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dc.contributor.authorWhitehead, Jesseen_NZ
dc.contributor.authorPearson, Amber L.en_NZ
dc.contributor.authorLawrenson, Rossen_NZ
dc.contributor.authorAtatoa-Carr, Pollyen_NZ
dc.date.accessioned2020-01-21T23:18:50Z
dc.date.available2019-01-01en_NZ
dc.date.available2020-01-21T23:18:50Z
dc.date.issued2019en_NZ
dc.identifier.citationWhitehead, J., Pearson, A. L., Lawrenson, R., & Atatoa-Carr, P. (2019). Spatial equity and realised access to healthcare - a geospatial analysis of general practitioner enrolments in Waikato, New Zealand. Rural and Remote Health, 19(4). https://doi.org/10.22605/RRH5349en
dc.identifier.issn1445-6354en_NZ
dc.identifier.urihttps://hdl.handle.net/10289/13390
dc.description.abstractIntroduction: Geographic measures of accessibility can quantify inequitable distributions of health care. Although closest distance measures are often used in Aotearoa New Zealand these may not reflect patient use of health care. This research examines patterns of patient enrolment in general practitioner (GP) services from a geospatial perspective. Methods: Patient enrolment records (n=137 596) from one primary health organisation were examined and geographic information systems used to determine whether patients enrolled with their closest GP service. A binomial logistic regression was performed to examine factors associated with the bypass of GP services closer to patients’ homes. Results: Overall 68.1% of patients in the sample bypassed the GP service closest to their home, while rates of GP bypass varied across the Waikato region and between rural and urban areas. A binary logistic regression analysis revealed that rurality of patient residence, patient ethnicity, patient age, area-level socioeconomic deprivation, sex, distance to the closest GP clinic, clinic after-hours availability, Māori service provider status, GP and nurse full time equivalent hours, and clinic fees were statistically significant predictors of increased closest-GP bypass. While residents of major urban areas had high rates of GP bypass, this was followed by patients living in rural areas – patients living more than 20 km from the closest GP service had exceptionally high rates of GP bypass. Conclusion: This study suggests that most patients in the Waikato region do not enrol with the GP service closest to their home and it outlines several factors, including rurality of residence, associated with the GP bypass. Closest distance accessibility measures may be inappropriate in mixed urban–rural settings, and researchers should consider other approaches to quantifying spatial equity. Health services should also be designed to better reflect the realities of the populations they serve.
dc.format.mimetypeapplication/pdf
dc.language.isoenen_NZ
dc.publisherCollege of Medicine and Dentistry, James Cook Universityen_NZ
dc.rightsThis work is licensed under a Creative Commons Attribution 4.0 International Licence
dc.subjectScience & Technologyen_NZ
dc.subjectLife Sciences & Biomedicineen_NZ
dc.subjectPublic, Environmental & Occupational Healthen_NZ
dc.subjectaccess to health careen_NZ
dc.subjectAotearoa New Zealanden_NZ
dc.subjectgeneral practiceen_NZ
dc.subjecthealth equityen_NZ
dc.subjectmedical geographyen_NZ
dc.subjectprimary health careen_NZ
dc.subjectrural health servicesen_NZ
dc.subjectSERVICE DELIVERYen_NZ
dc.subjectTRAVEL-TIMEen_NZ
dc.subjectACCESSIBILITYen_NZ
dc.subjectPATTERNSen_NZ
dc.subjectPATIENTen_NZ
dc.subjectNEIGHBORHOODSen_NZ
dc.subjectENVIRONMENTen_NZ
dc.subjectPEOPLEen_NZ
dc.titleSpatial equity and realised access to healthcare - a geospatial analysis of general practitioner enrolments in Waikato, New Zealanden_NZ
dc.typeJournal Article
dc.identifier.doi10.22605/RRH5349en_NZ
dc.relation.isPartOfRural and Remote Healthen_NZ
pubs.elements-id241340
pubs.issue4en_NZ
pubs.publication-statusPublisheden_NZ
pubs.volume19en_NZ
uow.identifier.article-noARTN 5349


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