ORs).
RESULTS: Adults with an internalising disorder were more likely to utilise primary health services (OR = 1.43–2.56, P < 0.001) compared to adults without an internalising disorder. However, they were more likely to have unmet needs due to cost or transport (OR = 2.45–3.38, P < 0.001), unfilled prescriptions due to cost (OR = 3.03, P < 0.001) and less likely to report positive experiences with general practitioners (OR = 0.67–0.79, P < 0.01).
DISCUSSION: Adults with internalising disorders require a higher level of support from primary healthcare, yet experience more barriers to accessing these services, and report less positive experiences with general practitioners. The NZHS may be a useful source of routinely collected data for understanding, monitoring and improving primary health service utilisation among people with internalising disorders.
KEYWORDS: Primary healthcare; depression; anxiety disorders; bipolar disorder; health service utilisation; health service access
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