New review launched into effectiveness of primary care

New review launched into effectiveness of primary care delivery to New Zealanders

The Ministry of Health (MoH) and the Health Research Council of New Zealand (HRC) have jointly awarded $1.33 million to a two-year research project that will evaluate the effectiveness of primary care models in New Zealand.

It will be the first comprehensive evaluation of general practice models of care since primary health organisations (PHOs) were introduced in 2001.

The research, led by Professor Nicolette Sheridan from Massey University (Auckland), will explore the complexities of access to care, and continuity of care, as experienced by patients and whanau.

“We expect this will lead to a clearer understanding of how primary care has developed into such a range of forms, and a deeper understanding of who does, and does not, receive adequate care,” says Professor Sheridan.

General practice models of care have changed over the years, and now include the Medical Home model and corporate ownership model as well as the traditional General Practitioner-centred model. “We will provide evidence for which model of primary care can best be linked to improved outcomes in specific contexts and for Māori, Pacific and other defined populations in New Zealand,” she says.

“A lack of joined-up data has impeded systematic progress in primary care. Good quality data – and the ability to use it – are essential for effective management of primary care,” she adds.

Professor Sheridan has drawn together a multi-disciplinary team of primary care clinicians and academics from five universities: Massey University, University of Auckland, University of Otago, Cambridge University (UK), and the Karolinska Institute (Sweden). “It’s a unique team and an incredible opportunity to work together to improve primary care,” she says.

Ministry of Health spokesperson Mr Andy Inder says this research will build the necessary evidence-base for informing future decisions about the models of care provided by PHOs.

“Primary care has a critical role to play in New Zealand’s health system, and we have to be prepared for challenges that are coming, including an ageing population, prevalence of long-term conditions and workforce capacity,” he says.

“Ultimately this is about building an understanding of people’s needs and ensuring we are able to invest in a health system that delivers better, more equitable health outcomes.”

The HRC’s chief executive, Professor Kath McPherson, says this joint funding initiative aims to deliver answers to pressing questions, with resources targeted at specific areas where knowledge is needed.

The HRC last month awarded an additional $4.78 million to a researcher-initiated proposal looking into enhancing primary health care services. That research, led by Professor Jacqueline Cumming from Victoria University of Wellington, will be carried out over the next five years. It will demonstrate where and how success is being achieved with respect to primary healthcare reform, and pinpoint the changes that need to be made to policy and practice to enable more effective and efficient delivery of healthcare.

The HRC also recently invested nearly $800,000 in a project to investigate if regional District Health Board (DHB) groupings have improved healthcare for New Zealanders, and if so, what it is about the way they operate that explains their success. It also invested more than $1m into a project to examine the impact of prescription charges on healthcare.

“Whilst these projects are being conducted independently, by a number of different teams, they will – as a whole – deliver knowledge and evidence that will strengthen our understanding of how the health system can best deliver what’s needed by New Zealanders,” says Professor McPherson.

The projects, combined, bring the HRC’s commitment to research involving primary care to nearly $8 million so far this year.

These research initiatives will complement the government’s wide-ranging review of New Zealand’s health and disability services. The review will look at how services are structured, resourced and delivered, with an interim report expected by the end of July 2019.

The first outcomes of Professor Sheridan’s MoH-HRC funded-research will be released in 12 months’ time following international review, with a final report due in July 2020.

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