This paper reports on a study of the patients and the services provided by the Nurse Maude District Nursing Association in Christchurch. The 1149 recipients were predominantly elderly, 80.8% being over 65, 68.8% female and long term patients with musculoskeletal disorders comprising more than one-third of the principal diagnoses. Services were provided to 26 per 1000 of the elderly population, which is close to suggested guidelines. This rate increased markedly with age. Ten percent of patients utilised 40% of the nursing time. They may be considered as borderline cases for whom community care with community support services was an acceptable and efficient alternative to long term hospital care.

Adolescent↗

PubMed1982

Factors associated with variations in general practitioner prescribing costs.

In this exploratory study information gathered from 520 patients of eight doctors in a city group practice was analysed to identify the collective and separate contributions of selected patient and doctor factors to script cost variations. Results suggested that variance in cost and item numbers was directly related to diagnosis. A principal diagnosis of hypertension or diabetes/endocrine/hormonal problems, or a multiple of diagnoses was associated most with high cost scripts. Other patient conditions, such as gravity of illness, accounted for a much smaller but still significant variance. Although there were only minor differences between males and females, the older age groups in both sexes were over-represented in the higher item and cost categories. Which doctor the patient saw accounted only for approximately half a percent of the total variance, and this was non-significant. The results indicated that doctor prescribing behaviour was related rationally to patient diagnosis, and suggested that peer review, as practised by these doctors, was operating to reduce both variance between doctor factors and prescribing costs.

Age Factors↗

PubMed1981

General practitioner prescribing rates and costs.

This study was undertaken to determine whether the relationship between availability (population/GP) and utilisation (services/person) shown in previous work also applied to general practitioner prescribing rates and costs. Pharmaceutical pricing office records of payments to pharmacists were used as a data base. Calculated rates of prescribing and costs for 1978/79 showed a wide variation between health districts ranging from 9.0 prescription items and $40.18 per capita in Whangarei, to 5.8 items and $26.83 in Invercargill. These rates were highly correlated with both availability and utilisation, thus indicating that the wide inequality in distribution of general practitioners is associated with an equivalent maldistribution of pharmaceutical expenditure. In 1978/79 each general practitioner on average issued 16315 prescriptions at a cost of $72 934. These findings have important cost and policy implications with the projected surplus of medical manpower seeking entry to general practice.

Drug Prescriptions↗

PubMed1980

The availability, distribution and utilisation of general practitioners in New Zealand. A study based upon GMS claims.

Data relating to GMS claims for 1977/78 and 1978/79 were analysed from all health districts. Calculations from these and other sources showed a figure for 1978/79 of 2120 population per full time equivalent general practitioner ranging from 1685 in Whangarei to 2691 in Invercargill. A mean GMS claim of $2.87 was used to calculate utilisation rates. These similarly varied from 4.8 services per person per year in Whangarei to 2.8 in Invercargill and were highly correlated with availability. This and other evidence suggests that supply is determining demand. Mean utilisation rates increased over the above period from 3.7 to 3.8 pointing to the cost consequences of an increasing number of general practitioners.

Health Services Accessibility↗

PubMed1979

Planning services for the intellectually handicapped in North Canterbury.

The development of a wider range of service alternatives for the care of the intellectually handicapped (IH) has led to the establishment of multiple agencies in the field of service provision. A multi-agency, multi-disciplinary working party has undertaken a survey of all IH persons in the area, including an assessment of problems in service provision. There were a total of 2330 IH persons in the area. The prevalence rate for North Canterbury is 3.94 per 1000 which is substantially higher than the New Zealand figure of 3.29 of a previous survey. The working party has sponsored communication and mutual understanding and support through workshops, the formation of a parents committee and an information exchange system.

Adolescent↗

PubMed1978

Balancing needs with resources: a service-based approach.

A service-based analysis of public sector health expenditure in North Canterbury is presented. The results indicate that the largest share of the $61 million spent by the North Canterbury Hospital Board and the Christchurch District Health Office in 1975-76 was devoted to primary health care, followed by mental health, surgery and medicine. The implications of this approach for the planning and development of health services are discussed and it is suggested that this provides a framework for setting priorities both within and between services.

Health Expenditures↗

PubMed1978

Planning a geriatric service for North Canterbury.

Explore the source record for details and available documents.

Geriatrics↗

PubMed1978

Establishing a health planning and research unit: the first two years of operation.

The Christchurch Health Planning and Research Unit was established in April 1975 to develop an approach to regional health services planning based upon researched community need, making the best use of available resources and involving agencies, health professionals and the community. This paper reports on the background to its establishment, the development of a planning strategy and progress and problems to date, especially in the fields of geriatrics, mental health and primary care.

Geriatrics↗

PubMed1974