Characteristics of a stratified random sample of New Zealand general practices
Sharon Leitch 1 , Susan M. Dovey 1 2 , Ari Samaranayaka 1 , David M. Reith 1 , Katharine A. Wallis 3 , Kyle S. Eggleton 3 , Andrew W. McMenamin 4 , Wayne K. Cunningham 2 , Martyn I. Williamson 1 , Steven Lillis 3 , Murray W. Tilyard 1 51 University of Otago, Dunedin School of Medicine, Dunedin, New Zealand
2 Royal College of Surgeons in Ireland - Medical University of Bahrain, Adliya, Bahrain
3 University of Auckland, Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, Auckland, New Zealand
4 Te Ngae Medical Centre, Rotorua, New Zealand
5 Best Practice Advocacy Centre Inc., Dunedin, New Zealand
Correspondence to: Sharon Leitch, University of Otago, Dunedin School of Medicine, PO Box 56, Dunedin 9054, New Zealand. Email: sharon.leitch@otago.ac.nz
Journal of Primary Health Care 10(2) 114-124 https://doi.org/10.1071/HC17089
Published: 29 May 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: Practice size and location may affect the quality and safety of health care. Little is known about contemporary New Zealand general practice characteristics in terms of staffing, ownership and services.
AIM: To describe and compare the characteristics of small, medium and large general practices in rural and urban New Zealand.
METHODS: Seventy-two general practices were randomly selected from the 2014 Primary Health Organisation database and invited to participate in a records review study. Forty-five recruited practices located throughout New Zealand provided data on staff, health-care services and practice ownership. Chi-square and other non-parametric statistical analyses were used to compare practices.
RESULTS: The 45 study practices constituted 4.6% of New Zealand practices. Rural practices were located further from the nearest regional base hospital (rural median 65.0 km, urban 7.5 km (P < 0.001)), nearest local hospital (rural 25.7 km, urban 7.0 km (P = 0.002)) and nearest neighbouring general practitioner (GP) (rural 16.0 km, urban 1.0 km (P = 0.007)). In large practices, there were more enrolled patients per GP FTE than both medium-sized and small practices (mean 1827 compared to 1457 and 1120 respectively, P = 0.019). Nurses in large practices were more likely to insert intravenous lines (P = 0.026) and take blood (P = 0.049). There were no significant differences in practice ownership arrangements according to practice size or rurality.
CONCLUSION: Study practices were relatively homogenous. Unsurprisingly, rural practices were further away from hospitals. Larger practices had higher patient-to-doctor ratios and increased nursing scope. The study sample is small; findings need to be confirmed by specifically powered research.
KEYWORDS: New Zealand; general practice; primary health care; practice characteristics; rural health
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